- Email: [email protected]
EEG abnormalities in preschool children with speech and language disorder without seizures
Clinical Neurophysiology 118 (2007) e133–e135 www.elsevier.com/locate/clinph
Society proceedings
The British Society for Clinical Neurophysiology, Oxford, 21st June 2002 Hon. Meetings Secretary : Dr D.A. Ingram The Royal London Hospital, Whitechapel, London, E1 1BB, UK
EEG abnormalities in preschool children with speech and language disorder without seizures—R.N. Chinthapalli 1, Y. Neighbour 1, Z. Zaiwalla 2 (1 Princess Margaret Hospital, Swindon, UK, 2 Park Hospital for Children, Oxford, UK) There is increasing recognition by paediatricians that children with speech and language delay (SLD) can have epileptiform EEG abnormalities but their therapeutic implication is controversial. This study aimed to identify the frequency of epileptiform abnormality in SLD children and consider their significance. Wake and sleep EEG’s of 49 SLD children based on the Ruth Griffith’s developmental scale (mean age 3.7 years) was compared with EEG’s of 30 normally developing children with febrile convulsions (FC; mean age 3.1 years) seen over the same 2 year period. SLD children with seizures or know aetiology were excluded. Focal and or generalised epileptiform abnormality was seen in 7 (14%) of SLD and 4 (12.4%) FC children (difference not significant). The developmental profile of SLD group with and without EEG abnormality was similar. The term Landau Kleffner variant has been used in SLD children with epileptiform abnormalities with or without autistic regression, implying causal relationship with the discharge. However the intensity of discharge and response to treatment is not comparable with the classical syndrome. Similar frequency of epileptiform abnormality in the FC group questions this causal relationship.
lus was developed to assess these defects in a paediatric population and has a sensitivity of 75% and a specificity of 85%. Method: The stimulus consists of a central black and white checker-board of 5° radius and a peripheral radial checker-board stimulus from 30–60degr. The two stimuli alternate at different rates. Five children aged 3–8 years, with in-utero exposure to vigabatrin were investigated. In addition, nine adults (mean age 29 ± 7.4 years) with learning difficulties were investigated using a modified stimulus to allow presentation at 30 cm distance. Results: The five children all complied with the H-Stimulus. Using the summed amplitude of the peripheral N135 response at 01 and 02, all five children with in-utero exposure had normal responses. Of the nine adults, only five could comply with the stimulus. The adults with severe learning difficulties were unable to accept the procedure. Of the five successful investigations, three were recorded monocularly and showed clear peripheral responses and two were recorded binocularly and were also normal. doi:10.1016/j.clinph.2006.07.171
MUP spike counts as a mean of quantifying the EMG pattern—N.S. Mytheen, J.A. Jarratt (Royal Hallamshire Hospital, Sheffield, UK)
doi:10.1016/j.clinph.2006.07.170
VEP identification of field defects in children of vigabatrin treated mothers and adults with learning difficulties—G. Harding, E. Spencer (Neurosciences Institute, Aston University, Birmingham, UK) Introduction: Vigabatrin is associated with field defects in approximately 25% of treated adults and children. The H-Stimu-
doi:10.1016/j.clinph.2006.07.169
Visual assessment of the fullness of the EMG pattern is an important but subjective element of clinical practice. We have developed an alternative, objective method. During attempted maximal voluntary contraction, counts were made of motor unit potential (MUP) spikes passing through 13 offsets on either side of zero at 25 lV intervals on 10 consecutive 100 ms epochs. Counts of positive and negative spikes were summed. Those at 50 lV showed the least variance. The highest of the 10 values at 50 lV was then used to quantify each pattern. Two recordings were made from each of two sites in first dorsal
Society proceedings
The British Society for Clinical Neurophysiology, Oxford, 21st June 2002 Hon. Meetings Secretary : Dr D.A. Ingram The Royal London Hospital, Whitechapel, London, E1 1BB, UK
EEG abnormalities in preschool children with speech and language disorder without seizures—R.N. Chinthapalli 1, Y. Neighbour 1, Z. Zaiwalla 2 (1 Princess Margaret Hospital, Swindon, UK, 2 Park Hospital for Children, Oxford, UK) There is increasing recognition by paediatricians that children with speech and language delay (SLD) can have epileptiform EEG abnormalities but their therapeutic implication is controversial. This study aimed to identify the frequency of epileptiform abnormality in SLD children and consider their significance. Wake and sleep EEG’s of 49 SLD children based on the Ruth Griffith’s developmental scale (mean age 3.7 years) was compared with EEG’s of 30 normally developing children with febrile convulsions (FC; mean age 3.1 years) seen over the same 2 year period. SLD children with seizures or know aetiology were excluded. Focal and or generalised epileptiform abnormality was seen in 7 (14%) of SLD and 4 (12.4%) FC children (difference not significant). The developmental profile of SLD group with and without EEG abnormality was similar. The term Landau Kleffner variant has been used in SLD children with epileptiform abnormalities with or without autistic regression, implying causal relationship with the discharge. However the intensity of discharge and response to treatment is not comparable with the classical syndrome. Similar frequency of epileptiform abnormality in the FC group questions this causal relationship.
lus was developed to assess these defects in a paediatric population and has a sensitivity of 75% and a specificity of 85%. Method: The stimulus consists of a central black and white checker-board of 5° radius and a peripheral radial checker-board stimulus from 30–60degr. The two stimuli alternate at different rates. Five children aged 3–8 years, with in-utero exposure to vigabatrin were investigated. In addition, nine adults (mean age 29 ± 7.4 years) with learning difficulties were investigated using a modified stimulus to allow presentation at 30 cm distance. Results: The five children all complied with the H-Stimulus. Using the summed amplitude of the peripheral N135 response at 01 and 02, all five children with in-utero exposure had normal responses. Of the nine adults, only five could comply with the stimulus. The adults with severe learning difficulties were unable to accept the procedure. Of the five successful investigations, three were recorded monocularly and showed clear peripheral responses and two were recorded binocularly and were also normal. doi:10.1016/j.clinph.2006.07.171
MUP spike counts as a mean of quantifying the EMG pattern—N.S. Mytheen, J.A. Jarratt (Royal Hallamshire Hospital, Sheffield, UK)
doi:10.1016/j.clinph.2006.07.170
VEP identification of field defects in children of vigabatrin treated mothers and adults with learning difficulties—G. Harding, E. Spencer (Neurosciences Institute, Aston University, Birmingham, UK) Introduction: Vigabatrin is associated with field defects in approximately 25% of treated adults and children. The H-Stimu-
doi:10.1016/j.clinph.2006.07.169
Visual assessment of the fullness of the EMG pattern is an important but subjective element of clinical practice. We have developed an alternative, objective method. During attempted maximal voluntary contraction, counts were made of motor unit potential (MUP) spikes passing through 13 offsets on either side of zero at 25 lV intervals on 10 consecutive 100 ms epochs. Counts of positive and negative spikes were summed. Those at 50 lV showed the least variance. The highest of the 10 values at 50 lV was then used to quantify each pattern. Two recordings were made from each of two sites in first dorsal