Editor's Note: If a child has a regression, ask your doctor if a sleep EEG is approrpiate. JR
When a child loses milestones, consider sleep EEG studies
Excess brain electrical activity at night can disrupt development -- but if found, may be treatable.
This is the second post in a series about new approaches for seizures and epilepsy.
When a 2- or 3-year-old child begins losing milestones like language, walking skills and fine motor abilities, or is slow to achieve them, it’s devastating for families. The good news, at least for some children, is that it might be treatable.
Tobias Loddenkemper, MD, a neurologist in theEpilepsy Center at Boston Children’s Hospital, suspected that some children with developmental delay have seizure-like activity in the brain at night. These spikes of electrical activity, referred to medically as sleep-potentiated epileptiform activity, can be readily and inexpensively detected by electroencephalography, or EEG, and readily treated with nighttime anti-seizure drugs.
But likely, no one’s thought of it. “Very few physicians have been looking to see what’s happening at night,” Loddenkemper says.
He and research fellow Iván Sánchez Fernández, MD, with other colleagues, decided to look themselves. They reviewed overnight EEG recordings from 147 patients who were seen at Boston Children’s over a 14-year period. They foundthat 100 of the 147 children indeed had prominent spikes in their EEGs during the night – and about one in five of them did not have known epilepsy.
Each wavy horizontal line on this child’s EEG shows electrical activity in different regions of the brain. Spiky triangular waves, like those highlighted in red, appear continuously during sleep, reflecting constant epileptic-like activity. Few such spikes were present in this child's daytime EEG.
“Kids can have an almost normal EEG while awake, but show increased spikes during sleep,” says Loddenkemper.
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