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Eyes closed? – Seizures Unlikely
Korff KM and Nordli DR. Paroxysmal Events in Infants: Persistent Eye Closure Makes Seizures Unlikely. PEDIATRICS Vol. 116 No. 4 October 2005, pp. e485-e486.
Objective. Paroxysmal events are frequent in infancy. A precise diagnosis is often difficult to assign despite adequate history and physical examination. Certain clinical signs may help to suggest the diagnosis, thereby avoiding unnecessary and costly investigations. The aim of this study was to determine the frequency of eye opening during infantile seizures and evaluate the potential usefulness of this simple observation in the differential diagnosis of acute events in infants.
Methods. We performed a retrospective video electroencephalogram review of the seizures recorded in infants at our Epilepsy Center, paying specific attention to eye opening.
Results. Ninety-one seizures in 69 infants were included. Eyes were open in 85 (93.4%) cases.
Conclusions. Infants whose eyes are closed throughout the paroxysmal event are most likely not having seizures.
Comments: This is a great clinical pearl for trying to
differentiate benign infantile myoclonus from true seizures. It’s too bad
that the predictive value was not 100%. If we want to be sure, I guess we
will still have to do a video EEG. ABK.
Date: 07 Oct 2005
Time: 19:02:23
Or a screening aEEG/CFM.
UserName: Ken Schroeter, DO, FAAP
Institution: University of Vermont
telephone:
email:
ken.schroeter@vtmednet.org
Editor's Note: Per Dr. Schroeter: aEEG stands for "amplitude integrated EEG", and CFM stands for "Cerebral Function Monitor". ABK.
Date: 07 Nov 2005
Time: 07:18:37
It is indeed a very useful clinical pointer towards neonatal seizure.One exception would perhaps be "Benign neonatal sleep myoclonus"(BNSM) which occurs typically during NREM sleep and aborts with wakefulness.This sign therefore reinforces the benign nature of BNSM which is confused at times with seizure disorder resulting in unnecessary investigations.
UserName: Dr B M John
Institution: Dept. Of Pediatrics, Air Force Hospital,Kanpur
telephone: India-0512-2380781
email: drbmj1972@yahoo.com
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