Patient's question:
Is mild abnormality in children's EEG definitely epilepsy? How is it diagnosed?Doctor's answer:
An electroencephalogram (EEG) is an important tool for diagnosing epilepsy. When a child is suspected of having epilepsy, an EEG is usually required. When parents see mild or moderate abnormalities mentioned in the EEG report, they often assume that the diagnosis of epilepsy is confirmed. However, this is not necessarily the case.There are many reasons that can cause EEG abnormalities. Any disease that affects brain function can alter the EEG. Fever, coma, poisoning, certain medications, or hunger are just a few examples that may lead to EEG abnormalities.
Is a mild EEG abnormality in children always indicative of epilepsy? EEG abnormalities can manifest in various ways, such as reduced normal rhythms, increased slow waves, asymmetry between the left and right sides, chaotic patterns, or low voltage. These are all considered abnormalities, but they are not specific to epilepsy. However, the presence of "epileptic discharges" carries greater diagnostic significance. Epileptic discharges include spikes, sharp waves, spike-and-slow-wave complexes, sharp-and-slow-wave complexes, multiple spike-and-slow-wave complexes, high-amplitude arrhythmias, and rhythmic discharges that stand out against the background.
However, even if a person has epileptic discharges, it does not necessarily mean they will experience epilepsy seizures. Experts from Beijing Guangji Epilepsy Hospital explain that a survey has been conducted, showing that 0.3% to 3% of people in the general population have epileptic discharges on their EEGs but have never had epilepsy seizures. Some epilepsy patients with a genetic predisposition may have abnormal EEGs in their family members, sometimes showing epileptic discharges, but they themselves have never had epilepsy seizures. In such cases, epilepsy cannot be diagnosed either.