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Epilepsies

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EEG versus clinical information : an apparent rivalry Volume 20, issue 1, janvier-février-mars 2008

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After a first clinical manifestation, can the EEG rivalize with the clinical evaluation in bringing the informations needed for precise diagnosis and early prognosis ? Starting with the 1989 international classification, and the diagnostic scheme proposed by Engel in 2001, we tried to assess the respective relevance of clinical and EEG data. Our experience is mostly about the early assessment of infants, children and adolescents, and less about epileptic disorders in adults. In « generalized » epilepsies and syndromes, EEG and clinical assessment appear to have equal value. However, in focal epilepsies, early EEG findings may have a higher value in diagnosis and especially in prognosis. There are also specific etiologies, e. g. in focal cortical dysplasias, where the EEG may suggest the diagnosis even before MRI. In some chromosomal disorders (ring chromosome 20 being the example of choice, but other entities are also concerned), specific EEG aspects may lead to diagnosis on their own.