What does the EEG of the brain show in children? Norms and causes of deviations

Knowing what an electroencephalogram (EEG) shows about a child’s brain can provide important information about their general development and health. The electrical activity in the brain is measured by an EEG, which enables medical professionals to determine whether or not there may be problems with how the brain develops. In children, this non-invasive test is especially helpful for assessing neurological disorders and developmental delays.

An EEG usually reveals brain wave patterns in children in good health that are within predetermined expected ranges. Children’s growth and development are reflected in these patterns, which alter as their motor and cognitive abilities advance. Doctors are able to ascertain whether a child’s brain activity is within the normal range for their age by comparing these patterns to established norms.

Deviations can occasionally point to underlying problems. Results from an abnormal EEG could point to neurological issues, sleep disorders, or epilepsy, among other conditions. Recognizing these deviations aids in early detection of possible issues and the selection of suitable interventions or treatments.

In general, an EEG is an essential tool for keeping track of and guaranteeing a child’s normal brain development. It provides a window into the electrical activity of the brain, making it easier to distinguish between typical variations and possible problem areas that may require more research.

What is EEG and what does it show?

The term "electroencephalography" is represented by the acronym EEG. It is a technique for capturing the cerebral cortex’s tiniest electrical active impulses. Because of this diagnostic’s extreme sensitivity, you can record activity indicators in milliseconds rather than just seconds. In a specific amount of time, no other study on brain functions offers such precise information.

In order to determine morphological alterations, the existence of cysts and tumors, and characteristics of the brain’s body and tissue development, additional video monitoring techniques are employed. These include neurosonography for children under the age of two and MRI and CT scanning for older children. However, the only way to truly understand how the brain functions and responds to both internal and external stimuli as well as environmental changes is to obtain a head electroencephalogram.

Electrical processes in neurons in general and in the brain in particular began to be studied at the end of the 19th century. Scientists in various countries of the world were engaged in this, but the greatest contribution was made by the Russian physiologist I. Sechenov. The first EEG recording was obtained in Germany in 1928. Today, EEG is a fairly routine procedure, used even in small clinics and clinics for diagnosis and treatment. It is carried out on special equipment called an electroencephalograph. The device is connected to the patient via electrodes. The results can be recorded either on paper tape or on a computer automatically. The procedure is painless and harmless. At the same time, it is very informative: the potentials of the electrical activity of the brain invariably change in the presence of a particular pathology.

Various injuries and mental illnesses can be diagnosed with the aid of EEG, and the technique is now widely used to monitor sleep at night.

Indications for carrying out

• in case of frequent attacks of headaches, dizziness;
• in the presence of cases of loss of consciousness;
• if the child has a history of seizures;
• if a head and brain injury is suspected;
• if cerebral palsy is suspected or to track the dynamics of the condition in previously diagnosed cerebral palsy;
• in case of reflex disorders, other neurological conditions that persist for a long time and are difficult to treat;
• in case of sleep disorders in a child;
• if a mental disorder is suspected;
• as a preparatory diagnostic before brain surgery;
• in case of delayed speech, mental, emotional and physical development.

EEG is used to measure the degree of brain immaturity in children. EEG is used during major and prolonged surgical procedures to assess the level of anesthesia.

A prescription for an EEG may also be based on certain behavioral characteristics of infants in their first year of life.

If neurosonography or magnetic resonance imaging do not reveal any abnormalities in the brain’s overall development, frequent and prolonged crying, as well as sleep disorders, are excellent grounds for diagnosing the potentials of electrical impulses in neurons.

Contraindications

Such diagnostics have very few contraindications. It is not done just if the young patient has recently sustained cuts to his or her head and needs surgical sutures. A severe runny nose or crippling cough that occurs frequently can sometimes result in a refusal of diagnostics.

EEG can be done in any other situation if the attending physician requests it.

When diagnosing small children, they attempt to do so while they are asleep, when they are at their most peaceful.

Is the examination harmful?

For parents, this is one of the most important questions. In the vastness of women’s forums, there is a lot of rumor and speculation surrounding EEG as a phenomenon, since not all mothers understand the fundamentals of the method. Regarding the study’s potential for harm, there are only two possible responses: EEG is perfectly safe because the electrodes and apparatus only record brain impulses rather than stimulating the brain in any way.

A child can have an EEG as often as needed, at any age, and in any condition. There are no limitations and repeated diagnostics are not forbidden.

Another question is whether small, hyperactive children can be prescribed sedatives to ensure that they can sit still for a while. In this case, the decision is made by a physician who is skilled in determining the precise dosage required to protect your child.

Preparing the child

It’s critical that you get your child ready for any electroencephalograms that may be scheduled.

With the sensors placed on the scalp, it is best to approach the examination with an empty mind. It suffices to do this by following standard hygiene protocols and giving the child’s hair a baby shampoo wash the day before.

Before attaching the electrodes for a period of 15 to 20 minutes, the infant needs to be fed right away. The ideal sleep pattern is one of natural sleep; a fed baby will sleep longer and more peacefully, and the doctor can record all the relevant signs. As a result, bring a bottle of formula or expressed breast milk for the baby when you visit the hospital.

It is ideal to arrange for your doctor’s examination to take place during a time when your baby typically naps during the day, based on their individual daily schedule.

EEG is done while the child is awake on older children. The child needs to follow all of the doctor’s instructions and behave calmly in order to get accurate results. Parents must first conduct preliminary psychological preparation in order to attain such calm. The youngster will be more attentive if you let them know ahead of time what fascinating game is coming. For a short while, you can assure your child that he will transform into a superhero or real space traveler.

It is obvious that the child, especially if he is between two and three years old, will find it difficult to focus on what is going on for too long. As a result, when you go to the clinic with the child, you should bring along a book or a toy that will at least momentarily hold his interest.

You must prepare the child for what is going to happen so that he is not afraid from the very beginning. With your child, play "astronaut" using any old hat you have at home. Put on the helmet cap, shut your eyes, breathe deeply and shallowly, and pretend that you can hear the radio in the helmet hissing. Then, give your space hero the same orders that the doctor will really give you during the EEG. Below, we will go over the stages of the examination in more detail.

You do not have to stop giving your child any medications before the electroencephalogram if they take them on a regular basis as directed by the attending physician. However, make sure you inform the physician about all medications the child has taken in the past two days, along with the dosage, before the diagnosis is made.

Remove the child’s headgear before you enter the office. For girls, make sure to take off headbands, elastic bands, hairpins, and any earrings that may be in the ears. In order to prevent losing anything important during the examination, it is best to leave all of these items for beauty and attractiveness at home when visiting the EEG.

How the procedure is performed: main stages

In order to properly prepare, parents and the young patient must be aware of the various stages involved in the EEG procedure beforehand. To begin with, let’s acknowledge that an electroencephalography room is not like a typical doctor’s office. This is a dark, sound-proof room. The actual room is typically not very large.

The child will be offered to sit on the couch. A changing table, which is also in the room, is used to place the infant.

An electrode-attached cloth or rubber cap is offered as a special "helmet" to be worn on the head. The physician manually inserts the required number of electrodes on some caps. Thin, flexible conductor tubes are used to connect the electrodes to the electroencephalograph.

An especial gel or saline is used to moisten the electrodes. This is required to ensure that the electrode adheres better to the baby’s head and that there is no space created between the skin and the signal-receiving sensor. Grounding the equipment is necessary. The child’s ears are fitted with non-conductive clips near the lobes.

The study takes fifteen to twenty minutes on average. The child needs to be as still as possible during this period.

Picking up infants is advised; in this scenario, the mother sits on the couch. An older child is positioned in a semi-sitting position on the couch.

The age of the small patient determines which tests need to be run. The tasks will get harder as the child gets older. There are various ways to record electrical potentials in a typical procedure.

• First, a background curve is recorded – this line on the resulting graph will display the impulses of neurons in the brain at rest.

• Then the brain"s reaction to the transition from rest to activity and work readiness is checked. For this, the child is asked to open and close his eyes at different tempos, which the doctor sets with his commands.

• The third stage is checking the brain function in a state of so-called hyperventilation. For this, the child is asked to take deep breaths and exhales at a frequency specified by the doctor. On the command "inhale", the child inhales, on the command "exhale", the child exhales. This stage allows us to identify signs of epilepsy, neoplasms that have led to disruptions in the functional capabilities of the brain.

• The fourth stage involves the use of photostimulation. Potentials continue to be recorded, but the doctor turns on and off a special light bulb at a certain frequency in front of the patient"s closed eyes. Such a test allows us to establish some features of both mental and speech development, as well as a tendency to epilepsy and convulsive syndromes.
• Additional stages are used mainly for older children. They include various doctor"s commands – from clenching and unclenching fingers into fists to answering questions of psychological tests, if the child is at an age at which answers and understanding are possible in principle.

Parents need not worry; they will not need him any more than a child can. We’ll just give him another task if he can’t handle it.

Norms and decoding results

The electroencephalogram, which is produced when potentials are automatically registered, is an enigmatic collection of curves, waves, sinusoids, and broken lines that is very difficult to interpret for non-specialists. Even medical professionals in other specialties, like surgeons or ENTs, will never comprehend the information displayed in the graphs. It can take several hours or several days to process the results. Generally, a day or so.

Regarding EEG, the term "norm" itself is not totally accurate. The reality is that norms come in a plethora of options. Every detail matters in this case: the dynamics, the frequency of recurrence of an anomaly, and its relationship to irritants. The resulting graphs will differ in two healthy children who do not have brain pathologies or issues with the functioning of the central nervous system.

Wave type is used to categorize the indicators, and bioelectrical activity and other factors are evaluated independently. There is nothing for parents to interpret because the conclusion explains the study’s findings and offers some advice. Let’s take a closer look at a few potential conclusions.

What does epileptiform activity indicate?

The electroencephalogram is dominated by sharp peaks that deviate significantly from the background rhythm, which is recorded in the resting position, if the conclusion contains such a difficult-to-understand term. This kind of outcome is typically observed in a child who has epilepsy. However, epilepsy is not always indicated by the presence of sharp peaks and EFA in the conclusion. Parents may be quite surprised when we discuss epiactivity in the absence of seizures because the child may never have experienced convulsions or seizures.

Physicians generally think that patterns show up on the EEG even if the child just has a genetic susceptibility to epilepsy. It is not always the case that a child diagnosed with epileptiform activity will also have the corresponding activity. However, this fact inherently suggests that a second examination is required. It’s possible that the diagnosis is confirmed or not.

It is important to note that children with epilepsy need specialized care from a neurologist, so you shouldn’t disregard the inclusion of EFA in the conclusion.

An electroencephalogram, or EEG, records electrical activity in the brain and offers important information about a child’s neurological health. This test assists in determining both typical brain wave patterns and any deviations that may point to neurological or developmental problems. Knowing what a normal child EEG looks like and how to spot abnormal results can help with the diagnosis of conditions like developmental delays, sleep disorders, or epilepsy, allowing for prompt and effective medical intervention.

Types and norms of rhythms

In particular, rhythms are crucial for interpreting the outcomes. Only four of them exist:

There are norms and potential fluctuations in normative values specific to each of these rhythms. We will attempt to make the complex information as clear as possible for parents so they can more easily navigate the encephalogram of the brain they receive.

Alpha rhythm is a basic, background rhythm that is recorded in a state of rest and relaxation. The presence of this type of rhythm is characteristic of all healthy people. If it is not there, they talk about asymmetry of the hemispheres, which is easily diagnosed using ultrasound or MRI. This rhythm dominates when the child is in the dark, in silence. If at this moment you turn on a stimulus, apply light, sound, the alpha rhythm may decrease or disappear. In a state of rest, it returns again. These are normal values. In epilepsy, for example, spontaneous episodes of alpha rhythm surges can be recorded on the EEG.

If the final result shows an alpha frequency between 8 and 14 Hz (25 and 95 μV), you can be sure the child is fine. If there is a noticeable frequency spread, deviations in the alpha rhythm can be seen if they are recorded in the frontal lobe. When a frequency is too high—beyond 14 Hz—it may indicate prior head trauma, brain vascular diseases, or both. Understated values could be a sign of a mental development delay. The rhythm might not be recorded at all if the child suffers from dementia.

When the brain is active, the beta rhythm is recorded and varies. The conclusion of a healthy baby will show amplitude values between 2 and 5 μV; the frontal lobe of the brain records these waves. A concussion or brain contusion may be suspected by the doctor if the values are higher than normal; a pathological decrease may indicate an inflammatory process affecting the meninges or tissues, such as encephalitis or meningitis. In children, beta waves with an amplitude between 40 and 50 μV may suggest a discernible developmental delay.

In patients who are unconscious or in deep sleep, patients exhibit a delta-type rhythm. If such a rhythm is found when the patient is awake, it could be a sign that a tumor is developing.

A theta rhythm is another trait shared by those who sleep. Serious disorders of the central nervous system are involved if it is detected in different parts of the brain at an amplitude greater than 45 μV. Children under the age of eight may exhibit this rhythm occasionally, but in older children, it frequently indicates underdevelopment and feeblemindedness. A disruption in the cerebral circulation may be indicated by a synchronous increase in delta and theta.

The basis for recording the brain’s bioelectrical activity is any kind of wave. There is no need to be concerned if the BEA is shown to be rhythmic. Frequent headaches are indicated by relatively rhythmic BEA.

If there are no other abnormalities, diffuse activity does not necessarily point to pathology. A child may, however, have a lower BEA when they are depressed.

Common disorders and possible diagnoses

An EEG by itself will never be used to diagnose a child. It might be necessary to confirm or disprove these studies using MRI, CT, or ultrasound technology. Electroencephalography results can only indicate the possibility of a porencephalic cyst, tumors, paroxysmal activity, epileptic activity without seizures, and mental abnormalities in a child.

Let’s examine the possible meaning that doctors may have when they identify specific pathologies in the EEG results.

• If it is indicated that a dysfunction of the middle parts of the brain has been detected, it is worth assuming that the child was simply stressed, that he did not get enough sleep, is often nervous, and therefore it will be enough for him to study with a psychologist, create a favorable environment in the family, reduce psychological stress and light sedatives of plant origin. This is not considered a disease.
• If the electroencephalogram says that interhemispheric asymmetry has been detected, this is not always a sign of pathology in childhood. The child will be recommended dynamic observation by a neurologist.
• Diffuse changes in the alpha rhythm in the conclusion may also be a normal variant. The child is prescribed additional studies.
• More dangerous is detection of a focus of pathological activity, which in most cases indicates the development of epilepsy or an increased tendency to seizures.
• Formulation "irritation of brain structures" indicates a violation of cerebral circulation, the presence of traumatic injuries after blows, falls, as well as high intracranial pressure.
• Detection of paroxysms may be a sign of epilepsy in the initial stage, but this is far from always the case. More often, the detection of paroxysms indicates a tendency, possibly hereditary, to epileptic seizures. Increased tone of synchronizing structures cannot be considered a pathology at all. But according to established practice, the child is still referred to a neurologist for observation.

Active discharges are a concerning indicator. It is necessary to check the child for tumors and neoplasms.

To what extent the baby is doing well is a question that only a physician can truly answer. Parents may find themselves in a situation where it is extremely difficult to find a reasonable and logical way out if they try to draw conclusions on their own.

When they give a conclusion?

In roughly a day, parents can receive a conclusion that includes a description of the findings. The length of time may vary depending on the doctor’s caseload and the length of the line at the specific medical facility.

Category	Description
What EEG Shows	EEG (electroencephalogram) measures electrical activity in the brain. It helps to understand how a child"s brain is functioning by tracking brain waves.
Normal EEG Patterns	Normal EEG patterns in children show regular brain wave activity that matches their age group. This includes consistent and predictable wave patterns during different states of sleep and wakefulness.
Common Deviations	Deviations from normal EEG patterns can include abnormal wave forms, irregularities, or unexpected bursts of activity. These might indicate neurological issues or developmental disorders.
Causes of Deviations	Causes of EEG deviations can include epilepsy, sleep disorders, head injuries, or other neurological conditions. It"s important to have a medical professional interpret these deviations to determine their significance.

Determining the cause of a child’s EEG findings can be essential to treating and diagnosing a number of neurological disorders. An EEG typically offers information about the electrical activity of the brain, assisting in the identification of typical patterns and any anomalies from the expected norms. Parents and other caregivers can feel more at ease knowing that most children’s EEGs show rhythmic patterns and activity that correspond with developmental milestones.

When deviations happen, they may point to diseases like developmental delays, sleep disorders, or epilepsy. Early detection of these deviations enables prompt intervention, which can be essential for providing supportive and effective treatment. For a complete picture of a child’s health, it is crucial to interpret EEG results in conjunction with developmental evaluations and other clinical data.

Parents should collaborate closely with medical professionals to comprehend the significance of EEG results and to create a plan that takes care of any problems found. Families can make sure their children receive the best care and support for their particular needs by being proactive and knowledgeable.

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