Dr. Mohammed Sumaili, Dr.Lamyaa Jad ,Dr.Adel Awad, Dr. Ahmed Hassan ,National Neuroscience Institute ,King Fahad Medical City Riyadh.

Abstract

Introduction: BRUE is defined as an event occurring in an infant younger than 1 year of age when an observer reports a sudden, brief, resolved episode of ≥1 of: cyanosis or pallor, absent, decreased, or irregular breathing; marked change in tone (hyper- or hypotonia); and altered level of responsiveness. A BRUE is diagnosed only when there is no explanation for a qualifying event after conducting an appropriate workup. Children admitted with BRUE undergo extensive investigations to identify the underlying etiology, including neurophysiological studies to rule out seizures. This is a retrospective study to identify the prevalence of seizures among infants admitted to our hospital with BRUE. Methods: Electroencephalographic(EEGs) studies were reviewed to determine the presence of epileptic discharges. The predictive value of EEG, developmental and neuroimaging findings in identifying seizures as an etiology was determined.51 children presenting with BRUE had EEG studies. Results:25% of infants presenting with BRUE were found to have seizures ,56% were diagnosed with other conditions and 17.6% continued to have an unidentified etiology.

Of those with seizures 92.3% had epileptiform discharges on EEG. 100% of BRUE had normal EEGs. Of 35 patients found to have abnormal EEGs that underwent neuroimaging 81.8% had positive findings. Development was normal in 61% of the seizure group,77.7 of the BRUE group and 70%of infants diagnosed to have other etiologies.