Identifying Pediatric Seizures With Hemispheric Regional Cerebral Oxygen Saturation

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Researchers observed significant overall differences with rcSO2 readings in patients with generalized or focal seizure compared with controls.
Researchers observed significant overall differences with rcSO2 readings in patients with generalized or focal seizure compared with controls.

Hemispheric regional cerebral oxygen saturation (rcSO2) readings are useful for seizure recognition, cerebral assessment, and intervention response in pediatric patients and patients with developmental challenges, according to findings from an observational, retrospective case series published in Pediatric Emergency Care.

In this study, investigators evaluated the use of rcSO2 readings in children with first-time generalized and focal seizures and children being treated for the first-time post seizure who had no pediatric emergency department (PED) seizures.

Compared with rcSO2 readings of patients without seizure and controls (n=115), there were significant overall differences in rcSO2 readings in patients with generalized or focal seizure (n=185) (P <.0001). The rcSO2 readings of patients with generalized and focal seizures were <60% or >80% vs nonseizure rcSO2 readings (P <.0001). Interhemispheric rcSO2 discordance was found to be >16 (P <.0001), and ipsilateral focal seizure rcSO2 readings correlated with seizure side (P <.0001). The investigators observed that seizure to preseizure rcSO2 discordance was 15.2 for generalized seizures and left 19.8 and right 20.3 for focal seizures (P <.0001).

The investigators suggest the identification and documentation of pediatric seizures could have been vulnerable to sampling error, which may have limited the findings. Additionally, the researchers comment that they were unable to correlate clinical seizures with seizure shown on electroencephalogram with hemispheric rcSO2 readings because hemispheric cerebral oximetry probes prohibit placement of ambulatory diagnostic electroencephalogram forehead probes.

In addition to the main findings of this study, the investigators suggest that the results advance “cerebral oximetry functionality as an adjunct neurological assessment tool in pediatric neuroresuscitation.”

Reference

Abramo TJ, McKinney S, Moore J, et al. Hemispheric cerebral oximetry monitoring during pediatric seizure activity in a pediatric emergency department [published online November 15, 2017]. Pediatr Emerg Care. doi:10.1097/PEC.0000000000001354

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