Differential diagnosis of staring spells in children: a video-EEG study

Pediatr Neurol. 1996 Apr;14(3):199-202. doi: 10.1016/0887-8994(96)00080-x.

Abstract

Staring is frequently a nonepileptic manifestation in children. To differentiate epileptic versus nonepileptic staring, we reviewed clinical and video-EEG findings in 143 patients, aged 5 months to 43 years, monitored for staring episodes. In 79 patients staring was of epileptic origin; 46 had partial seizures and 33 atypical absence. Thirty-five had behavioral staring, 8 psychogenic seizures, 1 a migraine equivalent, and in 20 no staring spells were recorded. In all patients with epileptic staring, epilepsy was suspected clinically. Only 22 of the admissions for behavioral staring and 3 for pseudoseizures were to exclude a possible nonepileptic phenomenon. Review of their clinical histories revealed that certain findings strongly support a nonepileptic origin. In conclusion, a careful clinical history will differentiate between epileptic and nonepileptic staring episodes in most patients. Video-monitoring is helpful to adjust treatment or to exclude nonepileptic events in patients with refractory staring spells.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child Behavior
  • Child, Preschool
  • Diagnosis, Differential
  • Electroencephalography*
  • Epilepsy / diagnosis*
  • Fixation, Ocular*
  • Humans
  • Infant
  • Migraine Disorders / diagnosis
  • Monitoring, Physiologic / methods
  • Seizures / diagnosis
  • Television