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DOI: 10.1055/s-0044-1791398
EKG Artifacts in Pediatric EEGS Are Localized to Occipital Regions: A Novel Observation and Implications in Occipital Epilepsies
Authors
In adults, EKG artifacts are seen in temporal electrodes due to the oblique orientation of cardiac QRS vector downwards and to the left (range: −30 to +90 degrees). In pediatric age group, the QRS axis vector is more vertical (100–119 degrees). We hypothesized that the localization of EKG artifacts in EEG of children would differ from that of the adults due to this difference in QRS axis direction. We reviewed 105 consecutive pediatric EEGs (age 7 months to 18 years). EKG artifacts were recognized by synchronicity with the QRS complexes of the EKG lead. We observed that EKG artifacts are seen in occipital electrodes in 11 recordings (age 2 and half years to 9 years). In 2 children, they were seen in O2, in 2 they were seen in O1 and in 7 they were seen in both O1 and O2. In children above 9 years, the EKG artifact localization assumed adult pattern. This is a novel observation, hitherto unreported in literature. Awareness of this fact is important to avoid misdiagnosis of occipital spikes. Notably, occipital epilepsies (Gastaut type, Panayiotopoulos type, and hypoxic ischemic encephalopathy) are common in this age group.
Publication History
Article published online:
12 September 2024
© 2023. Indian Epilepsy Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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