Video EEG in pediatric epilepsy: Diagnostic significance and association between frequency band power and cognitive impairment severity

Objective This study aimed to compare video electroencephalogram (VEEG) and routine electroencephalogram (EEG) in childhood epilepsy diagnosis and analyze the correlation between EEG frequency band power and cognitive impairment severity.Methods One hundred and sixty children suspected of having epilepsy underwent routine EEG and VEEG examinations. Diagnostic efficacy and detection rates were compared. Cognitive function was evaluated in 80 children diagnosed with epilepsy, who were allocated into normal intelligence (35 cases), borderline intelligence (25 cases), and intelligence-impaired (20 cases) groups. Clinical data, EEG parameters, and their correlation with cognitive impairment were analyzed.Results VEEG showed higher sensitivity, accuracy, and negative predictive value, and detection rates of epileptiform discharges, synchronous clinical seizures, and clinical symptoms than routine EEG (p < 0.05). Clinical characteristics and EEG parameters differed among the three groups (p < 0.05). The relative power of δ and θ bands and the awake and sleep discharge indices were positively correlated with cognitive impairment severity (r = 0.300, 0.643, 0.622, and 0.456), whereas α and β band power were negatively correlated (r = −0.515 and −0.410) (all p < 0.001).Conclusion VEEG demonstrated higher diagnostic performance than routine EEG, and EEG frequency band power was correlated with cognitive impairment severity.