Evaluation of EEG findings in pediatric patients presenting with dizziness.

OBJECTIVE

This study aimed to determine the frequency of epileptic etiology in pediatric patients presenting with dizziness, to correlate EEG findings with clinical data, and to evaluate the response to antiseizure treatment.

METHODS

The medical records of 736 pediatric patients who presented with dizziness to the Pediatric Neurology Outpatient Clinic of Medipol Mega University Hospital between September 2013 and January 2025 were retrospectively reviewed. Patients' sex, age, physical examination findings, EEG results, seizure history, and use of antiseizure medication were evaluated.

RESULTS

Of the patients, 61.7% (n = 454) were female and 38.3% (n = 282) were male. The median age was 11 ± 4.3 years (range: 2-18). Pathological findings were detected in 17 patients (2.3%) during physical examination. EEG was performed in 413 patients (56.1%). Among them, 87.7% had normal EEG findings, 11.6% showed epileptiform activity, and 0.7% had age-inappropriate background rhythm. Among the 48 patients with epileptiform discharges, 70.8% had focal and 29.2% had generalized activity. In terms of regional distribution, focal epileptiform activity most commonly involved the centrotemporal (n = 5), temporal (n = 5), occipital (n = 5), frontotemporal (n = 4), frontocentral (n = 4), and frontal (n = 4) regions. Less frequently observed foci included central (n = 3), centrotemporo-parietal (n = 2), centroparietal (n = 1), parietal (n = 1), and temporo-occipital (n = 1) areas. A clinical history of seizures was present in 20.8% of the patients with epileptiform activity. During follow-up, complete resolution of dizziness was observed in 87.4% of these patients.

CONCLUSION

While the prevalence of epilepsy in the general population is approximately 1%, the rate of epileptiform activity among children presenting with dizziness was found to be 11.6% in this study. This suggests that dizziness may be a manifestation of underlying epileptic activity in certain cases. Therefore, EEG may provide significant diagnostic and therapeutic value in the evaluation of pediatric patients with dizziness.