Diagnostic yield of electroencephalograms in infants and young children with frequent paroxysmal eye movements

Paroxysmal eye movement events are common in children. Many infants and young children are referred for a routine or a video-electroencephalography study. When epileptic, these events form part of a seizure and rarely occur as an isolated ictal event. The yield of the electroencephalogram in determining the nature of isolated paroxysmal eye movement episodes has not been reported. We reviewed our experience with video-electroencephalography studies in patients referred for paroxysmal eye movements. Twenty-one cases were analyzed, of which almost half were cognitively normal. All video-electroencephalography studies captured events that were found to be nonepileptic, including 6 records with interictal epileptiform activity. The semiology of the events differed between cognitively impaired individuals, who had more lateral eye deviation episodes, and normal patients, who showed blinking as a major manifestation. In conclusion, video-electroencephalography studies are probably not indicated in infants and young children with paroxysmal eye movements as their sole complaint.