Differential diagnostic value of electroencephalogram combined with NSE in pediatric febrile seizures and its predictive value for brain function prognosis

Abstract

Objective: To investigate the diagnostic value of electroencephalogram (EEG) combined with neuron-specific enolase (NSE) detection in differentiating febrile seizures and to evaluate their predictive value for brain function prognosis in pediatric patients.

Methods: A retrospective analysis was performed on the medical records of 95 pediatric patients with febrile seizures treated at the Second People's Hospital of Jingdezhen City from January 2021 to December 2023. Of these, 40 cases of simple febrile seizure (SFS) patients were categorized into Group A, and 55 cases of complex febrile seizure (CFS) patients were included in Group B. Brainwave data was collected within 72 hours of the seizure, and NSE levels were measured at 12 and 48 hours post-seizure, as well as immediately after treatment. Venous blood (1-2 mL) was drawn and tested within 2 hours. The number and incidence of abnormal EEG findings, along with NSE levels, were recorded. The diagnostic value of EEG, NSE, and their combined application in febrile seizures, as well as their predictive value for brain function prognosis, were analyzed.

Results: The incidence of abnormal EEG in Group B was notably higher than that in Group A (P=0.038). Additionally, the NSE level in Group B was consistently higher at all time points compared to Group A (all P<0.05). The area under the curve (AUC) for EEG, NSE, and their combined detection in differential diagnosis of febrile seizures was 0.600, 0.807, and 0.814, respectively. The specificity for these measures was 80.00%, 85.00%, and 75.00%, while the sensitivity was 40.00%, 72.73%, and 78.18%, respectively. The AUCs of EEG, NSE and their combined detection for predicting the prognosis of febrile seizures in children was 0.745, 0.878 and 0.951, with the specificity of 66.67%, 58.72% and 81.48%, and the sensitivity of 82.35%, 73.53% and 100.00%, respectively. Logistic multivariate analysis revealed that EEG findings, febrile seizure type, perinatal abnormalities, and NSE levels were independent risk factors affecting post-seizure sequelae in pediatric patients with febrile seizures.

Conclusion: The combination of EEG and NSE is valuable for the differential diagnosis of febrile seizures and offers strong predictive power for brain function prognosis. Their combined detection enhances diagnostic accuracy and offers substantial practical benefits.

Keywords: Electroencephalogram; febrile seizure; neuron-specific enolase.

Figure 1

Comparison of NSE levels between the two groups at 12, 48 hours post-seizure and post-treatment. A: Comparison of NSE levels between the two groups at 12 h after febrile seizure. B: Comparison of NSE levels between the two groups at 48 h after febrile seizure. C: Comparison of NSE levels between the two groups after treatment. Note: NSE, neuron-specific enolase; SFS, Simple febrile seizure; CFS, Complex febrile seizure.

Figure 2

Comparison of the trends in NSE levels between the two groups. Note: NSE, neuron-specific enolase.

Figure 3

ROC analysis of EEG, NSE and their combined detection for the differential diagnosis of febrile seizures. Note: ROC, Receiver operator characteristic; EEG, electroencephalogram; NSE, neuron-specific enolase; SFS, Simple febrile seizure; CFS, Complex febrile seizure.

Figure 4

ROC analysis of EEG, NSE and their combined detection in predicting the prognosis in children with febrile seizure. Note: ROC, Receiver operator characteristic; EEG, electroencephalogram; NSE, neuron-specific enolase.