All patients that had absence seizures during supine HV also had seizures during sitting HV. Seventeen of the 20 patients experienced absence seizures while sitting and 13 experienced seizures during supine HV (p = 0.031). Twenty children (four males) diagnosed with CAE were included in the analysis. During a routine EEG, children were asked to perform HV twice, in the supine and sitting positions.
We conducted a randomized multi-center controlled trial among children (4-10 years old) with suspected CAE. Therefore, we hypothesized that the position in which HV is performed may influence its yield in provoking absence seizures. In most instances, HV during routine EEG is performed in the supine position, while in the office HV is done with the child sitting-up. Interestingly, some children experience absence seizures while performing HV in the office yet do not experience absences during HV on subsequent routine EEG. When performed correctly, hyperventilation (HV) for three minutes provokes absence seizures in virtually all children, a finding suggestive of a diagnosis of childhood absence epilepsy (CAE).
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