Predictive value of frontal alpha asymmetry in evaluating prognosis of pediatric status epilepticus based on EEG assessment

To investigate the predictive value of frontal alpha asymmetry (FAA) assessed by electroencephalogram in the prognosis of pediatric status epilepticus (SE). A retrospective analysis was conducted on 177 pediatric SE patients admitted to our hospital from January 2021 to December 2024. Patients were divided into a good prognosis group (n = 126) and a poor prognosis group (n = 51) based on their clinical outcomes. Univariate and binary logistic regression analyses were performed to assess the influencing factors. The predictive value of FAA for the prognosis of pediatric status epilepticus was evaluated with receiver operating characteristic curve analysis. Significant differences were found between the 2 groups in terms of SE onset time, time from medication to seizure cessation, and FAA ( P < .05). Binary logistics regression analysis indicated that the time from medication to seizure cessation and FAA were independent influencing factors for the prognosis of pediatric SE ( P < .05). Receiver operating characteristic analysis revealed an area under the curve of 0.805 for FAA, with a standard error of 0.035 (95% confidence interval: 0.738–0.873), a Youden index of 0.43, a sensitivity of 90.20%, and a specificity of 52.38%. The optimal cutoff value for FAA was 88.96 (×10 ‐3 μV), with a higher probability of good prognosis in patients with FAA > 88.96 in comparison to those with FAA ≤ 88.96 ( P < .05). Patients with FAA > 88.96 also had lower levels of glial fibrillary acidic protein, S100-β protein, and gamma-aminobutyric acid after treatment compared to those with FAA ≤ 88.96. There was a statistically significant difference ( P < .05). FAA holds certain value in predicting the prognosis of pediatric SE and can provide reference for clinical decision-making.