Abstract Details

Title Utility of 2 Hour Outpatient EEG in a Pediatric Setting: Does an Extra Hour of Recording Increase Diagnostic Yield?

Topic Epilepsy

Presentation(s) P05 - (-)

Poster/Presentation
Number 092

Objective

Background BACKGROUND: Extended outpatient EEG studies greater than 1 hour are sometimes used in specific patient populations (i.e. followup after epilepsy surgery or in patients with frequent paroxysmal events) to allow longer sampling time and increase the likelihood of capturing awake, drowsy and sleeping states.

Design/Methods DESIGN/METHODS: Prospective analysis of 2-hour outpatient pediatric EEGs obtained at a tertiary children's hospital from 2010-2012 (n=91 studies in 66 patients ages 1-19). EEGs were analyzed with respect to the timing and duration of sleep (if it occurred) and the presence of epileptiform discharges with respect to sleep state and first vs. second hour of recording.

Results RESULTS: Sleep was obtained in 75% of EEGs (n=69) after a mean time of 50 minutes with average sleep duration of 30 minutes. In 26 studies, patients fell asleep only during the second hour of recording. EEG abnormalities were identified in 88% of studies (n=80; 62 studies with epileptiform discharges, 40 with non-epileptiform abnormalities such as focal slowing). Although 14 EEGs exhibited epileptiform abnormalities only during sleep, overall the rate of discharges was similar whether sleep was attained or not. Discharges were present in 69% (n=48) of 69 sleep EEGs and 63% (n=14) of 22 non-sleep EEGs. Just 3 of 91 studies had EEG abnormalities that were identified only during the second hour of recording. In all 3 cases, epileptiform discharges were present only during sleep and sleep onset began between 61-80 minutes of recording.

Conclusions CONCLUSIONS: One hour of EEG recording is sufficient to capture both epileptiform and non-epileptiform abnormalities in a pediatric epilepsy cohort, especially when sleep has been attained. The diagnostic yield is low for the second hour of recording.

Authors/Disclosures
Jayne Ness, MD (UAB Dept of Pediatrics, Div Pediatric Neurology) PRESENTER	An immediate family member of Dr. Ness has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Jan One. The institution of Dr. Ness has received research support from Chugai/Roche. The institution of Dr. Ness has received research support from National Multiple Sclerosis Society. The institution of an immediate family member of Dr. Ness has received research support from NIH. An immediate family member of Dr. Ness has received publishing royalties from a publication relating to health care.
Pongkiat Kankirawatana, MD (Children of Alabama Hospital - UAB)	No disclosure on file
Monisha Goyal, MD	Dr. Goyal has nothing to disclose.
Hyunmi Kim, MD (Stanford University)	Dr. Kim has nothing to disclose.
Dennis N. Bourdette, MD, FAAN	Dr. Bourdette has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Magellan Health Care. Dr. Bourdette has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Best Doctor's Inc. Dr. Bourdette has stock in Authobahn Therapeutics. Dr. Bourdette has received intellectual property interests from a discovery or technology relating to health care.

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