Abstract Details

Title Single-center Single-reader Prolonged Pediatric Routine EEGs and Long-term Outcome

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P7 - Poster Session 7 (11:45 AM-12:45 PM)

Poster/Presentation
Number 1-016

Objective To determine the utility of pediatric routine EEGs (rEEGs) in a single-reader high-volume tertiary children’s hospital with long-term follow-up

Background The value of rEEGs, especially in children, varies widely, in part due to different cohort size, short rEEG duration, years of follow-up, and inter-reader/inter-institutional variability.

Design/Methods In a retrospective cohort study of children that completed a rEEG during the calendar year 2014 at our institution, all interpreted by the same experienced board-certified pediatric clinical neurophysiologist (CS), key characteristics and outcomes from electronic medical records in the intervening years up to 2023 were extracted, to include pre- and post-Covid-19 pandemic years. Seizure outcomes were categorized as 1) never developed epilepsy with follow-up, 2) no follow-up, 3) developed epilepsy on anti-seizure medication (ASM), 4) developed epilepsy off ASM, and 5) 1 event with no ASM.

Results In the total cohort (977 children with 1042 rEEGs), age at the time of rEEG ranged from 1 day to 26 years (median age 6 years), with a rEEG duration standardly prolonged at 61 minutes. About 47% of rEEGs were abnormal with one or more abnormalities (interictal spikes 91%, slowing 93%, seizures during EEG 14%, hypsarrhythmia 1.2%), and 53% were normal. Approximately 39.5% of patients were lost to follow-up. In the subset with follow-up (n=630), an abnormal rEEG had a positive predictive value of 84% of developing epilepsy, and a normal rEEG had a negative predictive value of 59%, along with 64% sensitivity and 80% specificity. Additionally, a mortality rate from all causes of 2.60% was noted in the overall cohort.

Conclusions Capitalizing on the unique single-center single-reader at a high-volume tertiary children’s hospital with long-term outcome, this study may elucidate more precise rEEG predictive values and patient outcomes than prior studies. More work is needed to improve pediatric rEEG diagnostic and outcome prediction.

Authors/Disclosures
Joyce Y. Wu, MD (Lurie Children's Hospital) PRESENTER	Dr. Wu has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biocodex. Dr. Wu has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Marinus. The institution of Dr. Wu has received research support from National Institutes of Health. Dr. Wu has received personal compensation in the range of $500-$4,999 for serving as a Study section member with National Institutes of Health.
Emily Gost (Ann and Robert H. Lurie Children's Hospital of Chicago)	No disclosure on file
Cynthia V. Stack, MD (Lurie Children's Hospital of Chicago)	Dr. Stack has nothing to disclose.

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