Ideal Study Length for Routine Pediatric Electroencephalograms (P04.010)

Abstract

Objective: We hypothesized that the typical 20 minutes allotted for routine electroencephalograms (EEG) is too limiting to obtain adequate studies in a pediatric population. Background Routine EEGs are allotted 20 minutes study time. The ideal EEG captures the awake, drowsy and sleep states and demonstrates minimal artifact. Adult studies frequently capture all three states in 20 minutes. The appropriate time required to obtain EEGs in children has not been established. Our experience suggests 20 minutes in children is inadequate, obtaining non-ideal studies requiring repeat testing. This pilot study tests our observation to evaluate the need for longer EEGs in children. Design/Methods: 70 pediatric routine EEGs from both inpatient and outpatient settings at the Children9s Hospital of Los Angeles were evaluated for greater than 20 minutes of interpretable EEG data and capturing awake, drowsy and sleep states. Time until sleep, if captured, and until first abnormality were determined by a Board Certified Clinical Neurophysiologist. Mean and median times to sleep and first abnormality were calculated. Results: The average study length was 38 minutes and 8 seconds. Of the 70 studies, 3 obtained less than 20 minutes of interpretable EEG data. In children of normal or unknown developmental status, 45.5% did not display sleep. In those with developmental delays, 68% did not display sleep. Mean time to sleep was 22 minutes and 19 seconds. Median time was 25 minutes. Of the 43 abnormal studies, the majority of abnormalities occurred within the first minute. However, 4 occurred at 10 minutes, 10 minutes and 14 seconds, 29 minutes and 50 seconds, and 31 minutes and 40 seconds into the study. Conclusions: 1) 20 minutes of study is inadequate for the pediatric population. 2) Based on this pilot, a larger study is needed to determine appropriate duration for EEGs in children. Disclosure: Dr. Lallas has nothing to disclose. Dr. Ramos-Platt has nothing to disclose.