The utility of using EEG in pediatric emergency department

Abstract

Introduction: Electroencephalogram (EEG) has been used for assessing patients in the emergency department (ED), to support the diagnosis of epilepsy, sleep disorders as well as non-epileptic disorders. Methods: In this regard, to assess the importance of this technique in the ED, we made a retrospective observational study. We reviewed and analyzed data collected from pediatric patients who performed an EEG in the emergency room at a tertiary hospital in Portugal during the year 2022. We classified the indications of EEG in 2 categories: 1) New-onset epileptic events suspected and 2) Recurrent epileptic events. We collected socio demographic information, clinical presentation, waiting time in the emergency department, EEG reports, medications and outcome variables. Furthermore, the diagnosis and treatment performed during the follow-up were also recorded. Results: We included 79 patients ( mean age 5.63 ± 5.48 years; 56% males). EEG was useful in 82% of cases. Supported the diagnosis of epilepsy in 30% and allowed a differential diagnosis in 52%. In 18% cases, EEG did not agree with the final diagnosis. In patients with new onset seizures (n=69) the EEG was useful in 81%. In the group of patients with recurrent seizures (n=10) EEG was useful in 90%. Conclusion: EEG is an important tool in the emergency department for ruling out an epileptic event which provides the opportunity to reduce unnecessary hospitalizations, early initiation of medication in epilepsy and adequate guidance for the patients.