Highlights
- •Longer duration of EEG recordings is associated with a higher diagnostic yield.
- •Longer epilepsy duration is associated with greater likelihood of a diagnostic study.
- •Focal-onset seizures and abnormal results in a routine EEG are more likely to lead to a “diagnostic” prolonged EEG study.
Abstract
Aim
This exploratory study examines the association of the duration of electroencephalography
(EEG) recordings to diagnostic yield in children undergoing evaluation for seizures.
Method
Clinical and EEG data on three hundred and ten patients (167 males and 143 females)
were reviewed retrospectively. 134 (43.2%) children with focal-onset seizures, and
59 (19%) children with generalized-onset seizures. The mean duration of recordings
in studies interpreted as “diagnostic” was compared to studies that were interpreted
as “non-diagnostic”. EMU recordings were also compared to routine EEG studies to identify
the relationship between routine EEG and diagnostic studies.
Results
The principal finding of this study indicates that a longer duration of monitoring
is more likely to be associated with a positive diagnostic yield. Mean duration of
recording in children with a “non-diagnostic study” was 31.05 hours versus 44.27 hours;
p < 0.001 in a “diagnostic study”. EMU recordings are likely to be diagnostic with
longer epilepsy duration (2.6 years vs 3.7 years; p < 0.01). A diagnostic EEG from
a prolonged recording is more likely to be achieved in children with abnormal routine
EEG and focal-onset seizures. p < 0.001.
Interpretation
Tailoring the optimal duration of EEG recordings and factoring in confounding variables
will reduce the need for repeated studies, improving diagnostic utility and permitting
efficient utilization of resources.
Keywords
Abbreviations:
EEG (Electroencephalography), EMU (Epilepsy monitoring unit), PNES (Psychogenic nonepileptic seizures), CYWE (Children and Youth with epilepsy), CEC (Comprehensive Epilepsy Care), ASM (Anti-seizure medications), CSCN (Canadian Society of Clinical Neurophysiology)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 22, 2023
Accepted:
March 8,
2023
Received in revised form:
February 25,
2023
Received:
December 15,
2022
Identification
Copyright
© 2023 Elsevier Inc. All rights reserved.
