Research Article| Volume 142, 109172, May 2023

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Does the duration of video-EEG recording influence diagnostic yield in pediatric epilepsy: Results from a single center study

  • Mohammed A. Al-Omari
    Department of Pediatrics, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, King Fahad Hospital of the University, Al-Khobar, Saudi Arabia
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  • Andrea Andrade
    Depatment of Paediatrics, Schulich School of Medicine and Dentistry, Children’s Hospital, London Health Science Center, Western University, London, ON, Canada
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  • Asuri N. Prasad
    Corresponding author at: 800 Commissioners Road East, London, ON N6A5W9, Canada.
    Depatment of Paediatrics, Schulich School of Medicine and Dentistry, Children’s Hospital, London Health Science Center, Western University, London, ON, Canada
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      • 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.



      This exploratory study examines the association of the duration of electroencephalography (EEG) recordings to diagnostic yield in children undergoing evaluation for seizures.


      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.


      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.


      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.



      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)
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