The clinical utility of ambulatory EEG in childhood

Abstract

Purpose: To evaluate the clinical utility of the ambulatory electroencephalogram (AEEG) in children.

Method: Data from 199 consecutive referrals for a paediatric AEEG were reviewed retrospectively. Information was gathered on various aspects of the referral process, the characteristics of the children referred and the reasons for referral. Clinical utility was calculated as the percentage of cases in which the investigation provided useful information with respect to the question asked of the test.

Results: The AEEG was useful in 64.8% cases overall. In 51.4% of cases the reason for referral was to capture events, however the test was only useful in 42.6% of these. The most common reason for an unsuccessful investigation was failure to capture events (55.6%). Suspected encephalopathy with status epilepticus during sleep (ESES) was the indication in a substantial number of cases (38.6%), and the investigation was useful in most of these (97.5%). Technical issues were only responsible for 7 (9.7%) of unsuccessful studies.

Conclusion: The paediatric AEEG was useful in two thirds of patients. Failure to capture events appears to be the most significant limiting factor. The AEEG is very useful in investigating suspected ESES.

Keywords: Ambulatory EEG; Child; Clinical utility; Electroencephalography; Encephalopathy with status epilepticus during sleep; Epilepsy.