The diagnostic yield of a second EEG after partial sleep deprivation: a prospective study in children with newly diagnosed seizures.
OBJECTIVE
To assess the diagnostic yield of a repeated EEG (REPEEG) after partial sleep deprivation (SD) in children and adolescents with one or more seizures who previously had had a standard EEG (STDEEG) without epileptiform abnormalities (EAs). In the literature, 32-75% of such REPEEGs after SD were reported to show EA.


METHODS
In a prospective, multicentred study, we selected children aged 1 month to 16 years with one or more idiopathic or remote symptomatic newly diagnosed seizures. A REPEEG was recorded in children without EAs in their STDEEG.


RESULTS
Of 552 children and adolescents who entered the study, 243 (44%) had a STDEEG without EAs. In 177 (73% of eligible children), REPEEGs were recorded after SD. We found EAs in 61 (34.5%) REPEEGs and new nonepileptiform abnormalities in five (1%). In 552 children in the total cohort, the REPEEG thus added 11% with EAs to the 56% with EAs in the STDEEG. Of REPEEGs, 81% included sleep compared with 20% of STDEEGs. In about half the REPEEGs, EAs occurred during sleep only. One child had tonic-clonic seizures probably related to the SD.


CONCLUSIONS
One third of REPEEGs yielded new diagnostic information. Partial, age-dependent SD was highly effective in inducing sleep, which is important because in many cases EAs were found only during EEG recording in sleep. The procedure was safe and convenient.
Carpay
J A
JA
Department of Clinical Neurophysiology, Westeinde Hospital, The Hague, The Netherlands.
de Weerd
A W
AW
Schimsheimer
R J
RJ
Stroink
H
H
Brouwer
O F
OF
Peters
A C
AC
van Donselaar
C A
CA
Geerts
A T
AT
Arts
W F
WF
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography / Q000379:methods*; D004827:Epilepsy / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012890:Sleep / Q000502:physiology; D012892:Sleep Deprivation