title: Electroencephalography in the pediatric emergency department: when is it most useful?
abstract: This study aimed to identify the indications in which electroencephalography in the pediatric emergency department is most useful. We retrospectively reviewed the influence that the results of the emergent electroencephalogram had on the eventual disposition of patients at our pediatric emergency department. Sixty-eight children (mean age, 7.3 years; 32 males) underwent 70 emergent electroencephalograms. Fifty-seven emergent electroencephalograms were performed for the suspicion of ongoing seizures or status epilepticus. Thirteen of the 22 children (59.1%) discharged from the emergency department were sent home mainly based on the results of the emergent electroencephalogram, which prevented an admission. In particular, 11 of 38 children with frequent and recurrent paroxysmal events concerning for seizures and 2 of 19 children with suspected ongoing status epilepticus were discharged after excluding an epileptic disturbance. The emergent electroencephalogram provided meaningful clinical information that influenced disposition, especially in patients with ongoing events in which the clinical picture was clarified by a rapidly acquired electroencephalogram.
authors.affiliation: 1Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Iván Sánchez
authors.initials: IS
authors.lastname: Fernández
authors.forename: Tobias
authors.initials: T
authors.lastname: Loddenkemper
authors.forename: Anita
authors.initials: A
authors.lastname: Datta
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Kothare
authors.forename: James J
authors.initials: JJ
authors.lastname: Riviello
authors.forename: Alexander
authors.initials: A
authors.lastname: Rotenberg
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009422:Nervous System Diseases / Q000175:diagnosis*; D010372:Pediatrics; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D055815:Young Adult
keywords: diagnostic algorithms; paroxysmal events; seizures; status epilepticus