Electroencephalography

Indications

Listen
  • • Suspected epilepsy.

    • Suspected ongoing seizures or subclinical status epilepticus.

    • Epilepsy characterization.

    • Unexplained encephalopathy or coma.

    • Monitoring medication-induced coma.

    • Paralyzed patients with possible seizures.

    • Medication titration.

Risks

Listen
  • • Scalp abrasion after prolonged monitoring is a minor risk.

Pearls and Tips

Listen
  • • Automatic spike and seizure detection paradigms are not sensitive or specific enough to base clinical decisions on at this time.

    • Cardiac and respiratory artifacts are often misinterpreted as epileptiform.

    • Patients with focal (localization related) epilepsy may have normal or near normal interictal electroencephalograms (EEGs).

    • In neonates, there is a paucity of clear epileptiform abnormalities even in patients with frequent seizures, thus prolonged monitoring should be strongly considered in place of routine studies.

    • EEG must be considered in clinical context.

    • An abnormal EEG is not always suggestive of epilepsy and may reflect a nonepileptic encephalopathy.

Patient Preparation

Listen
  • • The EEG is not painful or dangerous, although the placement of the electrodes may require the child’s restraint for a few minutes.

    • Patient’s hair should be washed and free of oils and chemical agents prior to the study; any braids in hair need to be removed.

    • Metal EEG electrodes are placed over the scalp in standardized positions and fixed with a variety of specialty adhesives.

    • • The glue can leave a small red welt on the scalp, which will resolve in a few days.

      • Alcohol can be helpful in removing stuck adhesive.

    • Impedance is checked to determine appropriate electrical connectivity.

    • The electrode wires are attached to the head box, which is then attached to the monitoring unit (usually a computer with screen for EEG display).

Only gold members can continue reading. Log In or Register to continue

Stay updated, free articles. Join our Telegram channel

Jan 4, 2019 | Posted by in PEDIATRICS | Comments Off on Electroencephalography

Full access? Get Clinical Tree

Get Clinical Tree app for offline access