Indications
Risks
Pearls and Tips
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• 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
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• 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.
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• 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).
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