Impact of first continuous electroencephalographic monitoring on children in a Thai Tertiary Center

Abstract

Objective: The aim of this research is to study the impact of first continuous electroencephalographic (cEEG) monitoring on clinical decisions and outcomes of pediatric patients in a Thai Tertiary Center. Methods: Pediatric patients less than 15 years old underwent cEEG. Enrollment and data collection were part of a prospective analytical descriptive study. Results: Forty-four cEEG monitorings were included. Every patient chosen for cEEG monitoring had alteration of consciousness. Some of these patients also had paroxysmal events, and some were treated with a hypothermia process. Non-convulsive status epilepticus (NCSE) was detected in 27.3% of the monitorings. NCSE was found in patients diagnosed with febrile infection related epilepsy syndrome (FIRES), epilepsy, urea cycle defect with severe diffuse encephalopathy, lead encephalopathy, hydrocephalus, subdural hemorrhage, myocarditis with cardiac arrest and GM1 gangliosidosis. CEEG led to specific clinical decisions 45.5% of the time. Clinical decisions included changes in antiepileptic drug usage and urgent neuroimaging. The short term outcome for NCSE patients was poor but not statistically significantly different from that of non-NCSE patients. Conclusions: This study confirms the findings of prior publications by establishing the benefit of cEEG monitoring. The first cEEG monitoring of children in a Thai Tertiary Center impacted clinical decisions and patient outcomes in the majority of patients by providing an opportunity to detect NCSE or problems leading to appropriate clinical management.

Keywords

• Impact
• First continuous electroencephalographic (cEEG) monitoring
• Children
• Clinical decisions
• Outcomes