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Feasibility and usefulness of rapid 2-channel-EEG-monitoring (point-of-care EEG) for acute CNS disorders in the paediatric emergency department: an observational study
  1. Leopold Simma1,
  2. Florian Bauder2,
  3. Thomas Schmitt-Mechelke2
  1. 1Emergency Department, Luzerner Kantonsspital Kinderspital Luzern, Luzern, Luzern, Switzerland
  2. 2Department of Child Neurology, Luzerner Kantonsspital Kinderspital Luzern, Luzern, Luzern, Switzerland
  1. Correspondence to Dr Leopold Simma, Emergency Department, University Children's Hospital Zurich, Zurich, Switzerland; leopold.simma{at}kispi.uzh.ch

Abstract

Introduction The aim of this study was to determine the feasibility and clinical utility of point-of-care electroencephalogram (pocEEG) in the paediatric emergency department (ED) for children presenting with acute non-traumatic central nervous system (CNS) disorders.

Methods Retrospective observational study of prospectively collected data in paediatric patients (0–16 years) with acute non-traumatic CNS-disorders presenting between April 2014 and February 2017 to a single paediatric ED in Switzerland.

The 2-channel EEG was applied to all patients presenting with acute seizures or impaired consciousness to the ED. For a pocEEG, scalp surface electrodes are applied in five locations, thus allowing registration of fronto-temporal bilateral cortical activity. Neurology consultants assisted with interpretation of readings. EEG findings and clinical characteristics were collected. Feasibility and usefulness were rated via Likert scale.

Results 36 patients with acute seizures or altered mental status were analysed. Age range was 9 months to 15 years, median age of 34 months. 21 of 36 (58%) patients arrived out of hours. Application of electrodes was rated as ‘easy’ in 28 (77.8%) patients and rated as ‘difficult’ in 8 (22.2%). The utility of the EEG was rated by physicians as ‘very useful/diagnostic’ in 13 cases (36%), ‘useful’ in 21 cases (58%), ‘not useful’ in two cases (8%). None were rated ‘negative.’

Conclusion Uptake of pocEEG introduction has been very encouraging. Provider ratings were overwhelmingly positive. Recognition of non-convulsive status epilepticus was improved and pocEEG facilitated more targeted interventions.

  • emergency department
  • neurology
  • epilepsy
  • paediatrics
  • paediatric emergency medicine
  • clinical care
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Footnotes

  • Handling editor Gene Yong-Kwang Ong

  • Presented at Preliminary results of this investigation were presented at the annual congress of the Swiss Society of Paediatrics 2015 in Interlaken, Switzerland.

  • Contributors TSM and LS designed the study, LS extracted the data from the electronic medical record and wrote the initial draft. TSM and FB managed the EEG database, interpreted and collected the pocEEGs. All authors contributed to the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by the responsible ethics committee for Central Switzerland (EKNZ 2020–00155).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as online supplemental information. All data generated or analysed during this study are included in this published article.

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