Home-video EEG monitoring in a pediatric setting

Introduction: Pediatric video-EEG monitoring is a standard procedure in epilepsy clinics, typically conducted in in-hospital settings.However, hospitalizationis sometimesunnecessary and imposes a burden on children and their families. In response to the rise of telehealth, home video-EEG monitoring has emerged, utilizing portable EEG equipment and video-cameras. Objective: The aim of this study was to assess the feasibility of home video-EEGin a pediatric population. Methods: We conducteda prospective pilot study of twentyhome video-EEG tests in children. We evaluated the quality of EEG and video recordings using a 5-point scale.Demographic, clinical and quality data were comparedto a similar group undergoing in-hospital video-EEG monitoring. Results: Twenty children aged 2.1-17.2 years (mean 9.57 +/- 1.01), 12 females (60 %), underwent home video-EEG. A higher proportion of children with intellectual disability/autism were observed in the home-EEG group compared to the in-hospital group: 12 patients (60 %) vs. 5 (25 %) (p < 0.05*, Fisher exact test). In the ambulatory group patients with developmental and epileptic encephalopathy were overrepresented (7 i.e., 35 % vs. 0), while those withself-limited childhood epilepsy were more prevalent in the in-hospital group (5 i.e., 25 % vs 0) (p < 0.05*, Chi square). In the ambulatory group the reasons for referral were seizure localization/classification in 11 patients (55 %), paroxysmal event classification in 5 (25 %) and quantification of sleep epileptic activity in 4(20 %),similar to the in-hospital group (40 %, 40 % and 20 % respectively, p > 0.05, Chi square). The quality of the EEG recording was higher compared to in-hospital tests: median 5 [IQR 3.25-5] vs 4[IQR 3-4] (p < 0.05*, Mann-Whitney U test), while the quality of video recording was lower compared to in-hospital recordings: median 3[IQR 2.25-4] vs 5[IQR4-5] (p < 0.01**, Mann-Whitney U test). Conclusions: Home video-EEG monitoring is apromising option forlong-termpediatric EEG monitoring, particularlyfor children with special needs.