Outcome of EEGs Ordered at a Regional Children's Mental Health Service

Introduction: Clinical practice guidelines in child psychiatry recommend doing an EEG when warranted based upon a complete history and physical examination. The College of Physicians and Surgeons of Ontario published guidelines as to when an EEG is likely to provide useful information. Method: All the electroencephalograms ordered at a tertiary care children's mental health centre over about a 2 year period were reviewed and compared to the guidelines published by the Ontario College of Physicians and Surgeons for ordering EEGs. The outcome of the EEGs and what the ordering physician did after receiving the results were also reviewed. Results: About 53% were ordered for reasons that the guidelines indicated would result in a significant probability of obtaining clinically useful information. EEG abnormalities were identified in 49% of the youth in this category. About 20% were ordered for reasons the guidelines indicated that an EEG was not likely to provide clinically useful information. EEG abnormalities were identified in 24% of the youth in this category. About 27% of EEGs were ordered for reasons not mentioned in the guidelines. EEG abnormalities were identified in 52% of those youth. Youth who had abnormal results were generally followed up with further investigations. Those youth with more severe abnormalities were often referred to a pediatric neurologist for assessment and treatment. Conclusions: Children with severe mental health problems have an increased probability of having neurological problems which might have an impact on the ability to assess and treat the mental health problem.