Relevance of electroencephalography at the pediatric emergency department

Aim: To better understand the role of electroencephalography (EEG) in patients admitted at a pediatric emergency department. Procedure: A retrospective study, over an 18 months period, of 148 children admitted at the emergency department and referred to our neurophysiology unit was conducted. Symptoms, EEG recordings and reports, emergency physician decisions, and final diagnoses were analyzed. Results: EEG was normal in 111 children (75%) and abnormal in 37 (25%). EEG abnormalities were frequently noted in patients with confusional or behavioral disorders (5/10; 50%) and in cases of seizures associated with loss of consciousness (39/61; 36%). In newborns and young infants with faints, EEG was typically normal (23/24; 96%). When EEG was performed within the first 24 hours following emergency admittance, hospitalization was decided for 22/34 (65%) children with abnormal EEG and 17/74 (23%) children with normal EEG (P < 0.001). EEG characterized brain disorders in 25/126 patients with known final diagnoses. Conclusion: Our series stresses the relevance of EEG at the pediatric emergency department. EEG abnormalities help identify and characterize epilepsy or encephalopathy. A normal EEG recording help the emergency physician decide to discharge the child.