The Utility of Limited-Montage Electroencephalography for Seizure Detection in Children

Pediatr Neurol. 2022 Dec:137:1-5. doi: 10.1016/j.pediatrneurol.2022.08.011. Epub 2022 Sep 9.

Abstract

Background: The primary objective of this study was to investigate the utility of limited-montage electroencephalography (EEG) for seizure detection in children. We also aimed to determine whether the detection rate differed among different montage patterns.

Methods: This study was carried out between November 2019 and October 2020 at a tertiary children's hospital in Japan. The subjects were inpatients in the pediatric intensive care unit who had an epileptic seizure during EEG monitoring. Each patient's EEG record, consisting of a 15-minute recording during an epileptic seizure and a 15-minute recording in the absence of an epileptic seizure, was extracted from the medical charts. The EEG data were then analyzed using six, limited-montage coverage patterns: (1) Fp1-C3, Fp2-C4, (2) Fp1-O1, Fp2-O2, (3) Fp1-T3, Fp2-T4, (4) C3-O1, C4-O2, (5) C3-T3, C4-T4, and (6) O1-T3, O2-T4. The sensitivity and specificity of each montage for seizure detection was analyzed.

Results: One hundred thirty-two EEG data points from 11 patients were examined. Sensitivity and specificity were the highest for Fp1-O1 and Fp2-O2 at 73% and 91%, respectively. Overall, the montage covering the frontopolar area had the highest detection rate, followed by the montage covering the occipital, central, and temporal areas.

Conclusion: Limited-montage EEG identified seizures in children hospitalized in the intensive care unit, but the detection rate differed by montage coverage. The detection rate was highest in the montage covering the frontopolar area.

Keywords: Emergency room; Epilepsy; Epileptiform discharges; Intensive care unit; Seizure.

MeSH terms

  • Child
  • Electroencephalography*
  • Epilepsy*
  • Humans
  • Intensive Care Units
  • Seizures / diagnosis
  • Sensitivity and Specificity