Abstracts

Rationale: Ambulatory EEG monitoring is often preferred by patient families and ordered by providers rather than inpatient prolonged video EEG monitoring due to convenience and cost-effectiveness. These studies are however limited relative to their inpatient counterparts in that they are not monitored in real-time by technologists, so bedside testing, electrode repairs to ensure recording quality, and video adjustments to ensure patient visualization either do not occur or occur infrequently. The purpose of this study is to determine the diagnostic yield of ambulatory EEG monitoring within a pediatric neurology/epilepsy practice quantified based on interictal abnormalities, characterization of seizures/events of concern, and need for repeat monitoring. Methods: A retrospective review of the Texas Children's Hospital electronic medical record was performed for ambulatory EEG encounters that occurred within the 2018 calendar year. Studies were performed by Global Neurodiagnostics with standard 10-20 electrode placement and simultaneously recorded video on 2 cameras. Initial interpretation was performed by a board certified or board eligible clinical neurophysiologist shortly following recording. Reports were reviewed retrospectively for interictal abnormalities as well as for seizures or family/patient identified events of concern. Need for further prolonged EEG monitoring within a 6 month period was also quanitified. Data analysis was stratified by ordering provider group (pediatric neurologist or pediatric epileptologist). Results: Within 2018, 425 ambulatory EEG studies were performed by Global Neurodiagnostics on 402 unique patients seen in a Texas Children's Hospital neurology or epilepsy clinic. Each study ranged from 24-168 hours of recording with an average recording duration of 65 hours. Of the 425 studies, 50% were ordered by providers within the pediatric neurology clinic and 50% by epileptologists. Within 6 months of the initial study, 2 patients within the pediatric neurology group and 4 patients within the epilepsy group had repeat ambulatory EEG monitoring. Quantitification of interictal abnormalities and events characterization is in process and will be completed by the time of the conference. Conclusions: Preliminary analysis suggests that ambulatory video EEG monitoring is a useful diagnostic alternative to inpatient prolonged video EEG monitoring. Funding: No funding