Abstracts

RATIONALE: It has been reported that recording sleep during an EEG increases the incidence of epileptiform discharges. The benefits of sedation may not outweigh the risks in children. A sleep deprivation protocol restricting the child to less than four hours of sleep may not be reasonable for all children. Partial sleep deprivation (PSD) may improve compliance yet increase the likelihood of recording sleep. This study was done to see if there was an association between sleep deprivation protocols and EEG results.
METHODS: Patients having outpatient EEGs for evaluation of seizures were entered into the study. Two months of baseline data were collected. During the two month test period, instructions for PSD were given unless the child had a sleep deprived EEG ordered. Data were collected from three EEG protocols: total sleep deprivation, partial sleep deprivation, and no sleep deprivation. Clinical predictor variables were included in a multivariate logistic model.
RESULTS: Data were analyzed using SPSS. Eight hundred nineteen EEG reports were reviewed. The ages of the children ranged from zero to eighteen years. In the multivariate model, the adjusted odds of epileptiform discharges were significantly greater in older children and in children taking antiepileptic drugs (p[lt]0.001 for both). Neither sleep protocol nor the presence of stage II sleep appeared to be associated with epileptiform discharges.
CONCLUSIONS: Based upon this study, there is no evidence that sleep deprivation is useful in increasing the likelihood of seeing epileptiform discharges on EEGs in children being evaluated for seizures.
At the conclusion of this activity, participants should be able to discuss the association between sleep deprivation and increased incidence of epileptiform discharges on EEGs in children.