# Assessing the Yield of Reduced Duration-EEG Recordings in Children: A Cross-Sectional Study

## TL;DR

The study finds that 20-minute EEG recordings in children are sufficient to detect most neurological anomalies, but shorter durations miss many issues.

## Contribution

This study quantifies the diagnostic yield of shortened EEG durations in children, providing evidence for a 20-minute minimum.

## Key findings

- Reducing EEG duration to 20 minutes missed 24.1% of diagnostic anomalies.
- A 10-minute EEG missed 75.9% of anomalies, significantly reducing diagnostic accuracy.
- No single EEG protocol (e.g., drug-induced, routine) showed superior diagnostic yield over others.

## Abstract

Introduction

An EEG is an important tool in the diagnosis of neurological diseases. Performing an EEG on children can be challenging due to their tendency to not cooperate for the recommended duration. We aim to optimize the duration of EEG recording in children by finding the optimal duration of recording.

Materials and methods

A single-center prospective observational study was done after appropriate ethical clearance. Children aged 0-14 were recruited and examined, and the recommended EEG was done. Data were collected and analyzed.

Results

Of the 112 EEGs analyzed, 29 EEGs were normal, i.e., no diagnostic anomaly was noticed. In the remaining 83 EEGs, if the duration of the EEG was reduced to 20 minutes, it resulted in missing the diagnostic anomaly in 20 cases (24.1%; 95% CI: 11.2%-26.2%).

Reducing the duration of the EEG recording to 10 minutes resulted in missing 63 of the diagnostic anomalies (75.9%; 95% CI: 46.6%-65.6%). Of the 86 drug-induced EEGs, 22 were normal (25.6%; 95% CI: 16.8%-36.1%). Of the 24 routine EEGs, seven were normal (29.2%; 95% CI: 12.6%-51.1%). Of the two sleep-deprived EEGs, neither was normal (0.0%; 95% CI: 0.0%-84.1%).

Conclusion

In our study, we observed that optimization of the duration of EEG recording can be done to 20 minutes in all populations. We also observed that if we find a diagnostic abnormality early during EEG recording, then continuation of the EEG may not be necessary to make a valid report. Having said so, having a negative EEG may not necessarily rule out a diagnosis. We did not find the superiority of any of the EEG protocols over others, as their yield was comparable.