Abstracts

Rationale: Patients with complex febrile seizures are frequently investigated with an EEG during the initial hospital visit for complex febrile seizures (CFS). The goal of this study was to assess the utility of these EEG studies. Methods: We retrospectively reviewed patients 6-60 months of age who were evaluated in a pediatric Emergency Department from 1995-2010 due to a first CFS and admitted for observation. Cases were identified using computerized text-search followed by manual chart review. We excluded patients who were admitted for associated conditions (i.e. intubated, dehydration, pneumonia, electrolyte abnormalities), thus focusing on patients that were likely to be admitted for observation. Variables collected included: age, gender, seizure characteristics, seizure during admission, use of anti-epileptic drugs (AED). EEG results were reviewed and scored by two neurologists according to the following categories: 1) likely to change management in the acute setting (72 hrs), 2) likely to have an effect on management but not necessarily in the acute setting, 3) abnormal but unlikely to have an effect on management, or 4) normal. Descriptive statistics were used to assess rates of EEG abnormalities among separate subgroups. Results: One hundred eighty-three patients met inclusion criteria of whom 104 (57%) had EEGs during admission. The EEG result lead to change in management in the acute setting in one patient (1/104 1% - 95% C.I. 0.05- 6%), as it diagnosed a generalized epilepsy. In 23/104 patients (22% 95% C.I. 15-32%) EEG was likely to have an effect on management but not in the acute setting, in 6 patients (6% 95% C.I. 2.4-12.6%) EEG was unlikely to have an effect on management, and in 74 patients (71% - 95% C.I. 61-79%), EEG was normal. Results related to patient characteristics are presented in table 1. Conclusions: EEG findings had limited effect on acute management of children admitted for CFS, as they did not correlate well with further seizures during admission or the use of AED. We therefore conclude that early EEG should not be a sole reason for admission of these children, and if admitted then EEG could likely be deferred to the outpatient setting.