Is there a portable electroencephalogram (EEG) available for pediatrics to diagnose absence seizures?

From the Guidelines

Portable EEG devices, such as ambulatory EEG systems or smaller headset-style devices, are available for diagnosing absence seizures in pediatric patients, although a traditional 21-electrode EEG remains the gold standard for accurate diagnosis. When considering the diagnosis of absence seizures in children, it's crucial to weigh the benefits of portable EEG devices against the potential for lower sensitivity compared to hospital-grade equipment 1. The clinical scenarios discussed in the context of seizures in children, including the patient's age and clinical and electroencephalogram findings, are essential for guiding clinicians in clinical decision-making 1.

Some key points to consider when using portable EEG devices for diagnosing absence seizures in pediatric patients include:

• The ability to monitor the child in their natural environment, which can increase the likelihood of capturing seizure events
• The importance of having a pediatric neurologist interpret the results, as expertise is required for accurate diagnosis
• The potential for portable devices to have lower sensitivity than traditional hospital-grade equipment, which may impact diagnosis accuracy
• The need for extended monitoring, often 24-72 hours, to capture infrequent seizure events

In the context of diagnosing absence seizures, which are characterized by brief staring spells lasting 5-30 seconds with sudden onset and resolution, the traditional 21-electrode EEG can detect the characteristic 3 Hz spike-and-wave discharges, making it the preferred method for accurate diagnosis 1. However, portable EEG devices offer a convenient alternative for children who may be uncomfortable in clinical settings or when seizures occur infrequently.

From the Research

Portable EEG for Pediatrics to Diagnose Absence Seizures

• There are portable electroencephalogram (EEG) devices available for pediatrics to diagnose absence seizures, as seen in studies 2, 3, 4.
• These devices have been shown to be effective in detecting absence seizures in children and adults, with high sensitivity and accuracy 2, 3, 4.
• The use of portable EEG devices can facilitate long-term, remote monitoring of patients with absence epilepsy, allowing for personalized drug titration and determination of the duration of pharmacotherapy 2.
• Studies have also explored the use of automated detection algorithms for absence seizures, which can reduce the review time of EEG recordings and improve the accuracy of seizure detection 2, 3, 4.

Key Features of Portable EEG Devices

• Some portable EEG devices use dry electrodes embedded into a wearable headband, connected to a smartphone, to record one-channel EEG 4.
• Other devices use two-channel EEG recordings, with electrodes placed behind the ears, to detect absence seizures 3.
• These devices can be used in conjunction with automated detection algorithms, which can analyze the EEG in real-time and provide alerts to patients or caregivers 2, 3, 4.

Clinical Applications

• Portable EEG devices can be used to diagnose and monitor absence seizures in children and adults, particularly in those with refractory typical absences 3, 4.
• The use of these devices can improve seizure quantification and promote assessment of patients in their home environment, rather than in a clinical setting 4.
• Automated behavioral testing can also be linked to automated seizure detection, providing valuable information on patient responsiveness during seizures 4.