Emergency pediatric EEG in mental confusion, behavioral disorders and vigilance disorders: a retrospective study

Recording of electroencephalogram (EEG) is of value to estimate vigilance s tates in children as in adults. In order to determine the diagnostic and pr ognostic value of emergency EEG in case of mental confusion, behavioral dis orders and vigilance disorders in childhood, we conducted a retrospective s tudy in 397 children (aged 2 months to 16 years). EEG was recorded less tha n 24 hours after an emergency consultation for acute confusion or acute beh avioral disorder (n = 106) or after admission to the intensive care unit fo r comatose stage (n = 291). EEG gave diagnostic indications mainly in case of convulsive pathology or hepatic encephalopathy. In comatose children, we established a I-stage EEG scale of increasing severity. This classificatio n was compared to EEG scales already published in the literature and appear ed very similar to that from Pampiglione and Harden; established in 150 chi ldren after cardiac arrest. A highly poor pronostic value was associated wi th burst-suppression post-anoxic patterns and with isoelectric records sign aling brain death. Our classification of emergency EEG patterns is mainly h elpful in these two situations, but does not exclude strict and repeated cl inical and EEG follow-up in other cases, as a relatively preserved initial EEG may later deteriorate. (C) 1998 Elsevier, Paris.