Table 5.
Summary of AEEG studies done in pediatric population.*
| Study | Type of Study | No. of patients | Age Range | No. of channels | AEEG recording duration | Yield (Seizures) | Yield (IED) | Yield (NEE) | Comments |
|---|---|---|---|---|---|---|---|---|---|
| Foley et al (2000) | Retrospective | 84 | 17 months-18 yrs. | 18 | 1.4 days | 17% | 69% | NA | Computer assisted AEEG is well-tolerated, reliable and useful in 87% of children. |
| Olson (2001) | Retrospective | 167 | 4 months-18 yrs. | 16 | 1–4 days | 20.38% | NA | 68% | This study demonstrates that there is a high likelihood of recording a child’s typical seizure like events on AEEG when parents report that events occur 3 days a week or more |
| Saravannan et al (2001) | Retrospective | 54 | 1–16 yrs. | 8 | 48 hrs | 5.5% | 50% | 18.50% | AEEG helped in diagnosis in 31% of the patients. Children who are experiencing at least daily (and preferably many times a day) or sleeping episodes be considered for AEEG recording. |
| Wirrell et al (2008) | Prospective | 64 | 0–17 yrs. | 16 | 32.7 days (mean) | 16% | NA | 48% | AEEG contributed to diagnosis in 73% of children leading to a change in management in 27% of the patients. The yield in differentiating epileptic from non-epileptic events was 61%. |
| Hussain et al (2013) | Prospective | 100 | 11 days-16 yrs. | 8 | NA | NA | 24% | 45% | AEEG contributed to a clinical diagnosis in 71% of children, with diagnosis of epilepsy made in 26% of the patients. |
| Iqbal et al (2014) | Retrospective | 48 | 2–21 yrs. | NA | 1–3 days | NA | NA | NA | AEEG diagnosed seizures in two-thirds of children. When AEEG is inconclusive, video telemetry provides diagnosis in a further fifth. |
| Alix et al (2015) | Retrospective | 30 | 3–16 yrs. | NA | NA | NA | NA | NA | AEEG captured an event in 65% of the studies and video telemetry captured an event in 70% of the recordings. Combining both of them will provide diagnosis in almost all the instances. |
| Adhami et al (2015) | Retrospective | 50 | 10.25 yrs. (median age) | NA | 1–3 days | NA | NA | NA | AEEG helped in event characterization in 70.3% of patients and in seizure classification in 25% of the patients. It is valuable for event characterization and less likely to be of help in seizure classification. |
| Carlson et al^ (2018) | Prospective | 33 | 1–17 yrs. | NA | 1–3 days | 42% | NA | 9% | Ambulatory VEM is similar to inpatient VEM in capturing events and diagnostic efficacy. Despite technical difficulties encountered in ambulatory settings, it didn’t affect the EEG quality and is an accessible and cost effective alternative to inpatient VEM. |
| Nagyova et al (2018) | Retrospective | 199 | 5 months-19 yrs | 16 | 1–2 days | 42.6% | NA | NA | Pediatric AEEG was clinically useful in two-thirds of patients (64.8%). The most common reason for failure of AEEG recording is inability to capture an event. |
All included studies involved AEEG without video except Carlson et al.^; IED-Interictal epileptiform discharges; NEE-Non-epileptic events; NA-Not available; EA-Epileptiform abnormality; AEEG-Ambulatory EEG; rEEG-Routine EEG; sdEEG-Sleep deprived EEG; VEM-Video EEG monitoring.
*PubMed search of relevant articles until the year 2019 which talk about clinical utility of AEEG have been included. Articles discussing the role of AEEG in ASM withdrawal and pre-surgical assessment have been excluded.