No role for electroencephalogram in the initial work-up of pediatric acute lymphoblastic leukemia

The purpose of this study was to verify whether there is a prognostic benefit of electroencephalogram (EEG) performed during initial work-up of children with newly diagnosed acute lymphoblastic leukemia (ALL).

In this retrospective monocenter study, we analyzed the value of electroencephalogram (EEG) performed during initial work-up of children with newly diagnosed acute lymphoblastic leukemia (ALL). All pediatric patients were included in this study who were diagnosed with de novo ALL in our institution between January 1, 2005, and December 31, 2018, and in whom an EEG was performed for initial work-up within 30 days of diagnosis of ALL. EEG findings were associated with the occurrence and the etiology of neurologic complications occurring during intensive chemotherapy.

Out of 242 children, EEG revealed pathological findings in 6 patients. Two of them developed a seizure at a later time point due to adverse effects of chemotherapy, whereas 4 children had an uneventful clinical course. In contrast, 18 patients with normal initial EEG findings developed seizures during therapy for different reasons.

We conclude that routine EEG does not predict seizure susceptibility in children with newly diagnosed ALL and is unnecessary in the initial work-up as EEG investigation in young and often sick children requires sleep deprivation and/or sedation, and our data demonstrate no benefit in predicting neurological complications.