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Home-video EEG monitoring in a pediatric setting
Yael Michaeli1, Lubov Blumkin1,2, Mordekhay Medvedovsky3,4
1Pediatric Neurology Unit, Edith Wolfson Medical Center, Holon, Israel.
Insights
Home video-electroencephalogram (EEG) monitoring offers a feasible alternative to in-hospital evaluations for pediatric epilepsy. This approach provides higher quality EEG recordings, especially benefiting children with special needs.
Area of Science:
- Pediatric Neurology
- Epilepsy Diagnostics
- Telehealth in Medicine
Background:
- In-hospital pediatric video-electroencephalogram (EEG) monitoring is standard for epilepsy diagnosis but can be burdensome for families.
- Home-based video-EEG monitoring utilizes portable equipment as a telehealth alternative.
- The feasibility of this approach in children requires evaluation.
Purpose of the Study:
- To assess the feasibility of home video-EEG monitoring in a pediatric population.
- To compare home video-EEG data with traditional in-hospital monitoring.
Main Methods:
- A prospective pilot study involving twenty children undergoing home video-EEG.
- Evaluation of EEG and video recording quality using a 5-point scale.
- Comparison of demographic, clinical, and quality data with a matched in-hospital group.
Main Results:
- Home video-EEG included a higher proportion of children with intellectual disability/autism and developmental/epileptic encephalopathy.
- EEG recording quality was significantly higher in the home-based group (median 5 vs. 4).
- Video recording quality was lower in the home-based group (median 3 vs. 5).
Conclusions:
- Home video-EEG monitoring is a promising option for long-term pediatric EEG assessment.
- This method is particularly beneficial for children with special needs.
- Further research can optimize home-based epilepsy monitoring.
Introduction:
Pediatric video-EEG monitoring is a standard procedure in epilepsy clinics, typically conducted in in-hospital settings.However, hospitalizationis sometimesunnecessary and imposes a burden on children and their families. In response to the rise of telehealth, home video-EEG monitoring has emerged, utilizing portable EEG equipment and video-cameras.
Objective:
The aim of this study was to assess the feasibility of home video-EEGin a pediatric population.
Methods:
We conducteda prospective pilot study of twentyhome video-EEG tests in children. We evaluated the quality of EEG and video recordings using a 5-point scale.Demographic, clinical and quality data were comparedto a similar group undergoing in-hospital video-EEG monitoring.
Results:
Twenty children aged 2.1-17.2 years (mean 9.57 ± 1.01), 12 females (60 %), underwent home video-EEG. A higher proportion of children with intellectual disability/autism were observed in the home-EEG group compared to the in-hospital group: 12 patients (60 %) vs. 5 (25 %) (p < 0.05*, Fisher exact test). In the ambulatory group patients with developmental and epileptic encephalopathy were overrepresented (7 i.e., 35 % vs. 0), while those withself-limited childhood epilepsy were more prevalent in the in-hospital group (5 i.e., 25 % vs 0) (p < 0.05*, Chi square). In the ambulatory group the reasons for referral were seizure localization/classification in 11 patients (55 %), paroxysmal event classification in 5 (25 %) and quantification of sleep epileptic activity in 4(20 %),similar to the in-hospital group (40 %, 40 % and 20 % respectively, p > 0.05, Chi square). The quality of the EEG recording was higher compared to in-hospital tests: median 5 [IQR 3.25-5] vs 4[IQR 3-4] (p < 0.05*, Mann-Whitney U test), while the quality of video recording was lower compared to in-hospital recordings: median 3[IQR 2.25-4] vs 5[IQR4-5] (p < 0.01**, Mann-Whitney U test).
Conclusions:
Home video-EEG monitoring is apromising option forlong-termpediatric EEG monitoring, particularlyfor children with special needs.
