Proposed Guideline: Minimum standards for recording routine and sleep EEG

A working group of the ILAE and IFCN (International Federation of Clinical Neurophysiology) developed a proposal for joint minimum standards for recording routine and sleep EEGs.

Draft guideline: Joint ILAE and IFCN minimum standards for recording routine and sleep EEG

Appendices | Supplementary Tables

The proposal comprises 16 recommendations. It is available and open for public comments until 7 July 2022.

 

Submit comments on the draft guideline.


Comments

23 June 2022

I would like to comment the following:

  1. We have great success with partial sleep deprivation in kids younger than 12 years of age.
  2. In our setting we only use melatonin for EEG sedation and find having parents sleep deprive ADHD and autistic kids over a few days help with achieving sleep. This can only happen with co-operation from parents.
  3. I agree with Aleksei Rakitin about having an alarm or a bell to call for help when the patient is having a seizure i.e in our setting for the nurse to assist mum or caregiver who comes with the child.

Veena Kander


15 June 2022

I have several comments regarding general safety issues of routine/sleep EEG.

  1. Routine-EEG room should be equipped with an alarm button for a case in which the patient has a seizure and the nurse is at that moment alone with the patient. The nurse should have the possibility to call for help without leaving the patient alone during the seizure or post-seizure confusion. Additionally, what is opinion of the working group regarding the availability of i/v diazepam/midazolam in a routine EEG room? This could be needed for stopping long seizures (more than 5 min) or in the case of postictal aggressive behavior.
  2. Should the patient be monitored by the nurse or technician during sleep-EEG? Usually, during sleep-EEG the patient is alone in the room for hours (in our center 4 h), and with sleep-deprivation there is a small risk to provoke a seizure. The working group stated that there are no studies evaluating the safety of partial or full sleep deprivation. What about the risk of SUDEP or trauma during seizure or postictal confusion? From my experience every year we have at least 2-3 seizures during sleep-EEG.

Aleksei Rakitin


13 June 2022

Routine eeg should be 40 min. And filter setting HFF-70Hz and LFF -1 Hz. Notch always on. And Do eye open and eye close for 20 sec and do HV and after hV 20 min for sleep.

Sachin


9 June 2022

Any recommendations on doing hyperventilation during the COVID pandemic? Mask or no mask? Do you require all patients for prolonged EEG to have prior negative RT PCR or antigen testing?

Does photic stimulation require eyes to be open?

Josephine Gutierrez


9 June 2022

Please could table 2 state “ Clinical suspicion of epileptic seizure or epilepsy” rather than “Clinical suspicion of seizure or epilepsy”? Seizure is still used in many contexts to generically mean episodes including non-epileptic seizures. Using epileptic seizure I think would help affirm the intended indication for EEG, and reduce chance that EEG is done for any seizure. For example, not indicated for reflex anoxic seizures, non-epileptic seizure, syncope with seizure components, etc.

Colin Dunkley