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Outpatient Electroencephalogram (EEG)

  • While 75% of otherwise healthy, typically developing children with a first-time non-febrile seizure will not experience recurrence, 25% of these children may experience another non-febrile seizure.
  • As such, we recommend all children experiencing a first-time non-febrile seizure be referred for an outpatient routine EEG to evaluate for an underlying seizure tendency.
  • If the EEG returns abnormal, the child is at a higher risk for seizure recurrence, and the family should be counseled regarding antiepileptic therapy.
  • If the EEG is normal, the child may follow up with their pediatrician.
  • Because seizures are common, occurring in 1 in 10 individuals, while epilepsy is much less common, occurring in 1 in 100 individuals, automatic follow-up with a subspecialist, a pediatric neurologist, is not necessarily warranted, particularly if the EEG is normal. 

References

Aaberg, K. M., Gunnes, N., Bakken, I. J., Lund Søraas, C., Berntsen, A., Magnus, P., Lossius, M. I., Stoltenberg, C., Chin, R., & Surén, P. (2017). Incidence and Prevalence of Childhood Epilepsy: A Nationwide Cohort Study. Pediatrics, 139(5), e20163908. https://doi.org/10.1542/peds.2016-3908


Hirtz, D., Ashwal, S., Berg, A., Bettis, D., Camfield, C., Camfield, P. Crumrine, P., Elterman, R., Schneider, S., & Shinnar, S. (2000). Practice parameter: Evaluating a first nonfebrile seizure in children: Report of the Quality Standards Subcommittee of the American Academy of Neurology, the Child Neurology Society, and the American Epilepsy Society. Neurology, 55(5), 616-623. https://doi.org/10.1212/WNL.55.5.616 

These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.

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