Electroencephalograms (EEGs) and polysomnograms (PSGs) are critical and frequently ordered tests in the care of children with neurodevelopmental disabilities (NDD). Performing studies with this population can be very intimidating, given that the referral reasons and seizure types can be unique, and children with NDD may have any combination of behavioral or sensory challenges that can make it difficult to successfully complete a study. This article presents a variety of strategies that can be used to overcome these challenges through good preparation, patience, caregiver involvement, effective behavioral management techniques, and education about the medical aspects of EEG/ PSG in NDD. This Technical Tips article features ideas and experiences from an EEG/PSG technologist, two board-certified child neurologists (one who is further certified in Clinical Neurophysiology, while the other is further certified in Sleep Medicine), and two behaviorally trained pediatric psychologists.
"Either a patient's favorite movie or one provided by the lab TV or monitor, DVD player, DVDs (supplied by staff or have patient bring their favorite) Dickson-Gardiner 2006 Sewkarran 2010 Lee et al. 2012 Paasch et al. 2012 Lim et al. 2013 Sleep deprivation Age specifi c sleep deprivation guidelines Instructions to caregivers only Brown et al. 1997 Sweeney et al. 1997 Ong et al. 2004 Music CD/Radio/Live music Either a CD player, MP3 player, or a live musician Loewy et al. 2005 Dickson-Gardiner 2006 O'Callaghan et al. 2012 Paasch et al. 2012 Favorite comfort item Toy/pillow/blanket/doll Brought with patient Paasch et al. 2012 Pretend or show & tell Show patient materials used, explain them and allow patient to touch items None needed Dickson-Gardiner 2006 Webb and Moore 2002 Paasch et al. 2012 Melatonin Natural sleep inducer Prescription for melatonin and pharmacy Wassmer et al. 2001a, 2001b Caregiver assistance "
[Show abstract][Hide abstract] ABSTRACT: "The need for sedation can be decreased greatly by adequate preparation and by creating a less threatening, child friendly environment in which to perform the study" (Olson et al. 2001). In 2006, Bild encouraged the avoidance of sedation during EEG and provided several helpful ideas in his ASET News article "Alternatives to Sedation in the EEG Lab" (Bild 2006). In this article Bild states, "We recently discontinued the use of sedation in our lab and we were probably one of the last holdouts using chloral hydrate" (Bild 2006). Several years later chloral hydrate is still a common method of sedating children for EEG studies. This article will encourage exploration and utilization of sedation alternatives, and discourage the use of sedatives for neurophysiological testing. This article is based on a review of EEG lab websites, a literature review, and over a decade of experience as a neurophysiology technologist at multiple institutions.
The Neurodiagnostic journal 06/2014; 54(2):110-24.
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