This single-center retrospective cohort study examined which clinical factors drove point-of-care EEG (pocEEG) use in 163 children (<18 years) presenting to a tertiary pediatric ED with seizure or altered mental status between August 2024 and July 2025.
44% of children (72/163) received pocEEG. Independent predictors of pocEEG use were seizures lasting ≥15 min (aOR 2.95, 95% CI 1.48–5.96) and reduced GCS eye-opening on arrival (aOR 3.35, 95% CI 1.60–7.28). Nonconvulsive status epilepticus (NCSE) was identified in 10 of 72 monitored children (14%).
Single-center retrospective design limits generalizability. Firth-penalized regression suggests small cell sizes, reducing precision. No data on whether pocEEG findings changed clinical management or outcomes.
Consider pocEEG early in children with seizures lasting ≥15 min or reduced eye-opening on ED arrival, as NCSE was found in 14% of those monitored. Prospective studies are still needed to determine whether pocEEG findings actively change antiseizure medication decisions.
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