Reduced-lead electroencephalography performed at the discretion of emergency physicians in pediatric cases of altered mental status: A retrospective observational study.

Reduced-lead EEG identified electrographic seizures during pediatric emergency care and helped clinicians act while monitoring was underway. The retrospective study cannot show that this workflow improved neurological outcomes.

Yamaguchi H, Maruyama A, Ueda T, Oikawa S, Matsui S, Nozu K, Nagase H, Nishiyama M.
Epilepsy Research · Publication date: 2026-09-26
Added to site: 2026-10-02
DOI: 10.1016/j.eplepsyres.2026.107928

Online publication date verified in PubMed and Crossref; the journal issue is dated December 2026. This source date is separate from the site's addition date.

Modalities

EEG, Reduced-lead EEG

Clinical focus

Pediatric emergency care, Electrographic seizures, Timely intervention

Population

Patients younger than 18 years presenting to an emergency department with altered mental status and suspected electrographic seizures

Sample

51 recordings with minimal artifacts: 27 febrile-seizure, 8 acute encephalopathy or encephalitis, and 16 epilepsy cases

Intervention / method

Emergency physicians obtained and interpreted reduced-lead EEG at their discretion, while epileptologists retrospectively reviewed records and recordings

Comparator

Clinical diagnostic groups; there was no randomized intervention or conventional full-montage EEG comparator

Clinician summary

Electrographic seizures were identified in 8 of 27 febrile-seizure cases, 2 of 8 encephalopathy or encephalitis cases, and 15 of 16 epilepsy cases. Seizures resolved during monitoring in all but one febrile-seizure case, but causal outcome benefit was not established.

How to interpret the findings

EEG use was discretionary, only 51 recordings with minimal artifacts were analyzed, and there was no randomized group or full-montage comparator. The study could not determine whether hyperacute intervention improved outcomes, and the abstract does not expose montage details, false-negative rates or longer follow-up.

Equipment and disclosures

A reduced-lead EEG system was used in the emergency department. The checked abstract does not identify the device, lead count, electrode positions or acquisition settings.

The authors declared no competing interests. Crossref identifies support from the Japan Epilepsy Research Foundation and Japan's Ministry of Education, Culture, Sports, Science and Technology.

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