WASHINGTON, DC— Abnormal EEG findings were detected in only 12% of children with psychiatric conditions, according to new data. Furthermore, the EEG findings were nonspecific and did not contribute to the care of the patients, the report concluded. “Ordering EEG studies in children with psychiatric conditions should be individualized and not done routinely,” recommended lead investigator Joseph Maytal, MD. “EEGs should be reserved for cases of acute mental status change, acute psychosis, or for patients with abnormal neurologic exam.” Dr. Maytal is the Chief of Pediatric Neurology, Schneider Children’s Hospital, Long Island Campus of Albert Einstein College of Medicine in New Hyde Park, New York. He presented his findings at the 31st Annual Meeting of the Child Neurology Society.

The primary reason that a psychiatrist advises a patient to undergo an EEG examination is to rule out organic etiology, said Dr. Maytal. Although the rate of EEG abnormalities in adult psychiatric patients varies between 40% and 60%, pediatric data are limited. Therefore, Dr. Maytal sought to evaluate the utility of EEG in a variety of psychiatric conditions in children.

RELEVANT ABNORMALITIES QUESTIONED

Dr. Maytal conducted a retrospective review of all studies of patients with a primary psychiatric diagnosis referred for an EEG. Data were collected for a five-year period for 199 patients ranging in age from 2.5 to 22, with a mean age of 11. EEG abnormalities were found in 24 patients (12%). “No relevant changes in diagnosis or treatment were made as a result of the EEG findings,” Dr. Maytal noted. “There is a 95% probability that the true rate of relevant abnormalities on EEG studies in children with psychiatric conditions is 1.7% or less.”

Diagnoses for patients in the cohort included attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder, brief psychosis, bipolar disorder, attention-deficit disorder, major depression, psychosis not otherwise specified, mood disorder, intermittent explosive disorder, obsessive-compulsive disorder, conduct disorder, and impulse control, as well as others.

—Colby Stong

Suggested Reading
Clarke A, Barry R, McCarthy R, Selikowitz M. Children with attention-deficit/hyperactivity disorder and comorbid oppositional defiant disorder: an EEG analysis. Psychiatry Res. 2002;111:181.
El-Sayed E, Larsson JO, Persson HE, Rydelius PA. Altered cortical activity in children with attention-deficit/hyperactivity disorder during attentional load task. J Am Acad Child Adolesc Psychiatry. 2002;41:811-819.

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