New Pediatric Sleep & EEG Center in the Houston Texas Medical Center - Children and their Adults are Welcome!

Dear Friends,

Dr Susarla and Dr. Rotenberg are writing let you know about our new sleep and EEG facility in the Texas Medical Center.

Starting this week, we will offer EEG and sleep diagnostic services at our new location on the 4th floor of 7505 Fannin St -  across the street from The Woman's Hospital in the “Chase” building.

The facility will be dedicated to infants, children and teens….and their families.

We welcome teenagers and young adults in the practice, offering the same attention and care to adults as we do to the youngest of our patients.

This outpatient site joins Academy Diagnostics’ Kimberly Lane Location offering BOTH a West Side/Katy AND a central Medical Center alternative for our patients.

Please contact me or our office to speak to Miangela Kanaway or Shamile Morgan RPGST for more information.

Thank you for your patience this month as we transition from Healthbridge to our new home.

Warm Regards,

Dr. Joshua Rotenberg

LINK to Our Website

LINK to Academy Diagnostics Order Form for EEG or Sleep Studies

GOOGLE Map here

Effects of sleep deprivation on the pediatric electroencephalogram

Many are surprised to learn that the yield of a single EEG is limited.  A normal EEG does not exclude epilepsy.  

Neurologists request sleep deprivation with the goal of acquiring sleep tracing on the EEG and hopefully to provoke abnormalities.

This article is helpful in showing the yield may be higher in children over 3  and those who have already had a seizure. 

As an aside, a calm outpatient environment is also important in promoting sleep in an EEG.

JR 

Effects of sleep deprivation on the pediatric electroencephalogram.

Steven T DeRoos, Kipp L Chillag, Martina Keeler, Donald L Gilbert

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1. Steven T. DeRoos, MD^a,
2. Kipp L. Chillag, DO^a,
3. Martina Keeler, MD^b,
4. Donald L. Gilbert, MD^c

1. ^aDivisions of Pediatric Neurology
2. ^bPediatric Hospitalists, Helen DeVos Children's Hospital, Grand Rapids, Michigan
3. ^cDivision of Pediatric Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio

Abstract

BACKGROUND. The routine electroencephalogram aids in epilepsy syndrome diagnosis. Unfortunately, routine outpatient electroencephalogram results are normal in roughly half of children with epilepsy. To increase the yield, practice guidelines recommend electroencephalograms with sleep and sleep deprivation. The purpose of this study was to rigorously evaluate this recommendation in children.

METHODS. We conducted a randomized, blinded comparison of routine electroencephalograms versus sleep-deprived electroencephalograms in 206 children aged 0 to 18 years. Electroencephalograms were ordered for standard indications after a neurologist's clinical assessment indicated ≥1 seizure (83%) or unclear spell (17%). The primary outcome was the proportion of normal routine electroencephalogram results versus sleep-deprived electroencephalogram results. Logistic regression modeling was used to assess the influence of sleep, as well as other clinical factors.

RESULTS. Although children with sleep-deprived electroencephalograms had less sleep the night before (4.9 vs 7.9 hours) and more sleep during electroencephalograms (73% vs 55%), the increase in electroencephalogram yield was borderline significant (56% normal sleep-deprived electroencephalogram versus 68% normal routine electroencephalogram). Moreover, sleep during the electroencephalogram did not increase its diagnostic yield. Sleep-deprived electroencephalogram yield tended to be higher in children with preelectroencephalogram clinical diagnosis of seizure(s) and at older ages (>3 years).

CONCLUSIONS. Sleep deprivation, but not sleep during the electroencephalogram, modestly increases the yield of the electroencephalogram in children diagnosed with seizures by neurologists. Compared with a routine electroencephalogram, the number needed to test with sleep-deprived electroencephalogram to identify 1 additional child with epileptiform discharges is ∼11.

Key Words:

• Child neurology Epilepsy Serving Houston Sugar land Katy Cypress The Woodlands San antonio Seguin

What to know about seizures - A Primer - Basic information for your acquaintances or a concerned neighbor

Editor's Note: This is very basic information for your acquaintances or the concerned neighbor.


Darla Templeton, CEO of Epilepsy Foundation of Missouri and Kansas, said the 40 different types of epilepsy, or seizure disorder, exhibit various physical displays, so reactions vary when a seizure occurs. However, they all come down to keeping the person safe and judging whether it is a medical emergency requiring assistance.

"The most important thing about any of them is that you shouldn’t put something in a person’s mouth. That was the procedure suggested long ago, but it was found that people broke their teeth and it didn’t work well," she said.

Three situations require calling 911:

• A seizure lasting more than five minutes, 
• if it immediately reoccurs or 
• when it is the first one.

As a seizure passes, the person experiencing it will be slightly confused, so an onlooker should be reassuring and calm. Once senses clear to provide correct information like name and location, he probably can continue.

While a person with epilepsy certainly can enjoy summer, Templeton said, it is imperative always to swim with a buddy. If someone has a seizure while swimming, onlookers should get him out of the water for seizure control, plus check for possible water ingestion.

Generalized tonic clonis (grand mal)

Symptoms: Loss of consciousness, muscles stiffen and jerk, usually lasts 2 to 3 minutes.

What to know:

• Ease him to the ground if he already hasn’t fallen.
• Protect the head and remove things around him for safety.
• Turn him on his side. Loosen a collar, if wearing one.

Complex partial seizure

Symptoms: Impaired awareness, pulls on clothes, lip movement, aimless walking, usually shorter duration.

What to know:

• Try to keep out of harm’s way, particularly if person is walking.
• May be misinterpreted as other ailment like drug abuse or drunkenness.
• Holding or steering the person for safety may be misunderstood and push away the aid.

Absence seizure (petit mal)

Symptoms: Eyes roll back, flutter or stare for a few seconds.

What to know: Awareness returns just after a short period of unresponsiveness.


Read more: HERE