RT Journal Article
SR Electronic
T1 The use of choral hydrate in pediatric electroencephalography
JF Neurosciences Journal
JO Neurosciences (Riyadh)
FD Prince Sultan Military Medical City
SP 99
OP 102
VO 6
IS 2
A1 MohammedM. S. Jan
A1 Marilou F. Aquino
YR 2001
UL http://nsj.org.sa/content/6/2/99.abstract
AB OBJECTIVE: Sleep is a known activator of epileptiform discharges on electroencephalography. Chloral hydrate is used frequently for electroencephalography sedation. Our objectives were to study the value and limitations of chloral hydrate.METHODS: One hundred and fifty nine consecutive pediatric electroencephalograms were included prospectively. One electroencephalography technologist collected chloral hydrate related data. Electroencephalogram requisitions and recordings were reviewed separately by one certified electroencephalographer.RESULTS: The children’s ages ranged between 8 days to 19 years (mean=5.7 years). Natural sleep was recorded in 11% and only 2% were sleep deprived. Sedation was given to 45% mostly using chloral hydrate (96%). Children with chronic neurological abnormalities were more likely to receive chloral hydrate (odds ratio=9.8, 95% confidence interval=4.5-21). Chloral hydrate was effective in inducing sleep in 97%, however, 34% of the children woke up spontaneously before the test was completed, particularly those with chronic neurological abnormalities (p=0.0003). A second dose was necessary in 13%. Recording an initial period of wakefulness followed by sleep onset was more likely achieved in natural sleep electroencephalograms when compared to the sedated group (82% vs 10%, p<0.0001). These electroencephalograms were more likely to contain epileptiform discharges (p<0.001).CONCLUSION: Although chloral hydrate was effective in sleep induction, the sleep onset was frequently missed and the hypnotic effects were not sustained, particularly in children with chronic neurological abnormalities.