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DOI: 10.1016/j.ijep.2016.11.004
Melatonin versus chloral hydrate as the sedating agent in performing electroencephalogram in paediatric patients
Publikationsverlauf
Received: 21. August 2016
Accepted: 21. November 2016
Publikationsdatum:
06. Mai 2018 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00037682/201701/lookinside/thumbnails/10-1016-j-ijep-2016-11-004-1.jpg)
Abstract
Electroencephalography (EEG) is a valuable tool in the diagnosis of epilepsy. The attainment of a high quality EEG requires patient's co-operation which is particularly difficult in children. Chloral hydrate has been used as a sedating agent in EEGs but it has potential serious adverse effects and anti-epileptic activity. Melatonin is used increasingly in different investigations as a safe alternative. Our study is to compare their effectiveness as sedating agents in performing EEGs and the detection rate of abnormal EEGs. This is a retrospective study performed in a regional hospital in Hong Kong. One hundred and ninety two EEG studies were included from December 2010 to July 2014. One hundred and two children were given chloral hydrate (50 mg/Kg) in the first half of the period and 90 children were given melatonin (3 mg for =< 5 years or 6 mg for >= 5 year) in the later half. The two groups are compared with Pearson's Chi-squared test with Yates’ continuity correction. The successful rate in sedation was similar between the two groups while the pick up rate of abnormal EEGs was 52.56% in the melatonin group and 21.57% in the chloral hydrate group (p < 0.05). Subgroup analysis among patients with epilepsy or mental retardation and intellectual disability shared same findings with higher detection rate of abnormal EEGs in the melatonin group. No side effect was documented in the study. Compare with chloral hydrate, melatonin is a safe and effective alternative and probably has less interference with the electrographic activity.
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References
- 1 Slifera KJ, Avisc KT, Frutcheya RA. Behavioral intervention to increase compliance with electroencephalographic procedures in children with developmental disabilities. Epilepsy Behav 13 2008; 189-195
- 2 Johnson K, Page A, Williams H, Wassemer E, Whitehouse W. The use of melatonin as an alternative to sedation in uncooperative children undergoing an MRI examination. Clin Radiol 57 2002; 502-506
- 3 The International Federation of Societies for Electroencephalography and Clinical Neurophysiology, 1974. Electroencephalogr Clin Neurophysiol 37 1974; 521
- 4 Panayiotopoulos CP. A Clinical Guide to Epileptic Syndromes and their Treatment. 2nd ed..
- 5 Goulden KJ, Shinnar S, Koller H, Katz M, Richardson SA. Epilepsy in children with mental retardation: a cohort study. Epilepsia 32 1991; 690-697
- 6 Smith SJM. EEG in the diagnosis, classification, and management of patients with epilepsy. J Neurol Neurosurg Psychiatry 76 2005; ii2-ii7
- 7 Aminoff MJ. Aminoffs Electrodiagnosis in Clinical Neurology. 6th ed..
- 8 Pershad J, Palmisano P, Nichols M. Chloral hydrate: the good and the bad. Pediatr Emerg Care 15 1999; 432-435
- 9 Jan MM, Aquino MF. The use of chloral hydrate in pediatric electroencephalography. Neurosciences 6 2001; 99-102
- 10 Brzezinski A, Vangel MG, Wurtman RJ. et al. Effects of exogenous melatonin on sleep: a meta-analysis. Sleep Med Rev 9 2005; 41-50
- 11 Wassmer E, Quinn E, Whitehouse W, Seri S. Melatonin as a sleep inductor for electroencephalogram recordings in children. Clin Neurophysiol 112 2001; 683-685
- 12 Eisermann M, Kaminska A, Berdougo B, Brunet ML. Melatonin: Experience in its use for recording sleep EEG in children and review of the literature. Neuropediatrics 41 2010; 163-166
- 13 Dirani M, Nasreddine W, Melhem J, Arabi M, Beydoun A. Efficacy of the sequential administration of melatonin, hydroxyzine, and chloral hydrate for recording sleep EEGs in children. Clin EEG Neurosci 10 2016; 1-7
- 14 Wassmer E, Carter PF, Quinn E. et al. Melatonin is useful for recording sleep EEG: a prospective audit of outcome. Dev Med Child Neurol 43 2001; 735-738
- 15 Gustafsson G, Broström A, Ulander M, Vrethem M, Svanborg E. Occurrence of epileptiform discharges and sleep during EEG recordings in children after melatonin intake versus sleep-deprivation. Clin Neurophysiol 126 2015; 1493-1497
- 16 Ashrafi MR, Mohammadi M, Tafarroji J, Shabanian R, Salamati P, Zamani GR. Melatonin versus chloral hydrate for recording sleep EEG. Eur J Paediatr Neurol 14 2010; 235-238
- 17 Krsek P, Sebronová V, Procházka T, Maulisová A, Komárek V. Successful treatment of Ohtahara syndrome with chloral hydrate. Pediatr Neurol 27 2002; 388-391
- 18 Pranzatelli MR, Tate ED. Chloral hydrate for progressive myoclonus epilepsy: a new look at an old drug. Pediatr Neurol 25 2001; 385-389
- 19 Thoresen M, Henriksen O, Wannag E, Laegreid L. Does a sedative dose of chloral hydrate modify the EEG of children with epilepsy?. Electroencephalogr Clin Neurophysiol 102 1997; 152-157
- 20 Dinner DS. Sleep and pediatric epilepsy. Cleve Clin J Med 56 1989; 234-239