Ministry of Health

Al-Rantissi – Alnasr Hospital for Children

Pediatric Neurology department

Proposal for Electroencephalogram (EEG) machine providing

Prepared by : Dr.Mahdya H. Shamallakh
1.1 Context of the topic

This proposal was held in Gaza Strip or simply Gaza, At Al Rantisi –Nassr pediatrics
hospital which is the main specialised hospital that treat pediatric patients in most
of areas of Gaza city , providing different services to many children in different
specialities

Neurology department is one of the largest departments at Al-Rantisihospital ,

providing many services to thousands of patients who are suffering from
neurological deficits ,the department is followed by 3 main doctors.

abouthalf of the patients who are followed at neurology outpatient clinics are
epilepsy patients. About 100 to 120 patients are managed weekly in their
outpatient clinics

Epilepsy is a disease of the brain defined by any of the following conditions: (1) At
least two unprovoked (or reflex) seizures occurring >24 h apart; (2) one unprovoked
(or reflex) seizure and a probability of further seizures similar to the general
recurrence risk after two unprovoked seizures (at least 60%); and (3) diagnosis of
an epilepsy syndrome.

EEG is needed for diagnosis and followup of epilepsy patients. There’s only one EEG
machine in the department that helps about 1700 child yearly to have an EEG study
, in a range of 10-15 case daily . the only device is an old one with weekly to
monthly stop due to software or mechanical problems.

1.2 Goal of this proposal

It’s prepared to focus on the importance of EEG and Video EEG machines and to ask
for a new machine to provide better services to Gaza children.

1.3 Importance of EEG and Video EEG (INDICATIONS for EEG)

A. ROUTINE EEG
  Initial assessment for patients with possible epilepsy or after a seizure. If
normal, depending on the level of suspicion, a repeat routine EEG, a sleep-
deprived study, or a long-term EEG may be indicated.
 Follow-up assessment after the introduction of AEDs
 Follow-up assessment after the cessation of AEDs.

B. INPATIENT VEEG MONITORING

 Characterization of seizures in a person with known epilepsy who is
undergoing a pre-surgical evaluation.
 Determination of seizure frequency when undetected seizures are suspected.
For example, if a patient with known epilepsy is having worsened memory
problems, there may be subclinical seizures worsening cognition.
 Distinguishing between epileptic, psychogenic non-epileptic attacks (PNEA),
and other seizure mimics.
 Changing medications in a controlled and safe environment for those with
refractory epilepsy.
 Management of ongoing seizures or status epilepticus.
 Ongoing monitoring in patients with lethargy, obtundation, and coma to
ascertain if the altered level of consciousness is caused by ongoing seizures.
If seizure characterization is desired, various provocation techniques are
carried out during the study, including hyperventilation, photic stimulation,
and sleep deprivation.

C. AMBULATORY EEG (AEEG) MONITORING

This long-term monitoring technique has the attraction of sending the patient
home with a small, portable EEG amplifier with or without a camera. Typically, the
patient carries out normal activities and keeps a diary of any events that occur.
Recording may be carried out for days. Family members or friends can aid in the
note keeping as the patient may be unaware of events. Indications are more
constricted than the indications for in-patient VEEG, as it is not appropriate.

Note. Price offers to be associated