Introduction: -

The paucity of access to electroencephalograms (EEGs) in sub-Saharan Africa results in a high patient load attending the few centres with neurophysiology units. Sleep state for EEGs performed on children improves yield and reduces artefact.  Melatonin induces “natural sleep” without the risk of airway compromise. This study aims to evaluate the effectiveness of oral melatonin in attainment of useful electroencephalogram in South African children.

Method

Consecutive children booked for routine EEG that were either uncooperative or referred for sleep EEG received oral melatonin (3mg <  15kg; 6mg > 15kg) (September-December 2013).

Results

58 children were recruited, 30 (51.7%) male, median age 4.3 years (range 0.4 – 12.11 years).  Fifty-four (93.1%) children successfully slept for the study, whilst three (5.2%) were drowsy but cooperative. EEG could not be performed in one child who remained awake and uncooperative.  The quality of the EEG (background activity and detection of abnormal findings) did not differ when compared to children in who slept spontaneously. Fifteen (26%) of the 57 successful EEG studies detected abnormalities. There were no adverse events, and no child needed their study deferred due to intercurrent illnesses. Children showed no signs of post sedation irritability or persistent drowsiness. They were awoken and were immediately able to go home.

Conclusion

Melatonin is effective and safe in inducing sleep for EEG recording in our setting.