Clonidine-assisted EEG in children: A three year retrospective review of effectiveness and safety.

OBJECTIVE

To evaluate the effectiveness and safety of clonidine sedation for paediatric electroencephalography (EEG) in children unlikely to tolerate non-sedated recording.

METHODS

We conducted a retrospective review of all clonidine-sedated EEGs performed between September 2022 and September 2025 at our department. For each study, referral details and EEG reports were examined to record patient demographics, prior EEG history, sleep capture, study outcome, and any adverse events. EEGs were classified as successful if recording was completed and interpretable. Sleep was recorded as obtained or not. Descriptive statistics and Mann-Whitney U tests were used.

RESULTS

Seventy-five clonidine-sedated EEGs were included. The mean age was eight years (range 2-17), and 75% were male. Almost all children had a neurodevelopmental or behavioural diagnosis, and most (69%) had previously undergone a non-sedated EEG. Overall, 82% of clonidine EEGs were successfully completed, including 76% of children who had previously failed a non-sedated study. Sleep was obtained in 68% of recordings, and 78% of those who had not achieved sleep previously, did so with clonidine. Median recording duration was 74 min (IQR 53-91). EEG abnormalities were identified in 60% of successful studies. No unplanned admissions or abandoned procedures occurred.

CONCLUSIONS

Clonidine sedation is a safe and effective method for facilitating EEG acquisition and sleep capture in children with developmental or behavioural challenges who are unable to tolerate standard or sleep-deprived recordings. Use of clonidine in this population may reduce failed EEG attempts and support detection of EEG abnormalities in selected patients.