Neurophysiology Referral Form (EEG) and Melatonin Guidance (EEG Usage)

Background

Sometimes melatonin is needed to help children go to sleep, so we can capture part of the EEG when asleep and part of it when awake, which helps us with diagnosing and our assessment.

Protocol for Melatonin Sleep EEG

Melatonin is prescribed and organised through the neurophysiology department, which will contact the parent in advance about the protocol.

Melatonin is prescribed using standard AGE-related (rather than weight-related) doses as follows:

• 2.5mg-5mg for under 5's.
• 5mg-10mg for over 5's.
• 10mg for over 10's.
• The prescribing clinician should prescribe two doses of melatonin, in case one dose is not enough.
• No fasting is required before administration of melatonin.
• Melatonin is administered to the patient by the parent/guardian 30 minutes before the appointment time.
• On arrival at the EEG department clinical physiologist checks the time melatonin was taken and the dose given, then applies electrodes and ensures the patient is comfortable.
• Lighting is dimmed, and the "silence" sign is displayed prominently in the waiting area. The receptionist is instructed to maintain a peaceful atmosphere in the department.
• The patient is allowed to sleep for a minimum of 30 minutes, with some awake EEG included at the end of the recording.
• If the patient has not fallen asleep within 30 minutes of electrode application, the parent/guardian may administer a second dose of melatonin if deemed appropriate.
• If, after having had a second dose of melatonin, the patient does not fall asleep within 30 minutes, the recording should be terminated.

Contact

• Address: Department of Clinical Neurophysiology, Royal Free London, NHS Foundation Trust,
  Pond Street, London, NW3 2QG.
• Tel: 020 7830 2072 or 020 7794 0500.
• Internal extension 33255/33256.

Can be booked on EPR - In the "neurophysiology folder" on the requests tab.