Cross Section of Stat (Emergent) EEG Use. Who Orders Them? What Do We Find? What Indications Best Predict Finding Seizures?

Stat electroencephalograms (sEEG) recorded over a one year period were analyzed to determine the rate of seizure or status epilepticus (SE) detection and the best predictors based on: ordering physician, clinical indication for study, and clinical history. All consecutive sEEG reports done over a ye...

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Bibliographic Details
Published in:The Neurodiagnostic journal 2012-09, Vol.52 (3), p.281-290
Main Authors: Teleb, Mohamed S., Lee, Susan W., Crepeau, Amy Z., Chang, Jason, Wu, Tzu Ching, Chappie, Kristina, Chung, Steve, Maganti, Rama
Format: Article
Language:English
Subjects:
Arizona - epidemiology
Convulsive status epilepticus
Electroencephalography - statistics & numerical data
Emergency Medical Services - utilization
emergent EEG
Epilepsy - diagnosis
Epilepsy - epidemiology
Female
Humans
Male
non-convulsive seizures
nonconvulsive status epilepticus
Prevalence
Referral and Consultation - utilization
stat EEG
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Description
Summary:Stat electroencephalograms (sEEG) recorded over a one year period were analyzed to determine the rate of seizure or status epilepticus (SE) detection and the best predictors based on: ordering physician, clinical indication for study, and clinical history. All consecutive sEEG reports done over a year period at our institution were retrospectively reviewed. The following data were evaluated: sEEG findings, clinical history, clinical indication for study, requesting physician, location of patient, and demographics. Univariate analysis followed by a multivariate regression model analysis was performed. Of the 3,471 inpatient EEGs performed during the review period, 778 (22.4%) were sEEGs. 3.5% (n=27) nonconvulsive status epilepticus (NCSE), 0.4% (n=3) convulsive status epilepticus (CSE), and 1.1% (n=9) had discrete electro graphic seizures giving a total yield of 5.0% (39/778) patients with seizures or SE. A multivariate logistic retrospective model looking at ordering physician, clinical indication, and clinical history found that only clinical indications (overt continuous seizures/movements and witnessed seizure without return to baseline) were significant in the overall model. In our tertiary care institution sample, the rate of detecting status epilepticus or seizures among sEEG is low compared to prior studies. The best clinical predictors of finding SE or discrete seizures were overt continuous seizures/movements or witnessed seizure without return to baseline.
ISSN:2164-6821
2375-8627
DOI:10.1080/21646821.2012.11079863