Predictive value of acute EEG measurements for seizures and epilepsy after stroke using a dry cap electrode EEG system — Study design and proof of concept

• Published in: Epilepsy & behavior 2020-03, Vol.104 (Pt B), p.106486-106486, Article 106486
• Main Authors: Doerrfuss, Jakob I., Kilic, Tayfun, Ahmadi, Michael, Weber, Joachim E., Holtkamp, Martin
• Format: Article
• Language: English
• Subjects: Adult; Cohort Studies; Dry cap EEG; EEG; Electrodes; Electroencephalography - instrumentation; Electroencephalography - methods; Epilepsy - diagnosis; Epilepsy - etiology; Epilepsy - physiopathology; Female; Humans; Male; Middle Aged; Poststroke epilepsy; Predictive Value of Tests; Proof of Concept Study; Prospective Studies; Research Design; Seizures; Seizures - diagnosis; Seizures - etiology; Seizures - physiopathology; Stroke; Stroke - complications; Stroke - diagnosis; Stroke - physiopathology; Surveys and Questionnaires
• ISSN: 1525-5050; 1525-5069
• DOI: 10.1016/j.yebeh.2019.106486

The development of seizures is a common complication in patients with stroke. A recent study suggests that electroencephalography (EEG) could be useful to predict the occurrence of seizures after stroke. However, EEG is not routinely performed in the follow-up after stroke. We present the design and proof of concept of a large prospective cohort study in which we seek to evaluate the predictive usefulness of a single dry cap EEG measurement in the acute phase after stroke or transient ischemic attack (TIA) with respect to the development of poststroke epilepsy (PSE). In patients with ischemic stroke (IS), TIA, or intracerebral hemorrhage (ICH), an acute EEG measurement using a dry cap electrode EEG (dEEG) system is performed within 7 days of symptom onset. Electroencephalography data will be analyzed quantitatively and qualitatively looking for background asymmetry, different band power ratios, and epileptiform activity. The development of seizures will be assessed repeatedly during the first 2 years after stroke or TIA using a validated questionnaire. Results from the pilot phase of 11 patients showed that the dry cap EEG measurements in patients with acute stroke and TIA are feasible. In comparison with conventional EEG, a higher proportion of noise and artifacts was detected. This article is part of the Special Issue “Seizure & Stroke” •The development of seizures and epilepsy is a common complication after stroke.•As of now, EEG measurements are not part of the regular diagnostics performed in most patients with stroke.•We present the design of a prospective study analyzing the predictive value of dry cap EEG measurements after stroke.