Predictors of seizure detection and EEG clinical impact in an italian tertiary emergency department

Background and objectives Epileptic seizures pose challenges in emergency departments (ED), affecting up to 10% of admitted patients. This study aimed to assess emergency electroencephalogram (EmEEG) utilization, identifying factors predicting seizure detection and its influence on clinical decision...

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Bibliographic Details
Published in:Journal of neurology 2024-08, Vol.271 (8), p.5137-5145
Main Authors: Bellini, Anna, Curti, Davide Gusmeo, Cursi, Marco, Cecchetti, Giordano, Agosta, Federica, Fanelli, Giovanna F., Filippi, Massimo
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Convulsions & seizures
EEG
Electroencephalography
Electroencephalography - methods
Emergency medical care
Emergency Service, Hospital
Epilepsy
Female
Humans
Italy
Male
Medical imaging
Medicine
Medicine & Public Health
Middle Aged
Neuroimaging
Neurology
Neuroradiology
Neurosciences
Neurosurgery
Original Communication
Patients
Regression analysis
Retrospective Studies
Seizures
Seizures - diagnosis
Seizures - physiopathology
Statistical analysis
Statistical models
Status Epilepticus - diagnosis
Status Epilepticus - physiopathology
Tertiary Care Centers
Young Adult
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Summary:Background and objectives Epileptic seizures pose challenges in emergency departments (ED), affecting up to 10% of admitted patients. This study aimed to assess emergency electroencephalogram (EmEEG) utilization, identifying factors predicting seizure detection and its influence on clinical decisions. Methods A retrospective review of 1135 EmEEGs on 1017 patients at a tertiary teaching hospital between June 2022 and June 2023 was conducted. Data included demographics, medical history, EmEEG indications, neuroimaging findings, and clinical outcomes. Statistical analyses utilized Fisher’s exact tests and logistic regression models. Results EmEEG detected status epilepticus-related seizures in 5.40% of cases, seizures without status epilepticus in 3.05%, and status epilepticus without discrete seizures in 3.74%. Epileptiform abnormalities were noted in 22.12% of EmEEGs. EmEEG influenced initial diagnoses (21.24%), antiseizure medication changes (20.85%), and discharge decisions (39.04%). Predictors for seizures/status epilepticus included previous neurosurgery, seizures in the ED, and cognitive/behavioral impairment (p 
ISSN:0340-5354
1432-1459
1432-1459
DOI:10.1007/s00415-024-12464-4