Sensitivity of detecting interictal epileptiform activity using rapid reduced montage EEG

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Journal of the Neurological Sciences Pub Date : 2024-10-23 DOI:10.1016/j.jns.2024.123277

Brin E. Freund , Mariam Tsikvadze , Anteneh M. Feyissa , William D. Freeman , William O. Tatum IV

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引用次数: 0

Abstract

Objective

Rapid EEG devices (REDs) have demonstrated substantial benefit regarding reduced time to performance of study and diagnosis in cases where urgent EEG is needed to evaluate patients for potentially revealing nonconvulsive status epilepticus and seizures. However, urgent EEG is also important in identifying cases regarding the need for initiation of antiseizure medication as well as triaging the use of continuous EEG monitoring. Some forms of REDs have a reduced montage (RRME) with electrode derivations that are one-half of standard recordings. This could impact spatial resolution and therefore potentially limit recovery of epileptiform abnormalities.

Methods

In this study we evaluated the use of the Ceribell® rapid response EEG system and compared it to conventional video EEG (CvEEG). After applying inclusion and exclusion criteria, a total of 20 subjects were included in our analysis.

Results

RRME was highly sensitive in detecting abundant and periodic discharges (p = 0.013) as well as discharges with a broad spatial distribution on CvEEG (p = 0.039). Sensitivity for detecting less prevalent discharges or those with more restricted spatial distribution was lower.

Significance

Given the possibility of less frequent and more restricted epileptiform discharges eluding detection on RRME, we propose a protocol for the approach of using RRME and when to consider CvEEG when RRME is negative for epileptiform activity and highlight that urgent CvEEG may still be warranted following RRME.

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利用快速缩减蒙太奇脑电图检测发作间期癫痫样活动的灵敏度。

目的：快速脑电图设备（RED）在缩短研究和诊断时间方面已显示出巨大的优势，在需要进行紧急脑电图检查以评估患者是否可能出现非惊厥性癫痫状态和癫痫发作的情况下，可缩短研究和诊断时间。然而，紧急脑电图对于确定是否需要开始服用抗癫痫药物以及分流使用连续脑电图监测也很重要。某些形式的 RED 具有缩小的蒙太奇（RRME），其电极衍生为标准记录的二分之一。这可能会影响空间分辨率，从而可能限制癫痫样异常的恢复：在这项研究中，我们评估了 Ceribell® 快速反应脑电图系统的使用情况，并将其与传统视频脑电图（CvEEG）进行了比较。在应用了纳入和排除标准后，共有 20 名受试者纳入了我们的分析：结果：RRME 在检测大量和周期性放电（p = 0.013）以及 CvEEG 上具有广泛空间分布的放电（p = 0.039）方面具有很高的灵敏度。而检测较少发生的放电或空间分布较窄的放电的灵敏度较低：考虑到 RRME 可能无法检测到频率较低和空间分布较局限的癫痫样放电，我们提出了使用 RRME 的方法以及当 RRME 检测到癫痫样活动呈阴性时何时考虑 CvEEG 的方案，并强调在 RRME 之后仍有必要紧急进行 CvEEG 检测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the Neurological Sciences 医学-临床神经学

CiteScore

7.60

自引率

2.30%

发文量

313

审稿时长

22 days

期刊介绍： The Journal of the Neurological Sciences provides a medium for the prompt publication of original articles in neurology and neuroscience from around the world. JNS places special emphasis on articles that: 1) provide guidance to clinicians around the world (Best Practices, Global Neurology); 2) report cutting-edge science related to neurology (Basic and Translational Sciences); 3) educate readers about relevant and practical clinical outcomes in neurology (Outcomes Research); and 4) summarize or editorialize the current state of the literature (Reviews, Commentaries, and Editorials). JNS accepts most types of manuscripts for consideration including original research papers, short communications, reviews, book reviews, letters to the Editor, opinions and editorials. Topics considered will be from neurology-related fields that are of interest to practicing physicians around the world. Examples include neuromuscular diseases, demyelination, atrophies, dementia, neoplasms, infections, epilepsies, disturbances of consciousness, stroke and cerebral circulation, growth and development, plasticity and intermediary metabolism.