Point-of-Care Electroencephalography for Seizure Detection: Comparison of Electrode Placement in Two-Channel Electroencephalography

IF 2.1 3区医学 Q2 CLINICAL NEUROLOGY

Pediatric neurology Pub Date : 2025-07-12 DOI:10.1016/j.pediatrneurol.2025.07.005

Chantal Gammenthaler-Zaugg MD , Tatiani Soultana Ilia MM , Robin Münger MM , Andrea Seiler MD , Regula Everts-Brekenfeld PhD , Iciar Sanchez-Albisua PD

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Abstract

Background

The use of few-electrode electroencephalography (EEG) for seizure detection in pediatric emergency departments is developing rapidly and is emerging to an important point-of-care bedside test. The aim of this study was to investigate if frontotemporal (FT) electrode placement (F7-T5 and F8-T6) is superior to the usual centroparietal (CP) electrode placement (C3-P3 and C4-P4) in seizure detection, when point-of-care two-channel EEG (tcEEG) is applied.

Method

We reviewed a sample of 38 prerecorded long-term EEGs (gold standard, international 10-20 EEG system) with prior detected electrographic epileptic seizures in children (38 participants, median age, 10.11 years). The EEG parameters were retrospectively converted into two tcEEGs (F7-T5 and F8-T6 vs C3-P3 and C4-P4) and were independently analyzed by two epileptologists who were unaware of the gold-standard EEG findings.

Results

Our primary outcome showed that there was no significant difference in seizure detection in FT electrode placement compared with CP placement (sensitivity 69.9% vs 72.9%). Furthermore, we found significantly higher false-positive rates with FT electrode placement in samples with high interictal spike frequency. CP electrode placement showed significantly lower false-negative rates for seizures with bilateral onset and seizures without side difference during propagation. No significant correlation of FT and CP electrode placement was found with other EEG parameters.

Conclusions

FT or CP tcEEG electrode placement does not differ in seizure detection. Both reduced electrode montages can be used with similar sensitivities for point-of-care EEG bedside testing in pediatric emergency settings. However, the CP electrode placement shows minor advantages compared with FT electrode placement.

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即时脑电图检测癫痫发作：双通道脑电图中电极放置的比较

背景：在儿科急诊科使用少电极脑电图（EEG）检测癫痫发作正在迅速发展，并正在成为重要的护理点床边试验。本研究的目的是探讨当使用即时护理双通道脑电图（tcEEG）时，额颞叶（FT）电极放置（F7-T5和F8-T6）在癫痫检测方面是否优于通常的中央顶叶（CP）电极放置（C3-P3和C4-P4）。方法回顾性分析了38例预先记录的长期脑电图（金标准，国际10-20脑电图系统）的样本，这些样本先前检测到电性癫痫发作（38例参与者，中位年龄10.11岁）。回顾性地将EEG参数转换为两个tceeeg (F7-T5和F8-T6 vs C3-P3和C4-P4)，并由两名不知道金标准EEG结果的癫痫学家独立分析。结果我们的主要结果显示，与CP放置相比，FT电极放置对癫痫发作的检测无显著差异（灵敏度69.9% vs 72.9%）。此外，我们发现在间隔尖峰频率高的样品中，FT电极放置的假阳性率显着提高。CP电极放置在双侧癫痫发作和无侧位差异的癫痫发作中，假阴性率明显降低。FT和CP电极放置与其他EEG参数无显著相关性。结论ft电极与CP电极对癫痫发作的检测效果无显著差异。两种减少电极蒙太奇可以使用相似的灵敏度点护理脑电图床边测试在儿科急诊设置。然而，与FT电极放置相比，CP电极放置显示出较小的优势。

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

Pediatric neurology 医学-临床神经学

CiteScore

4.80

自引率

2.60%

发文量

176

审稿时长

78 days

期刊介绍： Pediatric Neurology publishes timely peer-reviewed clinical and research articles covering all aspects of the developing nervous system. Pediatric Neurology features up-to-the-minute publication of the latest advances in the diagnosis, management, and treatment of pediatric neurologic disorders. The journal''s editor, E. Steve Roach, in conjunction with the team of Associate Editors, heads an internationally recognized editorial board, ensuring the most authoritative and extensive coverage of the field. Among the topics covered are: epilepsy, mitochondrial diseases, congenital malformations, chromosomopathies, peripheral neuropathies, perinatal and childhood stroke, cerebral palsy, as well as other diseases affecting the developing nervous system.