Benefits of Routine Inpatient EEG in Practice: Experience from a Level 4 University Hospital

Purpose: Routine inpatient EEGs have been part of epilepsy practices for years. We aim to improve current routine EEG practices by studying their role at a large university hospital. Methods: Inpatient routine EEGs from January-July 2021 were included and patients <5 yrs., EEGs repeated on the same patient were excluded. Indications, floor status, abnormality, day of study, neurology consultation, results, treatment changes, discharge status, and prior AED use were analyzed using SAS 9.4. Results: The mean age for 250 patients was 57.27 yrs., where 54.22% were males and 45.78% were females. Indications listed were 26.5% altered mental status, 59.83% seizures, and 13.65% others. 87.36% of ICU patients had abnormal EEG vs 73.75% of floor patients. A significant association (p=0.0147) was found between floor status and EEG results. Abnormalities were 44% generalized slowing, 23.6% focal slowing, 9.2% epileptiform activity, and 23.2% others. Treatment was changed in 21.03% with abnormal vs 5.56% with normal EEG. AEDs were added in 18.46% with abnormal vs 3.7% with normal EEG. A significant association (p=0.014) was found between Neurology consultation and treatment change and with AED addition respectively. EEG result was associated with treatment change and AED addition. “Abnormal EEG” was significantly associated with further study. A significant association (p=0.0351) was found between EEG results and discharge status. 53.82% of patients were not on AED before EEG vs 46.18%. Prior AED had no association with EEG results. Conclusions: It is helpful to consult Neurology. Longer duration of routine EEGs may not show abnormalities. Routine EEG facilitates discharges and guides further workup.