Featured Research

from universities, journals, and other organizations

Electroencephalography (EEG) underused investigative tool in hospitals, study finds

Date:
April 1, 2013
Source:
Elsevier
Summary:
A retrospective study of patients who had in-hospital electroencephalography (EEG) has established that EEG is a valuable tool that could be deployed more widely to identify treatable causes of impaired consciousness in the hospital setting.

A retrospective study of patients who had in-hospital electroencephalography (EEG) has established that EEG is a valuable tool that could be deployed more widely to identify treatable causes of impaired consciousness in the hospital setting.

The study is published in the April issue of the Mayo Clinic Proceedings.

Altered mental status (AMS) and paroxysmal spells of uncertain origin are common among hospitalized patients. Impaired consciousness can sometimes be linked to metabolic or cardiac causes, but some of these spells may represent seizures or non-convulsive epilepsy, which can be detected only by electroencephalography (EEG). Although EEG is the key test in making these diagnoses, it is relatively underused in the inpatient setting owing to lack of availability and neurologic consultation at many hospitals in the United States.

In a unique analysis of non-intubated patients in a general hospital setting investigators from the Department of Neurology, University of California at San Francisco, studied hospital patients 18 years and older who had inpatient EEG for an indication of spells or altered mental status during a six-year period from January 2005. Their aim was to determine the frequency of seizures and markers of epilepsy-like activity detected by EEG.

The EEGs and reports were reviewed for ictal activity (electrographic seizures), interictal epileptiform abnormalities (abnormal EEG activity not associated with a clinical seizure), and nonepileptiform abnormalities (not specific to a particular cause).

Demographic and clinical data were gathered from electronic medical records to determine seizure predictors. Of the 1048 patients reviewed, nearly 80% had an abnormal EEG finding, with the most common abnormality being diffuse slowing, seen in 706 patients (67.4%). Seizures (ranging from a single seizure to status epilepticus) were noted in 78 patients (7.4%). Markers of seizure potential were found in 194 patients (18.5%). Epileptiform discharges were found in 130 of the 970 patients (13.4%) in whom no electrographic seizures were recorded, a finding that indicates that these patients are at increased risk for seizures.

"The present findings underscore the relatively high frequency of seizures in non-critical hospitalized patients with spells or AMS, a finding that has seemingly been underappreciated by neurologists and non-neurologists alike," observed lead investigator John P. Betjemann, MD, Assistant Clinical Professor, UCSF School of Medicine. "Because ictal disorders are treatable, having a relatively low threshold to obtain an EEG may be critical," he said.

EEG is a resource-intensive test so investigators also sought to identify clinical variables that are associated with positive EEG findings to help physicians determine when this test should be ordered and to guide health care systems regarding the need for EEG availability.

However many hospitals do not have access to EEG technology. "One major barrier involves a lack of trained technologists and epileptologists to perform and interpret extended (24-hour) EEG studies.…This study demonstrates that hospitals with limited resources can perform relatively brief EEGs (1-6 hours) and still identify most seizures in these non-critically ill patients," Betjemann concluded.

In an accompanying editorial William O. Tatum, DO, Mayo Clinic, Jacksonville, FL, and Joseph I. Sirven, MD, Mayo Clinic, Scottsdale, AZ, comment, "…the importance of the article by Betjemann et al lies in offering outcome measures using EEG in the general hospital setting. This type of information will affect care from neurologists and neurohospitalists by helping them design evidence-based monitoring and treatment protocols….The precise value of continuous EEG-facilitated diagnosis (eg, seizure detection coupled with treatment), and the resulting improvements in patient outcomes, indeed suggests that cEEG can provide a valuable 'window to the brain' for neurologically ill patients."


Story Source:

The above story is based on materials provided by Elsevier. Note: Materials may be edited for content and length.


Journal References:

  1. John P. Betjemann, Ivy Nguyen, Carlos Santos-Sanchez, Vanja C. Douglas, S. Andrew Josephson. Diagnostic Yield of Electroencephalography in a General Inpatient Population. Mayo Clinic Proceedings, 2013; 88 (4): 326 DOI: 10.1016/j.mayocp.2012.12.013
  2. William O. Tatum, Joseph I. Sirven. Does Electroencephalography Provide a “Window to the Brain” for the Neurologically Ill? Mayo Clinic Proceedings, 2013; 88 (4): 312 DOI: 10.1016/j.mayocp.2013.02.002

Cite This Page:

Elsevier. "Electroencephalography (EEG) underused investigative tool in hospitals, study finds." ScienceDaily. ScienceDaily, 1 April 2013. <www.sciencedaily.com/releases/2013/04/130401131849.htm>.
Elsevier. (2013, April 1). Electroencephalography (EEG) underused investigative tool in hospitals, study finds. ScienceDaily. Retrieved April 20, 2014 from www.sciencedaily.com/releases/2013/04/130401131849.htm
Elsevier. "Electroencephalography (EEG) underused investigative tool in hospitals, study finds." ScienceDaily. www.sciencedaily.com/releases/2013/04/130401131849.htm (accessed April 20, 2014).

Share This



More Health & Medicine News

Sunday, April 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Nine-Month-Old Baby Can't Open His Mouth

Nine-Month-Old Baby Can't Open His Mouth

Newsy (Apr. 19, 2014) Nine-month-old Wyatt Scott was born with a rare disorder called congenital trismus, which prevents him from opening his mouth. Video provided by Newsy
Powered by NewsLook.com
'Holy Grail' Of Weight Loss? New Find Could Be It

'Holy Grail' Of Weight Loss? New Find Could Be It

Newsy (Apr. 18, 2014) In a potential breakthrough for future obesity treatments, scientists have used MRI scans to pinpoint brown fat in a living adult for the first time. Video provided by Newsy
Powered by NewsLook.com
Little Progress Made In Fighting Food Poisoning, CDC Says

Little Progress Made In Fighting Food Poisoning, CDC Says

Newsy (Apr. 18, 2014) A new report shows rates of two foodborne infections increased in the U.S. in recent years, while salmonella actually dropped 9 percent. Video provided by Newsy
Powered by NewsLook.com
Scientists Create Stem Cells From Adult Skin Cells

Scientists Create Stem Cells From Adult Skin Cells

Newsy (Apr. 17, 2014) The breakthrough could mean a cure for some serious diseases and even the possibility of human cloning, but it's all still a way off. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins