Navigation Links
Electroencephalography underused investigative tool in hospitals
Date:4/1/2013

Rochester, MN, April 1, 2013 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."


'/>"/>

Contact: Rachael Zaleski
mcpmedia@elsevier.com
215-239-3658
Elsevier Health Sciences
Source:Eurekalert

Related medicine news :

1. Coronary rehabilitation programs in Europe are underused
2. Higher-spending hospitals have fewer deaths for emergency patients
3. Heart Attack Survival Varies Widely Among Hospitals, Study Finds
4. In Some Brain Bleeds, Patients Do Better at High-Volume Hospitals
5. Fewer prostate cancer surgery complications found in teaching hospitals with fellowship programs
6. Urban Hospitals May Act as Breeding Ground for MRSA
7. University Hospitals Case Medical Center experts present at ASCO Annual Meeting
8. Under pressure from Medicare, hospitals hold more seniors for observation
9. Ethics should drive health policy reform, especially with physician-owned specialty hospitals
10. Hospitals communication during residency matching may put stress on OB-GYN doctors-in-training
11. Becker's Hospital Review Shares 50 Top Grossing Hospitals in the Country
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:12/2/2016)... CO (PRWEB) , ... December 02, 2016 , ... Advanced ... announced it has appointed Jason Bice, CPA, MBA to serve as Advanced Inc.’s Chief ... for Advanced, Inc. , Jason brings extensive financial and operational leadership experience to ...
(Date:12/2/2016)... ... 2016 , ... The annual time frame to change Medicare health and prescription ... December 7th. Currently-enrolled Medicare beneficiaries who are looking to switch from their current plan ... to make changes during this period order for their new policy to go into ...
(Date:12/2/2016)... ... December 02, 2016 , ... ... two ostomy patients, standing as living proof that attitude and determination can combine ... and issues that spike around the holidays. This campaign will offer patients a ...
(Date:12/2/2016)... ... December 02, 2016 , ... Mediaplanet ... in USA Today, which covers the innovative treatments, therapeutic technologies, and revolutionized nutrition ... lives. “We are prolonging life 6 years in the last 3 decades,” says ...
(Date:12/2/2016)... OH (PRWEB) , ... December 02, 2016 , ... ... of veterinarian diagnostic imaging systems and the first company to offer ... With a Heart at their tradeshow booth # 941 for the American Association ...
Breaking Medicine News(10 mins):
(Date:12/2/2016)... -- The concept of rare diseases and the idea that ... has been taking shape in Europe ... initiatives related to orphan medicinal products have been emerging at ... states individually. Many member states in the EU have led ... medicinal products, the result of which took the shape of ...
(Date:12/2/2016)... -- Around the corners of world, cancer has infused ... present over earth. Cancer has become one of those ... time this is because of the increasing incidence rates ... steady increase in global cancer incidence with its associated ... of treatment, there is increasing interest in this stringent ...
(Date:12/2/2016)... 2, 2016 bioLytical Laboratories (das "Unternehmen"), ein Weltführer ... seinen  INSTI HIV-Selbsttests  in einer Version mit geringeren Kosten einzuführen.  ... ... New: INSTI Self Test! (PRNewsFoto/bioLytical Laboratories) ...      (Photo: http://photos.prnewswire.com/prnh/20161201/444833 ) ...
Breaking Medicine Technology: