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

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

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