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Is it time for individualized testing in the electroencephalogram (EEG) laboratory?

J Theitler1,2, D Dassa1, I Gelernter3

  • 1Electroencephalography Laboratory, Assaf Harofeh Medical Center, Zerifin, Israel.

European Journal of Neurology
|June 15, 2016
PubMed
Summary

The time to the first interictal epileptiform discharge (IED) on an electroencephalogram (EEG) is shorter in standard EEGs and for inpatients. This finding suggests that EEG recording durations can be individualized, potentially optimizing resource use in busy laboratories.

Keywords:
interictal epileptiform dischargesleep-deprived EEGstandard EEG

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Area of Science:

  • Neurology
  • Clinical Neurophysiology

Background:

  • The interictal electroencephalogram (EEG) is crucial for epilepsy diagnosis and management.
  • Current recommendations for EEG recording length consume valuable laboratory resources.
  • Understanding the time to the first interictal epileptiform discharge (IED) can inform optimized EEG protocols.

Purpose of the Study:

  • To investigate the time to the first IED in both standard and sleep-deprived EEGs.
  • To analyze factors influencing IED latency, including EEG type and patient status.

Main Methods:

  • Retrospective review of 684 standard and sleep-deprived EEG recordings over a 2-year period.
  • Exclusion of bedside and long-term video-EEG recordings.
  • Analysis of IED latency using the Kaplan-Meier estimator, stratified by EEG type, age, and inpatient/outpatient status.

Main Results:

  • Ninety percent of IEDs occurred within 18.5 minutes.
  • IEDs appeared significantly earlier in standard EEGs (14.6 min) compared to sleep-deprived EEGs (21.3 min).
  • Inpatient EEGs showed earlier IEDs (14 min) than outpatient EEGs (21.3 min); age did not affect latency.

Conclusions:

  • EEG type and inpatient status are significant factors in determining the optimal duration for EEG recordings.
  • Consideration should be given to reducing EEG recording times, particularly for inpatients, to improve resource efficiency.