Document Detail


Seizure identification in the ICU using quantitative EEG displays.
MedLine Citation:
PMID:  20861452     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the diagnostic accuracy of 2 quantitative EEG display tools, color density spectral array (CDSA) and amplitude-integrated EEG (aEEG), for seizure identification in the intensive care unit (ICU).
METHODS: A set of 27 continuous EEG recordings performed in pediatric ICU patients was transformed into 8-channel CDSA and aEEG displays. Three neurophysiologists underwent 2 hours of training to identify seizures using these techniques. They were then individually presented with a series of CDSA and aEEG displays, blinded to the raw EEG, and asked to mark any events suspected to be seizures. Their performance was compared to seizures identified on the underlying conventional EEG.
RESULTS: The 27 EEG recordings contained 553 discrete seizures over 487 hours. The median sensitivity for seizure identification across all recordings was 83.3% using CDSA and 81.5% using aEEG. However, among individual recordings, the sensitivity ranged from 0% to 100%. Factors reducing the sensitivity included low-amplitude, short, and focal seizures. False-positive rates were generally very low, with misidentified seizures occurring once every 17-20 hours.
CONCLUSIONS: Both CDSA and aEEG demonstrate acceptable sensitivity and false-positive rates for seizure identification among critically ill children. Accuracy of these tools would likely improve during clinical use, when findings can be correlated in real-time with the underlying raw EEG. In the hands of neurophysiologists, CDSA and aEEG displays represent useful screening tools for seizures during continuous EEG monitoring in the ICU. The suitability of these tools for bedside use by ICU nurses and physicians requires further study.
Authors:
C P Stewart; H Otsubo; A Ochi; R Sharma; J S Hutchison; C D Hahn
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural     Date:  2010-09-22
Journal Detail:
Title:  Neurology     Volume:  75     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-26     Completed Date:  2010-11-12     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1501-8     Citation Subset:  AIM; IM    
Affiliation:
Division of Neurology, The Hospital for Sick Children, Toronto, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Child
Child, Preschool
Color
Electroencephalography*
False Positive Reactions
Female
Fourier Analysis
Humans
Infant
Intensive Care Units, Pediatric*
Male
Seizures / diagnosis*
Sensitivity and Specificity
Signal Processing, Computer-Assisted* / instrumentation
Spectrum Analysis
Grant Support
ID/Acronym/Agency:
1U01HL094345-01/HL/NHLBI NIH HHS
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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