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Sensitivity of Compressed Spectral Arrays for Detecting Seizures in Acutely Ill Adults.
MedLine Citation:
PMID:  24052456     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Continuous EEG recordings (cEEGs) are increasingly used in evaluation of acutely ill adults. Pre-screening using compressed data formats, such as compressed spectral array (CSA), may accelerate EEG review. We tested whether screening with CSA can enable detection of seizures and other relevant patterns.
METHODS: Two individuals reviewed the CSA displays of 113 cEEGs. While blinded to the raw EEG data, they marked each visually homogeneous CSA segment. An independent experienced electroencephalographer reviewed the raw EEG within 60 s on either side of each mark and recorded any seizures (and isolated epileptiform discharges, periodic epileptiform discharges (PEDs), rhythmic delta activity (RDA), and focal or generalized slowing). Seizures were considered to have been detected if the CSA mark was within 60 s of the seizure. The electroencephalographer then determined the total number of seizures (and other critical findings) for each record by exhaustive, page-by-page review of the entire raw EEG.
RESULTS: Within each of the 39 cEEG recordings containing seizures, one CSA reviewer identified at least one seizure, while the second CSA reviewer identified 38/39 patients with seizures. The overall detection rate was 89.0 % of 1,190 total seizures. When present, an average of 87.9 % of seizures were detected per individual patient. Detection rates for other critical findings were as follows: epileptiform discharges, 94.0 %; PEDs, 100 %; RDA, 97.9 %; focal slowing, 100 %; and generalized slowing, 100 %.
CONCLUSIONS: CSA-guided review can support sensitive screening of critical pathological information in cEEG recordings. However, some patients with seizures may not be identified.
Authors:
Craig A Williamson; Sarah Wahlster; Mouhsin M Shafi; M Brandon Westover
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-9-20
Journal Detail:
Title:  Neurocritical care     Volume:  -     ISSN:  1556-0961     ISO Abbreviation:  Neurocrit Care     Publication Date:  2013 Sep 
Date Detail:
Created Date:  2013-9-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101156086     Medline TA:  Neurocrit Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Neurosurgery, University of Michigan Hospital, Ann Arbor, MI, USA, craigaw@med.umich.edu.
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