Document Detail

The role of EEG in patients with syncope.
MedLine Citation:
PMID:  22353986     Owner:  NLM     Status:  MEDLINE    
EEG is a popular, low-cost examination used in neurologic and nonneurologic evaluations. Nevertheless, the diagnostic usefulness of EEG has some limitations, and it may increase medical costs. The manifestations of syncope may lead to misdiagnoses, and frequently, it is mislabeled as epilepsy. An EEG is usually obtained, yet some studies have suggested that EEGs have little value in diagnosing this condition. We aimed to determine the diagnostic usefulness of EEG in patients with syncope. We retrospectively examined EEG recordings of 10,408 patients. EEG findings were evaluated for all patients with a diagnosis of syncope (syncope, convulsive syncope, loss of consciousness, or sudden unexplained falls), including requests from neurologists and nonneurologists. EEGs were classified into (1) normal, (2) epileptiform discharges (spike/sharp waves), and (3) slow waves. The EEGs were separated according to gender and age. From 1,003 patients with the diagnosis of syncope, 899 (89.53%) were normal, 62 (6.18%) showed bilateral slow waves, 19 (1.89%) right slow waves, 18 (1.79%) epileptiform discharges, and 6 (0.6%) left slow waves. Epileptiform discharges only occurred among females. Left focal sharp waves were disclosed in 18 (50%), generalized discharges in 8 (44.4%), and right focal discharges in 1 (5.6%). Bilateral slow waves were more prevalent among adults. We conclude that EEG is not useful for evaluating the diagnosis of syncope because of its very low diagnostic yield. Patients with syncope must have a correct history and physical examination plus cardiovascular tests.
Fábio Galvão Dantas; André Pinto Cavalcanti; Bruno Diego Rodrigues Maciel; Clarissa Dantas Ribeiro; Gabriella Carvalho Napy Charara; Johnnatas Mikael Lopes; Paulo Fernando Martins Filho; Luiz Ataíde Júnior
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society     Volume:  29     ISSN:  1537-1603     ISO Abbreviation:  J Clin Neurophysiol     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-02-22     Completed Date:  2012-06-18     Revised Date:  2012-11-29    
Medline Journal Info:
Nlm Unique ID:  8506708     Medline TA:  J Clin Neurophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  55-7     Citation Subset:  IM    
Department of Physiotherapy, State University of Paraiba.
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MeSH Terms
Aged, 80 and over
Brain / physiopathology*
Child, Preschool
Diagnostic Errors
Epilepsy / diagnosis*,  physiopathology
Middle Aged
Retrospective Studies
Sex Factors
Syncope / diagnosis*,  physiopathology
Comment In:
J Clin Neurophysiol. 2012 Aug;29(4):353, author reply 353   [PMID:  22854771 ]
J Clin Neurophysiol. 2012 Oct;29(5):477   [PMID:  23027107 ]

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