Screening electroencephalograms are feasible in the emergency department

Abstract

We investigated the feasibility and quality of a wireless, four-channel screening electroencephalogram (EEG) device on patients presenting to the emergency department (ED) with a possible seizure disorder. A convenience sample was used of ED patients presenting with a preliminary diagnosis of syncope, potential partial-complex or generalized seizure disorder, head injury with prolonged symptoms or acute undiagnosed altered mental status. Study patients had a screening EEG in the ED, but the emergency physician and patient were blinded to the results of the EEG so that neither patient care nor disposition were affected by inclusion in the study. A total of 227 patients were enrolled, with a mean age of 56 years. EEG quality was acceptable, i.e. a screening interpretation was able to be provided, in 208 of 227 cases (92%). The EEG interpretation was normal in 65%, identified generalized or focal slowing in 24% and identified sub-clinical epileptiform activity in 12% of patients. Screening EEGs performed in the ED are feasible, can be acquired with acceptable quality, and may identify sub-clinical seizure activity in a significant number of patients.