Dataset Information

Hidden cases of epilepsy in cognitive impairment clinics: Exploring the use of a portable device for simplified electroencephalography testing.

ABSTRACT: Late-onset epilepsy, particularly focal impaired awareness seizures, often present without convulsions and can cause memory impairment. This can lead patients to initially seek consultation at memory clinics, potentially delaying referral to epilepsy specialists. We report on three patients, aged 40s to 70s, admitted for cognitive evaluation who were finally diagnosed with epileptic seizures as the underlying cause of their symptoms. Notably, all initially presented to local clinics with symptoms suggesting cognitive impairment. Despite initial diagnostic uncertainty, all patients exhibited epileptic activity on electroencephalography (EEG) and responded positively to antiepileptic drugs, suggesting epileptic mechanisms were involved in their symptoms. Both traditional clinical EEG systems and newly developed, one-minute portable EEG devices were used in their evaluations. The portable device, medically approved in Japan, successfully captured sharp-waves like activities with the same durations, amplitudes, and shapes as traditional devices. This highlights its potential to improve epilepsy diagnosis and future screening due to its portability and ease of use. Implementing portable EEG devices could promote timely and appropriate treatment, preventing misdiagnosis of neurological conditions.

SUBMITTER: Hata M

PROVIDER: S-EPMC11342905 | biostudies-literature | 2024

REPOSITORIES: biostudies-literature

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Hidden cases of epilepsy in cognitive impairment clinics: Exploring the use of a portable device for simplified electroencephalography testing.

Hata Masahiro M Satake Yuto Y Miyazaki Yuki Y Omori Hisaki H Hirashima Atsuya A Kanemoto Hideki H Yoshiyama Kenji K Takahashi Shun S Ikeda Manabu M

Epilepsy & behavior reports 20240728

Late-onset epilepsy, particularly focal impaired awareness seizures, often present without convulsions and can cause memory impairment. This can lead patients to initially seek consultation at memory clinics, potentially delaying referral to epilepsy specialists. We report on three patients, aged 40s to 70s, admitted for cognitive evaluation who were finally diagnosed with epileptic seizures as the underlying cause of their symptoms. Notably, all initially presented to local clinics with symptom ...[more]

PMID: 39184193

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Project description:Electroencephalography (EEG) is one of the main tools for diagnosis and prognostication of encephalopathy. Our two objectives were to assess: 1) the reliability of intensivists' interpretations (one trained intensivist and nonexpert intensivists) on specific EEG patterns and 2) the feasibility of performing simplified EEG by a trained intensivist in ICU.DesignProspective, single-center study.SettingOne French tertiary-care center.PatientsThirty-six consecutive ICU patients with encephalopathy.InterventionA trained intensivist (1-year specific electrophysiologic course) recorded and interpreted EEGs using a 10 monopod montage at bedside. Then, 22 nonexpert intensivists underwent a 1-hour educational session on interpretation of EEG background (activity, continuity, and reactivity) and common patterns seen in ICU. Trained and nonexpert intensivists' interpretation of EEG recordings was evaluated and compared with an expert neurophysiologist's interpretation (gold standard). The agreement between the two interpretations was evaluated. Second, the duration of the entire EEG procedure (specifically EEG installation) at bedside was recorded.Measurements and main resultsAgreements and reliability between the trained intensivist and the neurophysiologist were acceptable for minimal (agreement, 94%; Pearson coefficient, 0.60) and maximal (89%, 0.89) background frequency, burst suppression (agreement, 100%; Kappa coefficient, 1), background continuity (83%, 0.59), and reactivity to auditory stimulus (78%, 0.44). Agreements between the 22 nonexpert intensivists and the neurophysiologist were heterogeneous. As a result, 87% of the 22 nonexpert intensivists obtained an acceptable reliability for the minimum background frequency, 95% for the maximum background frequency, and 73% and 95% for burst suppression and isoelectric background identification, respectively. The median duration of the entire EEG procedure was 47 minutes (43-53 min), including 22 minutes (20-28 min) of EEG installation.ConclusionsIntensivists can rapidly learn background activity and identify burst-suppression and isoelectric background. However, more educational sessions are required for interpretation of other EEG patterns frequently observed in the ICU setting.

Dataset Information

Hidden cases of epilepsy in cognitive impairment clinics: Exploring the use of a portable device for simplified electroencephalography testing.

Publications

Hidden cases of epilepsy in cognitive impairment clinics: Exploring the use of a portable device for simplified electroencephalography testing.

Similar Datasets

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