Routine vs extended outpatient EEG for the detection of interictal epileptiform discharges

David B. Burkholder, Jeffrey W. Britton, Vijayalakshmi Rajasekaran, Rachel R. Fabris, Perumpillichira J. Cherian, Kristen M. Kelly-Williams, Elson L. So, Katherine C Nickels, Lily Wong-Kisiel, Terrence D. Lagerlund, Gregory D Cascino, Gregory Alan Worrell, Elaine C Wirrell

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objective: To compare the yield of epileptiform abnormalities on 30-minute recordings with those greater than 45 minutes. Methods: We performed a prospective observational cross-sectional study of all outpatient routine EEGs comparing the rate of interictal epileptiform discharges (IEDs) and clinical events during the initial 30 minutes (routine) with those occurring in the remaining 30-60 minutes (extended). A relative increase of 10% was considered clinically significant. Results: EEGs from 1,803 patients were included; overall EEG duration was 59.4 minutes (SD ±6.5). Of 426 patients with IEDs at any time during the EEG, 81 (19.1%, 95% confidence interval 15.6-23) occurred only after the initial 30 minutes. The rate of late IEDs was not associated with age, indication, IED type, or sleep deprivation. Longer recording times also increased event capture rate by approximately 30%. Conclusions: The yield of IED and event detection is increased in extended outpatient EEGs compared to 30-minute studies.

Original languageEnglish (US)
Pages (from-to)1524-1530
Number of pages7
JournalNeurology
Volume86
Issue number16
DOIs
StatePublished - Apr 19 2016

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Electroencephalography
Outpatients
Sleep Deprivation
Cross-Sectional Studies
Confidence Intervals

ASJC Scopus subject areas

  • Clinical Neurology

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Burkholder, D. B., Britton, J. W., Rajasekaran, V., Fabris, R. R., Cherian, P. J., Kelly-Williams, K. M., ... Wirrell, E. C. (2016). Routine vs extended outpatient EEG for the detection of interictal epileptiform discharges. Neurology, 86(16), 1524-1530. https://doi.org/10.1212/WNL.0000000000002592

Routine vs extended outpatient EEG for the detection of interictal epileptiform discharges. / Burkholder, David B.; Britton, Jeffrey W.; Rajasekaran, Vijayalakshmi; Fabris, Rachel R.; Cherian, Perumpillichira J.; Kelly-Williams, Kristen M.; So, Elson L.; Nickels, Katherine C; Wong-Kisiel, Lily; Lagerlund, Terrence D.; Cascino, Gregory D; Worrell, Gregory Alan; Wirrell, Elaine C.

In: Neurology, Vol. 86, No. 16, 19.04.2016, p. 1524-1530.

Research output: Contribution to journalArticle

Burkholder, DB, Britton, JW, Rajasekaran, V, Fabris, RR, Cherian, PJ, Kelly-Williams, KM, So, EL, Nickels, KC, Wong-Kisiel, L, Lagerlund, TD, Cascino, GD, Worrell, GA & Wirrell, EC 2016, 'Routine vs extended outpatient EEG for the detection of interictal epileptiform discharges', Neurology, vol. 86, no. 16, pp. 1524-1530. https://doi.org/10.1212/WNL.0000000000002592
Burkholder DB, Britton JW, Rajasekaran V, Fabris RR, Cherian PJ, Kelly-Williams KM et al. Routine vs extended outpatient EEG for the detection of interictal epileptiform discharges. Neurology. 2016 Apr 19;86(16):1524-1530. https://doi.org/10.1212/WNL.0000000000002592
Burkholder, David B. ; Britton, Jeffrey W. ; Rajasekaran, Vijayalakshmi ; Fabris, Rachel R. ; Cherian, Perumpillichira J. ; Kelly-Williams, Kristen M. ; So, Elson L. ; Nickels, Katherine C ; Wong-Kisiel, Lily ; Lagerlund, Terrence D. ; Cascino, Gregory D ; Worrell, Gregory Alan ; Wirrell, Elaine C. / Routine vs extended outpatient EEG for the detection of interictal epileptiform discharges. In: Neurology. 2016 ; Vol. 86, No. 16. pp. 1524-1530.
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AU - Cherian, Perumpillichira J.

AU - Kelly-Williams, Kristen M.

AU - So, Elson L.

AU - Nickels, Katherine C

AU - Wong-Kisiel, Lily

AU - Lagerlund, Terrence D.

AU - Cascino, Gregory D

AU - Worrell, Gregory Alan

AU - Wirrell, Elaine C

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N2 - Objective: To compare the yield of epileptiform abnormalities on 30-minute recordings with those greater than 45 minutes. Methods: We performed a prospective observational cross-sectional study of all outpatient routine EEGs comparing the rate of interictal epileptiform discharges (IEDs) and clinical events during the initial 30 minutes (routine) with those occurring in the remaining 30-60 minutes (extended). A relative increase of 10% was considered clinically significant. Results: EEGs from 1,803 patients were included; overall EEG duration was 59.4 minutes (SD ±6.5). Of 426 patients with IEDs at any time during the EEG, 81 (19.1%, 95% confidence interval 15.6-23) occurred only after the initial 30 minutes. The rate of late IEDs was not associated with age, indication, IED type, or sleep deprivation. Longer recording times also increased event capture rate by approximately 30%. Conclusions: The yield of IED and event detection is increased in extended outpatient EEGs compared to 30-minute studies.

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