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The utility of EEG in the emergency department
  1. Ozlem Yigit1,
  2. Oktay Eray1,
  3. Ebru Mihci2,
  4. Derya Yilmaz1,
  5. Savas Arslan1,
  6. Burcu Eray2
  1. 1Department of Emergency Medicine, Akdeniz University Faculty of Medicine, Antalya, Turkey
  2. 2Department of Neurology, Akdeniz University Faculty of Medicine, Antalya, Turkey
  1. Correspondence to Ozlem Yigit, Department of Emergency Medicine, Akdeniz University Faculty of Medicine, Dumlupınar Bulvarı, Antalya 07059, Turkey; ozlemyigit{at}akdeniz.edu.tr

Abstract

Background and aim Seizure-related visits are common in the emergency department (ED) but the clinical situations for ordering emergency electroencephalography (EEG) are unclear. The aim of this study is to identify which clinical conditions meet with the pathological EEG and whether patient management is changed by abnormal results.

Methods A retrospective chart review study of all patients visiting the ED with a seizure or symptoms mimicking a seizure was performed. Patients who recorded an EEG within 16 h after the initial event were enrolled. Demographic data and EEG results of patients with provoked and unprovoked seizures were recorded and related factors were analysed.

Results A total of 449 patients (219 men) of mean±SD age of 45.48±21.83 years were evaluated. The seizure was thought to be provoked in 98 patients (21.8%) and unprovoked in 352 (78.2%) patients (31.2% remote symptomatic and 47.4% idiopathic). The EEG results of 281 patients (62.6%) revealed an abnormality, and the abnormal EEG ratio was high in patients with presumed seizure (p<0.001). One hundred and thirty-eight patients (30.7%) were hospitalised and the remainder (n=311, 69.3%) were discharged from the ED. An abnormal EEG was found in 98 (71%) of the hospitalised patients and in 183 (59.5%) of those discharged (p=0.019).

Conclusion EEG provides useful diagnostic information and should be considered in all patients presenting to the ED with a seizure. Since the timing of the study affects the diagnostic efficacy of the test, EEG recordings might be done within 24 h either in the ED or epilepsy clinic.

  • Seizure
  • diagnosis
  • emergency EEG
  • neuroimaging
  • management
  • emergency care systems
  • emergency departments
  • management
  • emergency department management
  • neurology
  • epilspsy
  • neurology
  • other

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Footnotes

  • Ethics approval This study was conducted with the approval of the Akdeniz University local ethics committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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