Article Text

Download PDFPDF
Single-channel electroencephalography of epileptic seizures in the out-of-hospital setting: an observational study
  1. Rainer Nitzschke,
  2. Jakob Müller,
  3. Stefan Maisch,
  4. Gunter N Schmidt
  1. Center of Anaesthesiology and Intensive Care Medicine, Department of Anaesthesiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
  1. Correspondence to Rainer Nitzschke, Department of Anaesthesiology, University Hospital Hamburg-Eppendorf, Martinistrasse 52, D-20246 Hamburg, Germany; r.nitzschke{at}


Objectives To evaluate whether single-channel electroencephalography (EEG) recording can be conducted in the out-of-hospital setting and whether it can be used to record electrographic signs of convulsive epileptic seizures.

Methods This prospective observational feasibility study included patients who presented with a recent or ongoing epileptic seizure during out-of-hospital emergency treatment. Bifrontal single-channel EEG recordings were conducted by ambulance physicians throughout the initial treatment. The data recorded were analysed for the quality of recording and the occurrence of ictal EEG patterns.

Results There were 45 adult patients who had a recent or an ongoing epileptic seizure in the study group and 15 patients with no neurological disorders in the control group. The median percentage of time during which no artefacts were detected by the device was 88.0% in the study group and 96.0% in the control group. EEG recordings for 3 out of 45 (6.6%) patients were of poor quality and not evaluable. Spike/wave or polyspike patterns were found in 98% and 100% of patients in the study and control groups, respectively, whereas the occurrence of periodic epileptiform discharges and delta waves with spikes showed a sensitivity and specificity of 100% (10/10) for the presence of an ongoing epileptic seizure.

Conclusions Single-channel EEG can be performed outside the hospital and yields useful recordings in most patients with acceptable rates of artefact. The diagnosis of generalised convulsive epileptic seizures by offline analysis of out-of-hospital EEG showed a high sensitivity and specificity when compared with the clinical diagnosis.

  • Artefacts
  • electroencephalography
  • epileptic seizure
  • generalised convulsive status epilepticus
  • prehospital emergency care
  • neurology
  • neurology
  • epilspsy
  • prehospital care

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Ethics approval This study was conducted with the approval of the ethics committee of the Medical Council Hamburg, Germany (reference number 2733).

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

Linked Articles

  • Primary survey
    Simon Carley