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Abstract Details

Diagnostic Utility of Reduced Electroencephalography for Seizure Detection: A Systematic Review
Epilepsy/Clinical Neurophysiology (EEG)
P5 - Poster Session 5 (8:00 AM-9:00 AM)
12-010
To systematically review the literature on the diagnostic sensitivity of electroencephalography (EEG) with a reduced number of electrodes for seizure detection.
Conventional EEG using a full set of 18+ electrodes is the gold standard for detecting seizures, particularly non-convulsive seizures associated with increased morbidity, mortality, and risk of neuronal injury. EEG with a reduced number of electrodes has potential to expediate the management of non-convulsive seizures, especially at hospitals without 24/7 EEG infrastructure. However, the perceived consensus of extant literature has been equivocal regarding the diagnostic utility of this approach, and as a result, reduced EEG is not widely used.
We searched electronic databases to identify studies that reported the sensitivity of reduced EEG compared to full EEG for seizure detection in adult or pediatric/neonatal patients based on visual inspection by trained epileptologists. We excluded studies that solely utilized automated detection algorithms, did not describe the reduced EEG array or reference standard, or presented raters with fewer than ten EEG samples.
We identified 22 studies (20 published articles, 2 conference abstracts) in adult (n=16) and pediatric (n=6) populations that described 27 reduced EEG montages with range of 2-14 electrodes, primarily offering coverage of temporal (n=19) and frontal (n=21) regions. The median sensitivity of reduced EEG for seizures was 80% [IQR 73-93%], range: 50-100%. Only three studies measured the sensitivity of full EEG for seizures (88% [IQR 87-93%], range: 85-98%). Seventeen studies encouraged further investigation or use of reduced EEG, and these reported higher median sensitivity (89% [IQR 77-94%], range: 50-100%) compared to studies that did not (70% [IQR 68-70%], range: 64-76%).
Our findings question the seemingly axiomatic notion that EEG electrode reduction results in suboptimal diagnostic sensitivity and highlight the need to study the impact these tools could have on clinical management.
Authors/Disclosures
Kapil Gururangan, MD (Northwestern University)
PRESENTER 		Dr. Gururangan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Ceribell Inc. Dr. Gururangan has stock in Ceribell Inc. The institution of Dr. Gururangan has received research support from NIH-NINDS. The institution of Dr. Gururangan has received research support from Leon Levy Foundation.
Babak Razavi, MD, PhD (Stanford University Medical Center) Dr. Razavi has stock in CortexXus. The institution of Dr. Razavi has received research support from Neuropace.
Rita A. Popat, PhD (Health Research Policy, Division of Epid) No disclosure on file