Diagnostic utility of eight-channel EEG for detecting generalized or hemispheric seizures and rhythmic periodic patterns
Diagnostic utility of eight-channel EEG for detecting generalized or hemispheric seizures and rhythmic periodic patterns
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DOI：
10.1016/j.cnp.2018.03.001
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发表时间：
2018-01-01
影响因子：
1.7
通讯作者：
Parvizi, Josef
中科院分区：
文献类型：
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作者：
Gururangan, Kapil;Razavi, Babak;Parvizi, Josef
目的：比较使用简化的8通道导联（rm-EEG）和完整的18通道导联（fm-EEG）的脑电图（EEG）在检测广泛或半球性癫痫发作和节律周期性模式（RPP）方面的诊断效用，这些诊断效用由接受过广泛EEG培训的神经科医生、EEG暴露最少的神经科住院医师和没有EEG经验的医学生进行。我们向20名神经科医生、20名住院医生和42名医学生提供了fm-EEG（双极导联）和rm-EEG（双极导联侧导联）的EEG样本。三位高级癫痫学家一致同意将样本定义为癫痫发作（n = 7）、RPP（n = 10）和正常或减慢（n = 20）。使用Wilcoxon符号秩检验评估中位准确性、敏感性和特异性的差异。结果：神经科医师读取完整和简化EEG时，显示出相似的准确性（fm-EEG：95%，rm-EEG：95%，p = 0.29）、居民（fm-EEG：80%，rm-EEG：80%，p = 0.05）和学生（fm-EEG：60%，rm-EEG：51%，p = 0.68）。此外，神经科医生检测癫痫发作活动的灵敏度在fm-EEG（100%）和rm-EEG（98%）之间相当（p = 0.17）。此外，rm-EEG对癫痫发作和RPP的特异性（神经科医师：100%、住院医师：90%、学生：86%）明显大于fm-EEG（神经科医师：93%，p = 0.03;住院医师：80%，p = 0.01;学生：69%，p < 0.001）。EEG通道数量从18个减少到8个并不影响神经科医生检测癫痫发作的灵敏度，癫痫发作通常是执行紧急EEG的核心原因。它也可以增加他们的特异性检测的节奏和周期性的模式，从而提供重要的诊断信息，以指导患者的management.Significance：我们的研究是第一个文件的实用性减少通道EEG以上的发际线相比，全蒙太奇EEG在协助医务人员不同程度的EEG培训，以检测全身或半球癫痫发作。(C)2018国际临床神经生理学联合会。由爱思唯尔公司出版
Objectives: To compare the diagnostic utility of electroencephalography (EEG) using reduced, 8-channel montage (rm-EEG) to full, 18-channel montage (fm-EEG) for detection of generalized or hemispheric seizures and rhythmic periodic patterns (RPPs) by neurologists with extensive EEG training, neurology residents with minimal EEG exposure, and medical students without EEG experience.Methods: We presented EEG samples in both fm-EEG (bipolar montage) and rm-EEG (lateral leads of bipolar montage) to 20 neurologists, 20 residents, and 42 medical students. Unanimous agreement of three senior epileptologists defined samples as seizures (n = 7), RPPs (n = 10), and normal or slowing (n = 20). Differences in median accuracy, sensitivity, and specificity were assessed using Wilcoxon signed-rank tests.Results: Full and reduced EEG demonstrated similar accuracy when read by neurologists (fm-EEG: 95%, rm-EEG: 95%, p = 0.29), residents (fm-EEG: 80%, rm-EEG: 80%, p = 0.05), and students (fm-EEG: 60%, rm-EEG: 51%, p = 0.68). Moreover, neurologists' sensitivity for detecting seizure activity was comparable between fm-EEG (100%) and rm-EEG (98%) (p = 0.17). Furthermore, the specificity of rm-EEG for seizures and RPP (neurologists: 100%, residents: 90%, students: 86%) was significantly greater than that of fm-EEG (neurologists: 93%, p = 0.03; residents: 80%, p = 0.01; students: 69%, p < 0.001).Conclusions: The reduction of the number of EEG channels from 18 to 8 does not compromise neurologists' sensitivity for detecting seizures that are often a core reason for performing urgent EEG. It may also increase their specificity for detecting rhythmic and periodic patterns, and thereby providing important diagnostic information to guide patient's management.Significance: Our study is the first to document the utility of a reduced channel EEG above the hairline compared to full montage EEG in aiding medical staff with varying degrees of EEG training to detect generalized or hemispheric seizures. (C) 2018 International Federation of Clinical Neurophysiology. Published by Elsevier B.V.