Abstract Details

Title Sensitivity of Compressed Spectral Array Displays for Seizures and Other Critical Patterns in Adult Long Term EEG Monitoring

Topic Critical Care/Emergency Neurology/Trauma

Presentation(s) P01 - (-)

Poster/Presentation
Number 021

Objective

Background CSA displays are increasingly used to review long-term monitoring (LTM) EEG recordings. However, the sensitivity of CSA review for seizures and other pathological patterns in adult patients is unknown. We hypothesized that CSA displays can reduce total EEG review burden while identifying nearly all critical findings.

Design/Methods CSA and raw EEG were reviewed in three stages. (1) After a brief tutorial, two reviewers without CSA experience reviewed 119 LTM EEGs. While blinded to the raw EEG data the reviewers evaluated CSA displays by marking each visually homogeneous CSA segment. (2) One of two experienced electroencephalographers scored each record by reviewing raw EEG data within 60 seconds of each CSA mark and recording any seizures, periodic epileptiform discharges (PEDs), rhythmic delta activity (RDA), focal or generalized slowing, and epileptiform discharges. (3) "Ground truth" detections were established by exhaustive review of all raw EEG data.

Results Within the 40 LTM EEG recordings containing seizures, both CSA reviewers identified at least one seizure in 38 records (95%). There was one EEG containing a single, brief, focal seizure that both reviewers failed to mark. One reviewer also missed one additional focal seizure in another EEG. The combined detection rate for all seizures was 89.0% of 1,192 seizures. Overall detection rates for the presence of other critical findings were: spikes or sharp waves, 94.2% (66/70); PEDs 100% (43/43); RDA, 97% (34/35), focal slowing, 100% (77/77); and generalized slowing, 100% (103/103).

Conclusions CSA can support sensitive screening of EEG information in LTM EEG recordings. However, some patients with brief focal seizures may not be identified.

Authors/Disclosures
Sarah Wahlster, MD PRESENTER	Dr. Wahlster has nothing to disclose.
Craig A. Williamson, MD (University of Michigan, Neurosurgery Department)	The institution of Dr. Williamson has received research support from Xoran Technolies, LLC. The institution of Dr. Williamson has received research support from United States Department of Defense. Dr. Williamson has received intellectual property interests from a discovery or technology relating to health care.
Mouhsin Shafi, MD, PhD	Dr. Shafi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant with Massachusetts Office of the Attorney General.
M. B. Westover, MD, PhD (MGH)	Dr. Westover has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Beacon Biosignals. Dr. Westover has stock in Beacon Biosignals. The institution of Dr. Westover has received research support from NIH. Dr. Westover has received publishing royalties from a publication relating to health care. Dr. Westover has a non-compensated relationship as a cofounder with Beacon Biosignals that is relevant to AAN interests or activities.
Sarah Gheuens, MD	No disclosure on file

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