Abstract Details

Title Automated Seizure Detection and Management using CERIBELL: A single center cohort study

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P10 - Poster Session 10 (8:00 AM-9:00 AM)

Poster/Presentation
Number 9-006

Objective To determine whether point-of-care electroencephalography (POC-EEG) monitoring, using the Ceribell device can reduce time from hospital arrival to EEG and successful treatment of seizure activity when compared to conventional 10-20 EEG.

Background Ceribell is a point-of-care electroencephalography (POC-EEG) device that includes machine-learning algorithms to detect status epilepticus without the requirement of a trained technologist. We compared time to monitoring and outcomes with POC-EEG against conventional EEG.

Design/Methods A process improvement paradigm was implemented in which POC-EEG was used for suspected seizure activity when 10-20 EEG monitoring was not immediately available (off-hours 6pm-8am, June 2021 - June 2022). Data regarding diagnostic testing and seizure treatment were compared to patients monitored in the preceding period using the conventional paradigm (Mar 2020 - May 2021).

Results Of the 142 patients with suspected seizure activity for whom an EEG was requested during off-hours, 85 (60%) were monitored using POC-EEG. Compared to those monitored using a conventional 10-20 system, those monitored with POC-EEG had no significant clinical differences between groups (age, race, ethnicity, history of seizure, indication for EEG). Among patients monitored within 24h of hospital arrival for presumed seizure (n=97), POC-EEG was associated with shorter time to monitoring (median 225min [IQR 76-422] vs. 567min [IQR 290-914], p<0.001). Only 8 monitored patients experienced electrographic seizures (n=3 for POC-EEG), precluding comparisons in time to seizure detection, treatment, or cessation. In 72% of patients monitored, POC-EEG was thought to have expedited diagnostic testing or treatment.

Conclusions

Compared to the 10-20 conventional EEG, POC-EEG may allow for more rapid diagnostic evaluation of patients with suspected seizure. While few included patients were diagnosed with seizures in this cohort, earlier exclusion of seizure may reduce unnecessary treatment and expedite second tier diagnostic testing for altered mentation or abnormal movements.

Authors/Disclosures
Ajay Rajshekar, DO (Cooper University Hospital) PRESENTER	Dr. Rajshekar has nothing to disclose.
James E. Siegler III, MD (University of Chicago)	Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Siegler has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Bayer. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Serb. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ceribell. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Wallaby Phenox. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Stroke: Vascular and Interventional Neurology. Dr. Siegler has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for Precision Medicine, LLC. The institution of Dr. Siegler has received research support from Philips. The institution of Dr. Siegler has received research support from Medtronic.
Jared C. Wolfe, MD (Cooper Medical School)	Dr. Wolfe has nothing to disclose.
Miranda Flamholz	Miss Flamholz has nothing to disclose.
	No disclosure on file
	No disclosure on file
Stefan Gillen, DO (Cooper University Hospital)	Dr. Gillen has nothing to disclose.

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