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Abstract Details

Long-term EEG Utilization After Ambulatory EEG?(aEEG)?versus Epilepsy Monitoring Unit (EMU)?Admission in US Veterans
Epilepsy/Clinical Neurophysiology (EEG)
P6 - Poster Session 6 (8:00 AM-9:00 AM)
1-016
To compare long-term EEG utilization rates between veterans monitored with aEEG and those admitted to EMU. 
AEEG is a cost-effective alternative to gold-standard EMU for seizure evaluation. Few studies have evaluated long-term rates of EEG utilization following aEEG testing. 
Retrospective cohort of all patients who underwent a first aEEG longer than 12 hours at a VA hospital between 2012-2014 or were admitted to the EMU in 2013. Data on EEGs and neurology clinic visits over the 9-11 years of patient follow-up was obtained via chart review. 

49 aEEG and 59 EMU studies met study criteria. Among aEEG patients, age ranged from 26-92 years, and study duration ranged from 20-47 hours. Among EMU patients, age ranged from 23-76 years, and study duration was 1-11 days. 10.2% of patients were female.  

Yield of abnormal findings was 16/49 (32.7%) by aEEG compared to 21/59 (35.6%) by EMU. Epileptic seizures were captured in one aEEG study compared with nine EMU studies (2.0% vs 35.6%). Surface EEG-negative events were captured in six aEEG studies (12.2%) compared with 34 EMU studies (57.6%). 

Prior EEG testing had been performed in 41 aEEG patients (83.7%) vs 40 EMU (67.8%). Prior EMU admissions were conducted in 9 (18.4%) aEEG patients vs 11 (18.6%) EMU patients. Subsequent EMU evaluation was performed in 7 (14.3%) aEEG patients (5 without prior EMU) vs 5 (8.5%) EMU patients. No further EEG testing was performed in 32 (65.3%) aEEG patients compared to 44 (74.6%) EMU patients over the 10-year study period.

Veterans monitored by aEEG were similar to those monitored in the EMU with regard to subsequent EMU evaluation (14.3% vs 8.5%). Most patients monitored by aEEG (65.3%) and EMU (74.6%) did not undergo repeat EEG, suggesting that aEEG can be a cost-effective tool in the evaluation of seizures.  
Authors/Disclosures
Tae Kim, MD (OHSU)
PRESENTER 		Dr. Kim has nothing to disclose.
Jacqueline Hirschey, MD Dr. Hirschey has nothing to disclose.
Martin C. Salinsky, MD (Oregon Health Sciences Univ Epilepsy Center) Dr. Salinsky has nothing to disclose.
David C. Spencer, MD, FAAN Dr. Spencer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Jazz Pharmaceuiticals. Dr. Spencer has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NeuroPace Inc. Dr. Spencer has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Various. The institution of Dr. Spencer has received research support from NIH. Dr. Spencer has received publishing royalties from a publication relating to health care. Dr. Spencer has received personal compensation in the range of $500-$4,999 for serving as a Faculty in Teaching Course supported by unrestricted educational grants with Creative 好色先生 Concepts.
Marissa Kellogg, MD, MPH, FAAN (VA Portland Healthcare System, Dept of Neurology) The institution of Dr. Kellogg has received research support from VA & DoD.