Value of the electroencephalogram in adult patients with untreated idiopathic first seizures.
We prospectively studied the reliability and accuracy of the electroencephalogram as a predictor of the risk of recurrence within 2 years in 157 patients with untreated idiopathic first seizures. In all patients, a standard electroencephalogram and, if necessary, an electroencephalogram after partial sleep deprivation were obtained. All electroencephalograms were scored by one observer according to a fixed protocol. The finding of epileptic discharges was associated with a risk of recurrence of 83% (95% confidence interval, 69% to 97%) vs 41% (95% confidence interval, 29% to 53%) in patients with nonepileptic abnormalities and 12% (95% confidence interval, 3% to 21%) in patients in whom both electroencephalograms were normal. The sensitivity proved to be 48%. Interobserver agreement among four neurologists, who independently read 50 electroencephalograms, was found to be moderate. Predictive value for each observer, however, was good. We conclude that electroencephalogram findings may play a role in the decision to initiate or delay treatment after an idiopathic first seizure.
van Donselaar
C A
CA
Department of Neurology and Clinical Neurophysiology, University Hospital Rotterdam-Dijkzigt, The Netherlands.
Schimsheimer
R J
RJ
Geerts
A T
AT
Declerck
A C
AC
D000200:Action Potentials; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000503:physiopathology; D004569:Electroencephalography / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D012640:Seizures / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D012892:Sleep Deprivation