title: Current practice in administration and clinical criteria of emergent EEG.
abstract: Policies of administration and availability of EEG offered during nonbusiness hours vary widely among EEG laboratories. The authors surveyed medical directors of accredited EEG laboratories (n = 84) to determine the ranges of availability and clinical indications for approval of continuously available emergent EEG (E-EEG). Of 46 respondents, 37 (80%) offered E-EEG. Two centers recently lost funding for E-EEG. Availability was not associated with the total number of EEGs performed annually. The mean estimated response time from request to expert interpretation was 3 +/- 4 hours (range, 1-24 hours). The five clinical indications for which most respondents approved E-EEGs were possible nonconvulsive status epilepticus (100%), treatment of status epilepticus (84%), cerebral death exam (81%), diagnosis of convulsive status epilepticus (79%), and diagnosis of coma or encephalopathy (70%). Respondents disagreed widely when asked which clinical situations merited E-EEG, with some approving all requests and others denying all except for nonconvulsive status epilepticus. The wide range of current practice suggests that research focused on outcomes of aggressive, EEG-aided patient evaluation and treatment are needed to define better the costs and benefits of a continuously available EEG service.
authors: Department of Neurology, University of Virginia, Charlottesville, Virginia 22908, USA.
authors: M
authors: M
authors: Quigg
authors: B
authors: B
authors: Shneker
authors: P
authors: P
authors: Domer
mesh_terms: D001926:Brain Death / Q000175:diagnosis; D001927:Brain Diseases / Q000175:diagnosis; D002170:Canada; D003128:Coma / Q000175:diagnosis; D004569:Electroencephalography / Q000191:economics / Q000706:statistics & numerical data*; D004638:Emergency Treatment / Q000592:standards*; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D007755:Laboratories, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data* / Q000639:trends; D012017:Referral and Consultation / Q000706:statistics & numerical data; D013226:Status Epilepticus / Q000175:diagnosis; D013996:Time and Motion Studies; D014481:United States; D000078329:Workforce