Assessment of hairline EEG as a screening tool for nonconvulsive status epilepticus.
OBJECTIVE
Because of the high incidence of nonconvulsive status epilepticus (NCSE), the attraction of a "quick and easy" screening electroencephalogram (EEG) is obvious. Previous studies have shown utility of hairline EEG in diagnosing epilepsy. However, this technique has not been evaluated as a screening tool for NCSE. We wanted to provide proof of principle that a screening hairline EEG has sufficient sensitivity to use as a screening tool for diagnosing NCSE.


METHODS
A total of 120, 2- to 3-min EEG samples of normal and various abnormal digital EEG studies were reformatted in three six-channel montages (A, longitudinal bipolar; B, referential to ipsilateral ear; C, referential to contralateral ear) that mimicked a hairline recording and were interpreted by five neurophysiologists. The test data interpretation was compared with the original EEG interpretation.


RESULTS
Performance was best with montages A and B; 71% and 70.5% of the samples were interpreted correctly by using these montages. Only 65% of the samples were correctly interpreted by using montage C. With the best montage (A), the sensitivities ranged from 91% for normal EEG to 54% for periodic lateralized epileptiform discharges (PLEDs). The sensitivity for seizures was only 72%. Seizures were frequently misinterpreted as more benign patterns such as normal and diffuse slowing.


CONCLUSIONS
EEG data reformatted to resemble a hairline EEG had low sensitivity for detecting seizures. As a result, we do not recommend further pursuit of hairline EEG as a "quick and easy" screening tool for NCSE.
Kolls
Brad J
BJ
Department of Medicine (Neurology), Duke University Medical Center, Durham, NC 27710, USA.
Husain
Aatif M
AM
D003627:Data Interpretation, Statistical; D004566:Electrodes; D004569:Electroencephalography / Q000379:methods* / Q000706:statistics & numerical data; D005069:Evaluation Studies as Topic; D007839:Functional Laterality; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D008499:Medical Records; D009482:Neurophysiology; D012535:Scalp; D012680:Sensitivity and Specificity; D013226:Status Epilepticus / Q000175:diagnosis*