title: Efficacy of a reduced electroencephalography electrode array for detection of seizures.
abstract: BACKGROUND
  The expertise required for proper electroencephalography (EEG) setup can make the 10-20 array unwieldy in the hospital setting. There may be a role for an EEG array with reduced leads to improve the efficiency of inpatient practice.
  
  
  METHODS
  Clips from 100 EEG records, 50 ictal and 50 non-ictal, in adult inpatients from January 1, 2007, to January 1, 2012, were retrospectively reviewed and selected for digital lead reduction and blind review. Two epileptologists reviewed these tracings and documented the presence of seizures and severe disturbance of background. The reduced array included 7 leads spanning the scalp. Three different montages were available. Sensitivity and specificity of the reduced array were calculated using the formal EEG report as the comparison standard.
  
  
  RESULTS
  For the detection of any seizure, the reduced array EEG had a sensitivity of 70% and specificity of 96%. Sensitivity for identifying encephalopathic patterns was 62% and specificity was 86%. Focal seizures were more readily identified by the reduced array (20 of 25) than were generalized ictal patterns (13 of 25).
  
  
  CONCLUSIONS
  The reduced electrode array was insufficiently sensitive to seizure detection. Reducing EEG leads might not be a preferred means of optimizing hospital EEG efficiency.
authors.affiliation: Department of Neurology, School of Graduate Medical Education, Mayo Clinic, Rochester, MN, USA.
authors.forename: Mark N
authors.initials: MN
authors.lastname: Rubin
authors.affiliation: Department of Neurology, Division of Epilepsy, Mayo Clinic, Rochester, MN, USA.
authors.forename: Oliver J
authors.initials: OJ
authors.lastname: Jeffery
authors.affiliation: Department of Neurology, Division of Critical Care Neurology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Fugate
authors.affiliation: Department of Neurology, Division of Epilepsy, Mayo Clinic, Rochester, MN, USA.
authors.forename: Jeffery W
authors.initials: JW
authors.lastname: Britton
authors.affiliation: Department of Neurology, Division of Epilepsy, Mayo Clinic, Rochester, MN, USA.
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Cascino
authors.affiliation: Department of Neurology, Division of Epilepsy, Mayo Clinic, Rochester, MN, USA.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Worrell
authors.affiliation: Department of Neurology, Division of Critical Care Neurology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Sara E
authors.initials: SE
authors.lastname: Hocker
authors.affiliation: Department of Neurology, Division of Critical Care Neurology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Eelco F
authors.initials: EF
authors.lastname: Wijdicks
authors.affiliation: Department of Neurology, Division of Critical Care Neurology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Alejandro A
authors.initials: AA
authors.lastname: Rabinstein
keywords: EEG; array; hospital; montage; reduced; seizure