title: Electroencephalography findings in patients presenting to the ED for evaluation of seizures.
abstract: BACKGROUND
  Status epilepticus is a life-threatening, time-sensitive emergency. Acquiring an electroencephalogram (EEG) in the emergency department (ED) could impact therapeutic and disposition decisions for patients with suspected status epilepticus.
  
  
  OBJECTIVE
  The objective of this study is to estimate the proportion of EEGs diagnostic for seizures in patients presenting to an ED with a complaint of seizures.
  
  
  METHODS
  This retrospective chart review included adults presenting to the ED of an urban, academic, tertiary care hospital with suspected seizures or status epilepticus, who received an EEG within 24 hours of hospital admission. Data abstraction was performed by a single, trained, nonblinded abstractor. Seizures were defined as an epileptologist's diagnosis of either seizures or status epilepticus on EEG. The proportion of patients with seizures is given with confidence interval95 (CI95).
  
  
  RESULTS
  Of 120 included patients, 67 (56%) had a history of epilepsy. Mean age was 52 years (SD, 16), 58% were White, and 61% were male. Within 24 hours, 3% had an EEG diagnostic for seizures. Electroencephalogram was obtained in the ED in 32 (27%) of 120 (CI95, 19%-35%), and 2 (6%) of 32 (CI95, 1%-19%) had seizures. Electroencephalogram was performed inpatient for 88 (73%) of 120 (CI95, 65%-81%), and 2 (2%) of 88 (CI95, 0.5%-7.1%) had seizures.
  
  
  CONCLUSIONS
  Only 3% of ED patients with suspected seizures or status epilepticus had EEG confirmation of seizures within 24 hours. Early EEG acquisition in the ED may identify a group of patients amenable to ED observation and subsequent discharge from the hospital.
authors.affiliation: University of Cincinnati Department of Emergency Medicine, Cincinnati, OH, USA.
authors.forename: Pooja
authors.initials: P
authors.lastname: Kadambi
authors.affiliation: University of Cincinnati Department of Emergency Medicine, Cincinnati, OH, USA.
authors.forename: Kimberly W
authors.initials: KW
authors.lastname: Hart
authors.affiliation: University of Cincinnati Department of Emergency Medicine, Cincinnati, OH, USA; University of Cincinnati Department of Neurosurgery, Division of Neurocritical Care, Cincinnati, OH, USA.
authors.forename: Opeolu M
authors.initials: OM
authors.lastname: Adeoye
authors.affiliation: University of Cincinnati Department of Emergency Medicine, Cincinnati, OH, USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Lindsell
authors.affiliation: University of Cincinnati Department of Emergency Medicine, Cincinnati, OH, USA; University of Cincinnati Department of Neurosurgery, Division of Neurocritical Care, Cincinnati, OH, USA. Electronic address: William.Knight@uc.edu.
authors.forename: William A
authors.initials: WA
authors.lastname: Knight
mesh_terms: D003937:Diagnosis, Differential; D004569:Electroencephalography; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012640:Seizures / Q000175:diagnosis*; D013226:Status Epilepticus / Q000175:diagnosis*; D013997:Time Factors