title: Routine vs extended outpatient EEG for the detection of interictal epileptiform discharges.
abstract: OBJECTIVE
  To compare the yield of epileptiform abnormalities on 30-minute recordings with those greater than 45 minutes.
  
  
  METHODS
  We performed a prospective observational cross-sectional study of all outpatient routine EEGs comparing the rate of interictal epileptiform discharges (IEDs) and clinical events during the initial 30 minutes (routine) with those occurring in the remaining 30-60 minutes (extended). A relative increase of 10% was considered clinically significant.
  
  
  RESULTS
  EEGs from 1,803 patients were included; overall EEG duration was 59.4 minutes (SD ±6.5). Of 426 patients with IEDs at any time during the EEG, 81 (19.1%, 95% confidence interval 15.6-23) occurred only after the initial 30 minutes. The rate of late IEDs was not associated with age, indication, IED type, or sleep deprivation. Longer recording times also increased event capture rate by approximately 30%.
  
  
  CONCLUSIONS
  The yield of IED and event detection is increased in extended outpatient EEGs compared to 30-minute studies.
authors.affiliation: From the Departments of Neurology (D.B.B., J.W.B., V.R., R.R.F., K.M.K.-W., E.L.S., T.D.L., G.D.C., G.A.W.) and Child and Adolescent Neurology (P.J.C., K.C.N., L.C.W.-K., E.C.W.), Division of Epilepsy, Mayo Clinic, Rochester, MN; Department of Neurology (V.R.), Baylor Scott and White Health, Temple, TX; Department of Neurology (V.R.), West Virginia University Health Science Center, Morgantown; Spectrum Medical Group (R.R.F.), Rockford, MI; Division of Neurology (P.J.C.), McMaster University, Hamilton, Canada; and Minneapolis Clinic of Neurology (K.M.K.-W.), Edina. burkholder.davidb@gmail.com.
authors.forename: David B
authors.initials: DB
authors.lastname: Burkholder
authors.affiliation: From the Departments of Neurology (D.B.B., J.W.B., V.R., R.R.F., K.M.K.-W., E.L.S., T.D.L., G.D.C., G.A.W.) and Child and Adolescent Neurology (P.J.C., K.C.N., L.C.W.-K., E.C.W.), Division of Epilepsy, Mayo Clinic, Rochester, MN; Department of Neurology (V.R.), Baylor Scott and White Health, Temple, TX; Department of Neurology (V.R.), West Virginia University Health Science Center, Morgantown; Spectrum Medical Group (R.R.F.), Rockford, MI; Division of Neurology (P.J.C.), McMaster University, Hamilton, Canada; and Minneapolis Clinic of Neurology (K.M.K.-W.), Edina.
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Britton
authors.affiliation: From the Departments of Neurology (D.B.B., J.W.B., V.R., R.R.F., K.M.K.-W., E.L.S., T.D.L., G.D.C., G.A.W.) and Child and Adolescent Neurology (P.J.C., K.C.N., L.C.W.-K., E.C.W.), Division of Epilepsy, Mayo Clinic, Rochester, MN; Department of Neurology (V.R.), Baylor Scott and White Health, Temple, TX; Department of Neurology (V.R.), West Virginia University Health Science Center, Morgantown; Spectrum Medical Group (R.R.F.), Rockford, MI; Division of Neurology (P.J.C.), McMaster University, Hamilton, Canada; and Minneapolis Clinic of Neurology (K.M.K.-W.), Edina.
authors.forename: Vijayalakshmi
authors.initials: V
authors.lastname: Rajasekaran
authors.affiliation: From the Departments of Neurology (D.B.B., J.W.B., V.R., R.R.F., K.M.K.-W., E.L.S., T.D.L., G.D.C., G.A.W.) and Child and Adolescent Neurology (P.J.C., K.C.N., L.C.W.-K., E.C.W.), Division of Epilepsy, Mayo Clinic, Rochester, MN; Department of Neurology (V.R.), Baylor Scott and White Health, Temple, TX; Department of Neurology (V.R.), West Virginia University Health Science Center, Morgantown; Spectrum Medical Group (R.R.F.), Rockford, MI; Division of Neurology (P.J.C.), McMaster University, Hamilton, Canada; and Minneapolis Clinic of Neurology (K.M.K.-W.), Edina.
authors.forename: Rachel R
authors.initials: RR
authors.lastname: Fabris
authors.affiliation: From the Departments of Neurology (D.B.B., J.W.B., V.R., R.R.F., K.M.K.-W., E.L.S., T.D.L., G.D.C., G.A.W.) and Child and Adolescent Neurology (P.J.C., K.C.N., L.C.W.-K., E.C.W.), Division of Epilepsy, Mayo Clinic, Rochester, MN; Department of Neurology (V.R.), Baylor Scott and White Health, Temple, TX; Department of Neurology (V.R.), West Virginia University Health Science Center, Morgantown; Spectrum Medical Group (R.R.F.), Rockford, MI; Division of Neurology (P.J.C.), McMaster University, Hamilton, Canada; and Minneapolis Clinic of Neurology (K.M.K.-W.), Edina.
authors.forename: Perumpillichira J
authors.initials: PJ
authors.lastname: Cherian
authors.affiliation: From the Departments of Neurology (D.B.B., J.W.B., V.R., R.R.F., K.M.K.-W., E.L.S., T.D.L., G.D.C., G.A.W.) and Child and Adolescent Neurology (P.J.C., K.C.N., L.C.W.-K., E.C.W.), Division of Epilepsy, Mayo Clinic, Rochester, MN; Department of Neurology (V.R.), Baylor Scott and White Health, Temple, TX; Department of Neurology (V.R.), West Virginia University Health Science Center, Morgantown; Spectrum Medical Group (R.R.F.), Rockford, MI; Division of Neurology (P.J.C.), McMaster University, Hamilton, Canada; and Minneapolis Clinic of Neurology (K.M.K.-W.), Edina.
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Kelly-Williams
authors.affiliation: From the Departments of Neurology (D.B.B., J.W.B., V.R., R.R.F., K.M.K.-W., E.L.S., T.D.L., G.D.C., G.A.W.) and Child and Adolescent Neurology (P.J.C., K.C.N., L.C.W.-K., E.C.W.), Division of Epilepsy, Mayo Clinic, Rochester, MN; Department of Neurology (V.R.), Baylor Scott and White Health, Temple, TX; Department of Neurology (V.R.), West Virginia University Health Science Center, Morgantown; Spectrum Medical Group (R.R.F.), Rockford, MI; Division of Neurology (P.J.C.), McMaster University, Hamilton, Canada; and Minneapolis Clinic of Neurology (K.M.K.-W.), Edina.
authors.forename: Elson L
authors.initials: EL
authors.lastname: So
authors.affiliation: From the Departments of Neurology (D.B.B., J.W.B., V.R., R.R.F., K.M.K.-W., E.L.S., T.D.L., G.D.C., G.A.W.) and Child and Adolescent Neurology (P.J.C., K.C.N., L.C.W.-K., E.C.W.), Division of Epilepsy, Mayo Clinic, Rochester, MN; Department of Neurology (V.R.), Baylor Scott and White Health, Temple, TX; Department of Neurology (V.R.), West Virginia University Health Science Center, Morgantown; Spectrum Medical Group (R.R.F.), Rockford, MI; Division of Neurology (P.J.C.), McMaster University, Hamilton, Canada; and Minneapolis Clinic of Neurology (K.M.K.-W.), Edina.
authors.forename: Katherine C
authors.initials: KC
authors.lastname: Nickels
authors.affiliation: From the Departments of Neurology (D.B.B., J.W.B., V.R., R.R.F., K.M.K.-W., E.L.S., T.D.L., G.D.C., G.A.W.) and Child and Adolescent Neurology (P.J.C., K.C.N., L.C.W.-K., E.C.W.), Division of Epilepsy, Mayo Clinic, Rochester, MN; Department of Neurology (V.R.), Baylor Scott and White Health, Temple, TX; Department of Neurology (V.R.), West Virginia University Health Science Center, Morgantown; Spectrum Medical Group (R.R.F.), Rockford, MI; Division of Neurology (P.J.C.), McMaster University, Hamilton, Canada; and Minneapolis Clinic of Neurology (K.M.K.-W.), Edina.
authors.forename: Lily C
authors.initials: LC
authors.lastname: Wong-Kisiel
authors.affiliation: From the Departments of Neurology (D.B.B., J.W.B., V.R., R.R.F., K.M.K.-W., E.L.S., T.D.L., G.D.C., G.A.W.) and Child and Adolescent Neurology (P.J.C., K.C.N., L.C.W.-K., E.C.W.), Division of Epilepsy, Mayo Clinic, Rochester, MN; Department of Neurology (V.R.), Baylor Scott and White Health, Temple, TX; Department of Neurology (V.R.), West Virginia University Health Science Center, Morgantown; Spectrum Medical Group (R.R.F.), Rockford, MI; Division of Neurology (P.J.C.), McMaster University, Hamilton, Canada; and Minneapolis Clinic of Neurology (K.M.K.-W.), Edina.
authors.forename: Terrence D
authors.initials: TD
authors.lastname: Lagerlund
authors.affiliation: From the Departments of Neurology (D.B.B., J.W.B., V.R., R.R.F., K.M.K.-W., E.L.S., T.D.L., G.D.C., G.A.W.) and Child and Adolescent Neurology (P.J.C., K.C.N., L.C.W.-K., E.C.W.), Division of Epilepsy, Mayo Clinic, Rochester, MN; Department of Neurology (V.R.), Baylor Scott and White Health, Temple, TX; Department of Neurology (V.R.), West Virginia University Health Science Center, Morgantown; Spectrum Medical Group (R.R.F.), Rockford, MI; Division of Neurology (P.J.C.), McMaster University, Hamilton, Canada; and Minneapolis Clinic of Neurology (K.M.K.-W.), Edina.
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Cascino
authors.affiliation: From the Departments of Neurology (D.B.B., J.W.B., V.R., R.R.F., K.M.K.-W., E.L.S., T.D.L., G.D.C., G.A.W.) and Child and Adolescent Neurology (P.J.C., K.C.N., L.C.W.-K., E.C.W.), Division of Epilepsy, Mayo Clinic, Rochester, MN; Department of Neurology (V.R.), Baylor Scott and White Health, Temple, TX; Department of Neurology (V.R.), West Virginia University Health Science Center, Morgantown; Spectrum Medical Group (R.R.F.), Rockford, MI; Division of Neurology (P.J.C.), McMaster University, Hamilton, Canada; and Minneapolis Clinic of Neurology (K.M.K.-W.), Edina.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Worrell
authors.affiliation: From the Departments of Neurology (D.B.B., J.W.B., V.R., R.R.F., K.M.K.-W., E.L.S., T.D.L., G.D.C., G.A.W.) and Child and Adolescent Neurology (P.J.C., K.C.N., L.C.W.-K., E.C.W.), Division of Epilepsy, Mayo Clinic, Rochester, MN; Department of Neurology (V.R.), Baylor Scott and White Health, Temple, TX; Department of Neurology (V.R.), West Virginia University Health Science Center, Morgantown; Spectrum Medical Group (R.R.F.), Rockford, MI; Division of Neurology (P.J.C.), McMaster University, Hamilton, Canada; and Minneapolis Clinic of Neurology (K.M.K.-W.), Edina.
authors.forename: Elaine C
authors.initials: EC
authors.lastname: Wirrell
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000379:methods*; D000927:Anticonvulsants / Q000627:therapeutic use; D001921:Brain / Q000503:physiopathology; D002648:Child; D003430:Cross-Sectional Studies; D004569:Electroencephalography / Q000379:methods*; D004827:Epilepsy / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D011446:Prospective Studies; D012890:Sleep / Q000502:physiology; D012892:Sleep Deprivation / Q000503:physiopathology; D013997:Time Factors
chemical_list: D000927:Anticonvulsants