title: The use of routine EEG in acute ischemic stroke patients without seizures: generalized but not focal EEG pathology is associated with clinical deterioration.
abstract: OBJECTIVE
  Specialized electroencephalography (EEG) methods have been used to provide clues about stroke features and prognosis. However, the value of routine EEG in stroke patients without (suspected) seizures has been somewhat neglected. We aimed to assess this in a group of acute ischemic stroke patients in regard to short-term prognosis and basic stroke features.
  
  
  METHODS
  We assessed routine (10-20) EEG findings in 69 consecutive acute ischemic stroke patients without seizures. Associations between EEG abnormalities and NIHSS scores, clinical improvement or deterioration as well as MRI stroke characteristics were evaluated.
  
  
  RESULTS
  Mean age was 69 ± 18 years, 43 of the patients (62.3%) were men. Abnormal EEG was found in 40 patients (58%) and was associated with higher age (p = 0.021). The most common EEG pathology was focal slowing (30; 43.5%). No epileptiform potentials were found. Abnormal EEG in general and generalized or focal slowing in particular was significantly associated with higher NIHSS score on admission and discharge as well as with hemorrhagic transformation of the ischemic lesion. Abnormal EEG and generalized (but not focal) slowing were associated with clinical deterioration ( p = 0.036, p = 0.003). Patients with lacunar strokes had no EEG abnormalities.
  
  
  CONCLUSIONS
  Abnormal EEG in general and generalized slowing in particular are associated with clinical deterioration after acute ischemic stroke. The study demonstrates the value of routine EEG as a simple diagnostic tool in the evaluation of stroke patients especially with regard to short-term prognosis.
authors.affiliation: a Department of Neurology , Universitaetsmedizin Mannheim, University of Heidelberg , Mannheim , Germany.
authors.forename: Marc E
authors.initials: ME
authors.lastname: Wolf
authors.affiliation: a Department of Neurology , Universitaetsmedizin Mannheim, University of Heidelberg , Mannheim , Germany.
authors.forename: Anne D
authors.initials: AD
authors.lastname: Ebert
authors.affiliation: a Department of Neurology , Universitaetsmedizin Mannheim, University of Heidelberg , Mannheim , Germany.
authors.forename: Anastasios
authors.initials: A
authors.lastname: Chatzikonstantinou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications; D004569:Electroencephalography / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012640:Seizures / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications* / Q000209:etiology; D055815:Young Adult
keywords: EEG; NIHSS score; ischemic stroke; stroke prognosis