Effect of Inpatient Electroencephalography on Clinical Decision Making

Abstract

In this study, inpatient EEGs rarely contributed to clinical decision making and in no case resulted in a change in diagnosis or management. These findings warrant future research on the effectiveness of inpatient EEGs for a wide breadth of clinical inpatient diagnoses.

An investigation of the patterns and outcomes of Electroencephalographic (EEG) recording requests in the management of neuropsychiatric disorders in a teaching Hospital in Nigeria

“…The results of this study show that more males 89 (62.7%) than females 53 (37.3%) were referred for EEG and 84.5% of the patients were less than 30 years old. Preponderance of male referrals over females for EEG reported in this study is similar to reports from two previous Nigerian studies and studies from USA 9 – 11 , but differs from that of Pearce and Cock, from United Kingdom, which reported a preponderance of females over male referrals 8 . It has been reported that male preponderance may be a reflection of the fact that more male patients than females are affected by epilepsy.…”

“…The provisional diagnosis of the referring doctors in this study showed that epilepsy (79.5%) was the commonest reason for referral, (with 30.9% having specific or classified diagnosis and 48.6% unclassified diagnosis), cerebral palsy 8.5% and some other minor conditions. The finding from this study that epilepsy was the commonest reason for which patients were referred for EEG is similar to some other studies in Nigeria 9 , 10 , Africa 14 and Europe 12 but differs from result of a study from USA 11 . Harmon et al, reported that the commonest reason for EEG referral was altered mental status 52 (26%) followed by seizure 48 (24%) 8 .…”

“…As a result of a variety of conditions in which EEG is used as a diagnostic tool, some studies have questioned the appropriateness or otherwise of its use 7 , 8 . Even though some Nigerian authors reported that EEG services are limited and that the available ones are probably under- utilized 9 , 10 , authors from industrialized nations have reported over use or misuse of EEG as diagnostic and management tool 7 , 8 , 11 , 12 .…”

How valuable is inpatient electroencephalogram for medical decision‐making?

“…As expected, the EEG findings that were mainly associated with diagnosis and/or treatment change included electrographic seizures and interictal epileptiform discharges. In previous studies, EEGs confirmed diagnosis and altered management in 0–22% of the patients . Higher yield of abnormal findings and higher rates of contribution to making the diagnosis (42–100%) were reported in the emergent setting, when EEGs were performed for diagnosis of nonconvulsive and subtle status epilepticus, follow‐up of convulsive status epilepticus and suspected cerebral death in patients presented to the emergency department or admitted in intensive care units with altered mental states, although low rates of 5% and 10·7% of status epilepticus confirmation were reported in these patients as well .…”

Electroencephalographic Grading of Neuronal Dysfunction in Various Etiologies of Encephalopathy

“…2 EEG may assist in determining the underlying brain dysfunction and its severity in these patients, 3 given ample body of empirical evidence suggesting that different grades of background activity slowdown correlate with the functional severity of clinical encephalopathy. 4 However, when considering the prognostic correlation of an increasing background slowing, it is always important to perform activation procedures to test the reactivity, including eye opening, as well as response to sounds and painful stimulations. Even on a very slow EEG, a clear reactivity (regardless of either high voltage slowing or an acceleration with amplitude attenuation) heralds a better prognosis.…”