When should a sleep-deprived EEG be performed following a presumed first seizure in adults?
Abstract
OBJECTIVES: To evaluate the effect of the interval between the seizure and the EEG recording on the yield of early sleep-deprived EEG (SD-EEG) in patients admitted following a presumed first seizure.
MATERIALS AND METHODS: We retrospectively reviewed the EEG recordings and medical records of patients admitted to the Neurology Department in Assaf Harofeh Medical Center because of a presumed first seizure during a 3-year period between 2006 and 2009 and who had a SD-EEG following a first routine EEG without epileptiform discharges (EDs).
RESULTS: The study group included 78 patients aged 18-78 years (mean 35 ± 17). Previous seizures were recognized through repeated history in 32 (41%) patients. EDs were recorded in the SD-EEG in 16 (21%) patients: 13/46 (28%) with a SD-EEG performed within 3 days following the seizure and 3/32 (9%) with a later SD-EEG (P = 0.042) and in 10/32 (31%) patients in whom previous seizures were recognized and 6/46 (13%) with a first seizure (P = 0.05).
CONCLUSIONS: EDs in the SD-EEG following a first diagnosed seizure occur more commonly when the test is performed within 3 days following a first seizure or when previous seizures are recognized.
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 78 participants or records.
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