ArticleThe American journal of emergency medicine2013
Prevalence of non-convulsive seizure and other electroencephalographic abnormalities in ED patients with altered mental status.
Article in The American journal of emergency medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 49 citations in OpenAlex.
- Informed consent in critically ill adults participating to a randomized trial.Brain and behavior · 2021Trial
- Effect of microEEG on clinical management and outcomes of emergency department patients with altered mental status: a randomized controlled trial.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2014Trial
- Hyperglycemic Hyperosmolar Syndrome With Higher Brain Dysfunction in Which Arterial Spin Labeling Revealed Abnormal Cerebral Blood Flow: A Case Report.Clinical case reports · 2026Article
- EEG in patients with altered mental status in the emergency department.International journal of emergency medicine · 2026Article
- Utility of Clinical Features in Identifying Electrographic Seizures in Hospitalized Patients Admitted for Non-Neurological Diagnoses.Critical care explorations · 2024Article
- Utility and rationale for continuous EEG monitoring: a primer for the general intensivist.Critical care (London, England) · 2024Review
- Point-of-care electroencephalography enables rapid evaluation and management of non-convulsive seizures and status epilepticus in the emergency department.Journal of the American College of Emergency Physicians open · 2023Article
- Quantitative Infrared Pupillometry in Nonconvulsive Status Epilepticus.Neurocritical care · 2021Observational
- Diagnostic Reliability of Headset-Type Continuous Video EEG Monitoring for Detection of ICU Patterns and NCSE in Patients with Altered Mental Status with Unknown Etiology.Neurocritical care · 2020Article
- Improving the ability of ED physicians to identify subclinical/electrographic seizures on EEG after a brief training module.International journal of emergency medicine · 2019Article
- Altered Mental Status: Current Evidence-based Recommendations for Prehospital Care.The western journal of emergency medicine · 2018Review
- Clinical characteristics of non-convulsive status epilepticus diagnosed by simplified continuous electroencephalogram monitoring at an emergency intensive care unit.Acute medicine & surgery · 2017Article
- Can patients with non-convulsive seizure be identified in the emergency department?World journal of emergency medicine · 2017Article
- Successful treatment of non-convulsive status epilepticus diagnosed using bedside monitoring by a combination of amplitude-integrated and two-channel simplified electroencephalography.Acute medicine & surgery · 2016Article
- Electroencephalographic features of convulsive epilepsy in Africa: A multicentre study of prevalence, pattern and associated factors.Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2016Article
- Neurocritical care update.Journal of intensive care · 2016Review
- Diagnostic accuracy of microEEG: a miniature, wireless EEG device.Epilepsy & behavior : E&B · 2014Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
unlabelledFour to ten percent of patients evaluated in emergency departments (ED) present with altered mental status (AMS). The prevalence of non-convulsive seizure (NCS) and other electroencephalographic (EEG) abnormalities in this population is unknown.
objectivesTo identify the prevalence of NCS and other EEG abnormalities in ED patients with AMS.
methodsA prospective observational study at 2 urban ED. Inclusion: patients ≥13 years old with AMS. Exclusion: An easily correctable cause of AMS (e.g. hypoglycemia). A 30-minute standard 21-electrode EEG was performed on each subject upon presentation. OUTCOME: prevalence of EEG abnormalities interpreted by a board-certified epileptologist. EEGs were later reviewed by 2 blinded epileptologists. Inter-rater agreement (IRA) of the blinded EEG interpretations is summarized with κ. A multiple logistic regression model was constructed to identify variables that could predict the outcome.
resultsTwo hundred fifty-nine patients were enrolled (median age: 60, 54% female). Overall, 202/259 of EEGs were interpreted as abnormal (78%, 95% confidence interval [CI], 73-83%). The most common abnormality was background slowing (58%, 95% CI, 52-68%) indicating underlying encephalopathy. NCS (including non-convulsive status epilepticus [NCSE]) was detected in 5% (95% CI, 3-8%) of patients. The regression analysis predicting EEG abnormality showed a highly significant effect of age (P < .001, adjusted odds ratio 1.66 [95% CI, 1.36-2.02] per 10-year age increment). IRA for EEG interpretations was modest (κ: 0.45, 95% CI, 0.36-0.54).
conclusionsThe prevalence of EEG abnormalities in ED patients with undifferentiated AMS is significant. ED physicians should consider EEG in the evaluation of patients with AMS and a high suspicion of NCS/NCSE.
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