PMID- 30585889
OWN - NLM
STAT- MEDLINE
DCOM- 20190612
LR  - 20191210
IS  - 1537-1603 (Electronic)
IS  - 0736-0258 (Linking)
VI  - 36
IP  - 2
DP  - 2019 Mar
TI  - Nonconvulsive Status Epilepticus: Validating the Salzburg Criteria Against an 
      Expert EEG Examiner.
PG  - 141-145
LID - 10.1097/WNP.0000000000000556 [doi]
AB  - PURPOSE: Rapid and correct diagnosis of nonconvulsive status epilepticus (NCSE) 
      is crucial for optimal treatment. However, electroencephalographic diagnosis can 
      be challenging. Salzburg Consensus Criteria (SCC) have been proposed to 
      facilitate correct diagnosis, but their validity needs to be further established. 
      METHODS: We retrospectively reanalyzed the first EEG in adult patients (n = 284) 
      referred under the suspicion of NCSE at our institution in 2014. Nonconvulsive 
      status epilepticus or possible NCSE was diagnosed according to the SCC by an 
      examiner specifically trained in SCC and was compared with the original diagnosis 
      made by an expert EEG examiner, which in this context served as the reference 
      standard, to assess the validity of the criteria. Furthermore, the clinical 
      outcome for patients not diagnosed using SCC (false-negatives) was examined. 
      RESULTS: Nonconvulsive status epilepticus or possible NCSE was diagnosed in 40 
      patients by the inexperienced reader using the SCC, blinded to other clinical 
      data, and in 47 patients by the experienced reader, not blinded to the clinical 
      data, who did not use SCC. There were eight false-negatives, one false-positive, 
      39 true-positives, and 236 true-negatives. Concordance between SCC and the 
      reference standard was high (k = 0.88 [95% confidence interval, 0.80 to 0.96]). 
      Four of the eight false-negatives suffered from anoxic encephalopathy. The 
      remainder had a history of epilepsy and returned to preictal functional state. 
      CONCLUSIONS: The SCC for NCSE implemented by an inexperienced EEG reader, blinded 
      to all other data, yielded results highly concordant with the evaluation of EEG 
      by an experienced reader. False-negative diagnoses were associated with postictal 
      states or anoxic encephalopathy.
FAU - Krogstad, Martin H
AU  - Krogstad MH
AD  - Department of Neurology, Odense University Hospital, Odense, Denmark.
FAU - Hogenhaven, Hans
AU  - Hogenhaven H
AD  - Department of Neurology, Odense University Hospital, Odense, Denmark.
FAU - Beier, Christoph P
AU  - Beier CP
AD  - Department of Neurology, Odense University Hospital, Odense, Denmark.
AD  - Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
FAU - Kroigard, Thomas
AU  - Kroigard T
AD  - Department of Neurology, Odense University Hospital, Odense, Denmark.
AD  - Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
LA  - eng
PT  - Journal Article
PT  - Validation Study
PL  - United States
TA  - J Clin Neurophysiol
JT  - Journal of clinical neurophysiology : official publication of the American 
      Electroencephalographic Society
JID - 8506708
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Brain/physiopathology
MH  - Clinical Competence
MH  - Diagnosis, Differential
MH  - Diagnostic Errors
MH  - *Electroencephalography/methods
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Status Epilepticus/*diagnosis/physiopathology
EDAT- 2018/12/27 06:00
MHDA- 2019/06/14 06:00
CRDT- 2018/12/27 06:00
PHST- 2018/12/27 06:00 [pubmed]
PHST- 2019/06/14 06:00 [medline]
PHST- 2018/12/27 06:00 [entrez]
AID - 10.1097/WNP.0000000000000556 [doi]
PST - ppublish
SO  - J Clin Neurophysiol. 2019 Mar;36(2):141-145. doi: 10.1097/WNP.0000000000000556.