PMID- 31617115 OWN - NLM STAT- MEDLINE DCOM- 20210208 LR - 20231013 IS - 1556-0961 (Electronic) IS - 1541-6933 (Linking) VI - 32 IP - 1 DP - 2020 Feb TI - 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. PG - 217-225 LID - 10.1007/s12028-019-00863-9 [doi] AB - BACKGROUND/OBJECTIVE: Simplified continuous electroencephalogram (cEEG) monitoring has shown improvement in detecting seizures; however, it is insufficient in detecting abnormal EEG patterns, such as periodic discharges (PDs), rhythmic delta activity (RDA), spikes and waves (SW), and continuous slow wave (CS), as well as nonconvulsive status epilepticus (NCSE). Headset-type continuous video EEG monitoring (HS-cv EEG monitoring; AE-120A EEG Headset, Nihon Kohden, Tokyo, Japan) is a recently developed easy-to-use technology with eight channels. However, its ability to detect abnormal EEG patterns with raw EEG data has not been comprehensively evaluated. We aimed to examine the diagnostic accuracy of HS-cv EEG monitoring in detecting abnormal EEG patterns and NCSE in patients with altered mental status (AMS) with unknown etiology. We also evaluated the time required to initiate HS-cv EEG monitoring in these patients. METHODS: We prospectively observed and retrospectively examined patients who were admitted with AMS between January and December 2017 at the neurointensive care unit at Asakadai Central General Hospital, Saitama, Japan. We excluded patients whose data were missing for various reasons, such as difficulties in recording, and those whose consciousness had recovered between HS-cv EEG and conventional cEEG (C-cEEG) monitoring. For the included patients, we performed HS-cv EEG monitoring followed by C-cEEG monitoring. Definitive diagnosis was confirmed by C-cEEG monitoring with the international 10-20 system. As the primary outcome, we verified the sensitivity and specificity of HS-cv EEG monitoring in detecting abnormal EEG patterns including PDs, RDA, SW, and CS, in detecting the presence of PDs, and in detecting NCSE. As the secondary outcome, we calculated the time to initiate HS-cv EEG monitoring after making the decision. RESULTS: Fifty patients (76.9%) were included in the final analyses. The median age was 72 years, and 66% of the patients were male. The sensitivity and specificity of HS-cv EEG monitoring for detecting abnormal EEG patterns were 0.974 (0.865-0.999) and 0.909 (0.587-0.998), respectively, and for detecting PDs were 0.824 (0.566-0.926) and 0.970 (0.842-0.999), respectively. We diagnosed 13 (26%) patients with NCSE using HS-cv EEG monitoring and could detect NCSE with a sensitivity and specificity of 0.706 (0.440-0.897) and 0.970 (0.842-0.999), respectively. The median time needed to initiate HS-cv EEG was 57 min (5-142). CONCLUSIONS: HS-cv EEG monitoring is highly reliable in detecting abnormal EEG patterns, with moderate reliability for PDs and NCSE, and rapidly initiates cEEG monitoring in patients with AMS with unknown etiology. FAU - Egawa, Satoshi AU - Egawa S AD - Neurointensive Care Unit, Department of Neurosurgery, and Stroke and Epilepsy Center, TMG Asaka Medical Center, Saitama, Japan. FAU - Hifumi, Toru AU - Hifumi T AD - Department of Emergency and Critical Care Medicine, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan. hifumitoru@gmail.com. FAU - Nakamoto, Hidetoshi AU - Nakamoto H AD - Department of Neurosurgery, Saiseikai Kurihashi Hospital, Saitama, Japan. FAU - Kuroda, Yasuhiro AU - Kuroda Y AD - Emergency Medical Center, Kagawa University Hospital, Kagawa, Japan. FAU - Kubota, Yuichi AU - Kubota Y AD - Department of Neurosurgery, and Stroke and Epilepsy Center, TMG Asaka Medical Center, Saitama, Japan. LA - eng PT - Journal Article PL - United States TA - Neurocrit Care JT - Neurocritical care JID - 101156086 SB - IM MH - Aged MH - Aged, 80 and over MH - Brain/physiopathology MH - Brain Diseases/diagnosis/physiopathology MH - Brain Injuries, Traumatic/physiopathology MH - Cerebral Hemorrhage/physiopathology MH - Cerebral Infarction/physiopathology MH - Delta Rhythm MH - Electroencephalography/*instrumentation/methods MH - Female MH - Humans MH - Intensive Care Units MH - Male MH - Middle Aged MH - Neurophysiological Monitoring/*instrumentation/methods MH - Prospective Studies MH - Reproducibility of Results MH - Sensitivity and Specificity MH - Status Epilepticus/*diagnosis/physiopathology MH - Subarachnoid Hemorrhage/physiopathology MH - Video Recording/*instrumentation/methods OTO - NOTNLM OT - Continuous electroencephalogram OT - Electroencephalography OT - Headset-type continuous video electroencephalography OT - Nonconvulsive status epilepticus OT - Periodic discharges EDAT- 2019/10/17 06:00 MHDA- 2021/02/09 06:00 CRDT- 2019/10/17 06:00 PHST- 2019/10/17 06:00 [pubmed] PHST- 2021/02/09 06:00 [medline] PHST- 2019/10/17 06:00 [entrez] AID - 10.1007/s12028-019-00863-9 [pii] AID - 10.1007/s12028-019-00863-9 [doi] PST - ppublish SO - Neurocrit Care. 2020 Feb;32(1):217-225. doi: 10.1007/s12028-019-00863-9.