Measuring expertise in identifying interictal epileptiform discharges.

Objective: Interictal epileptiform discharges on EEG are integral to diagnosing epilepsy. However, EEGs are interpreted by readers with and without specialty training, and there is no accepted method to assess skill in interpretation. We aimed to develop a test to quantify IED recognition skills.

Minimum clinically important difference (MCID) of the personal impact of epilepsy scale (PIES).

Introduction: The Personal Impact of Epilepsy Scale (PIES) assesses patient functional status in subscales of (1) seizure impact, (2) medication effects, (3) mood & social status, and (4) overall quality of life. This study was designed to determine the Minimal Clinically Important Change (MCID) in PIES subscale and total scores that demonstrate improvement.

Methods: To ascertain the correspondence of PIES score change and clinical status change (improved, same, worse) in each PIES subscale and total score, we used two distinct retrospective anchor-based assessments of clinical status (patient self-assessment and trained rater assessment) across two clinic visits.

Interictal Epileptiform Discharge Detection in EEG in Different Practice Settings.

Objective: The goal of the study was to measure the performance of academic and private practice (PP) neurologists in detecting interictal epileptiform discharges in routine scalp EEG recordings.

Methods: Thirty-five EEG scorers (EEGers) participated (19 academic and 16 PP) and marked the location of ETs in 200 30-second EEG segments using a web-based EEG annotation system. All participants provided board certification status, years of Epilepsy Fellowship Training (EFT), and years in practice.

Characteristics of EEG Interpreters Associated With Higher Interrater Agreement.

Purpose: The goal of the project is to determine characteristics of academic neurophysiologist EEG interpreters (EEGers), which predict good interrater agreement (IRA) and to determine the number of EEGers needed to develop an ideal standardized testing and training data set for epileptiform transient (ET) detection algorithms.

Methods: A three-phase scoring method was used. In phase 1, 19 EEGers marked the location of ETs in two hundred 30-second segments of EEG from 200 different patients.

Mortality following status epilepticus in persons with and without epilepsy.

Purpose: Incidence of status epilepticus (SE) ranges from 6.8 to 41.0 per 100,000 population.

Comparison of a Novel Dry Electrode Headset to Standard Routine EEG in Veterans.

Objective: This purpose of this study was to evaluate the usefulness of a prototype battery-powered dry electrode system (DES) EEG recording headset in Veteran patients by comparing it with standard EEG.

Methods: Twenty-one Veterans had both a standard electrode system recording and DES recording in nine different patient states at the same encounter. Setup time, patient comfort, and subject preference were measured.

Premature deaths among children with epilepsy - South Carolina, 2000-2011.

Epilepsy is a common childhood neurologic disorder. In 2007, epilepsy affected an estimated 450,000 children aged 0-17 years in the United States. Approximately 53% of children with epilepsy and special health care needs have co-occurring conditions, and only about one third have access to comprehensive care.

Risk of venous thromboembolism in people with epilepsy.

Objective: Risk of venous thromboembolism (VTE) among people with epilepsy (PWEs) has not been previously reported. Standard VTE prevention methods may increase the risk of complications in this population. This statewide study assessed the risk of VTE in PWEs.

Epilepsy beyond seizure: a population-based study of comorbidities.

Comorbid conditions may affect the quality of life in persons with epilepsy (PWE) more than seizures. Using legally mandated healthcare encounter data, somatic, psychiatric, and neurodevelopmental comorbidities in a large population-based cohort of PWE, were compared to persons with migraine (PWM), a similar neurologic condition, and lower extremity fracture (PWLF), otherwise healthy controls. 64,188 PWE, 121,990 PWM, and 89,808 PWLF were identified from inpatient, outpatient, and emergency department from 2000 to 2011.

Standardized database development for EEG epileptiform transient detection: EEGnet scoring system and machine learning analysis.

The routine scalp electroencephalogram (rsEEG) is the most common clinical neurophysiology procedure. The most important role of rsEEG is to detect evidence of epilepsy, in the form of epileptiform transients (ETs), also known as spike or sharp wave discharges. Due to the wide variety of morphologies of ETs and their similarity to artifacts and waves that are part of the normal background activity, the task of ET detection is difficult and mistakes are frequently made.

Relationship of number of seizures recorded on video-EEG to surgical outcome in refractory medial temporal lobe epilepsy.

Introduction: Surgical planning for refractory medial temporal lobe epilepsy (rMTLE) relies on seizure localization by ictal electroencephalography (EEG). Multiple factors impact the number of seizures recorded. We evaluated whether seizure freedom correlated to the number of seizures recorded, and the related factors.

Medial temporal lobe epilepsy is associated with neuronal fibre loss and paradoxical increase in structural connectivity of limbic structures.

Background: It has been hypothesised that seizure induced neuronal loss and axonal damage in medial temporal lobe epilepsy (MTLE) may lead to the development of aberrant connections between limbic structures and eventually result in the reorganisation of the limbic network. In this study, limbic structural connectivity in patients with MTLE was investigated, using diffusion tensor MRI, probabilistic tractography and graph theory based network analysis.

Methods: 12 patients with unilateral MTLE and hippocampal sclerosis (five left and seven right MTLE) and 26 healthy controls were studied.

Subtypes of medial temporal lobe epilepsy: influence on temporal lobectomy outcomes?

Surgical resection of the hippocampus is the most successful treatment for medication-refractory medial temporal lobe epilepsy (MTLE) due to hippocampal sclerosis. Unfortunately, at least one of four operated patients continue to have disabling seizures after surgery, and there is no existing method to predict individual surgical outcome. Prior to surgery, patients who become seizure free appear identical to those who continue to have seizures after surgery.

Sixty day continuous use of subdermal wire electrodes for EEG monitoring during treatment of status epilepticus.

Introduction: Use of continuous EEG in the ICU setting is increasing. The EEG electrode continues to be a weak link in the chain from recording to interpretation. The technical difficulties of maintaining artifact-free, low impedance data collection are magnified by the ICU environment and prolonged duration of monitoring often required for these patients.