Electroencephalographic findings in consecutive emergency department patients with altered mental status: a preliminary report.

Eur J Emerg Med

Department of Emergency Medicine, Downstate Medical Center & Kings County Hospital Center, State University of New York, Brooklyn, USA.

Published: April 2013

AI Article Synopsis

  • EEG is a valuable tool for diagnosing altered mental status (AMS) and identifying nonconvulsive seizures (NCS) in emergency department patients.
  • A study on patients aged 13 and older with AMS found that 70% exhibited abnormal EEG results, with the most common issue being slowed brain activity.
  • The findings suggest that a significant number of AMS patients have EEG abnormalities, highlighting the importance of EEG in their assessment and potential seizure risk.

Article Abstract

Electroencephalography (EEG) can help narrow the differential diagnosis of altered mental status (AMS) and is necessary to diagnose nonconvulsive seizure (NCS). The objective of this prospective observational study is to identify the prevalence of EEG abnormalities in emergency department patients with AMS. Patients of at least 13 years of age with AMS were enrolled, whereas those with an easily identifiable cause (e.g. hypoglycemia) underlying their AMS were excluded. Easily identifiable cause of AMS (e.g. hypoglycemia). A 30-min EEG with the standard 19 electrodes was performed on each patient. Descriptive statistics (%, 95% confidence interval) are used to report EEG findings of the first 50 enrolled patients. Thirty-five EEGs (70%, 57-81%) were abnormal. The most common abnormality was slowing of background activities (46%, 33-60%), reflecting an underlying encephalopathy. NCS was diagnosed in three (6%, 1-17%), including one patient in nonconvulsive status epilepticus. Nine patients (18%, 10-31%) had interictal epileptiform abnormalities, indicating an increased risk of spontaneous seizure. Patients presenting to the emergency department with AMS have a high prevalence of EEG abnormalities, including NCS.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3434317PMC
http://dx.doi.org/10.1097/MEJ.0b013e32835473b1DOI Listing

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