The influence of the abundance and morphology of epileptiform discharges on diagnostic accuracy: How many spikes you need to spot in an EEG

Mustafa Aykut Kural, Erisela Qerama, Birger Johnsen, Steffen Fuchs, Sándor Beniczky

Publikation: Bidrag til tidsskriftArtikelForskningpeer review

Abstrakt

OBJECTIVE: The operational definition of interictal epileptiform discharges (IEDs) of the International Federation of Clinical Neurophysiology (IFCN) described six morphological criteria. Our objective was to assess the impact of pattern-repetition in the EEG-recording, on the diagnostic accuracy of using the IFCN criteria. For clinical implementation, specificity over 95% was set as target.

METHODS: Interictal EEG-recordings of 20-minutes, containing sharp-transients, from 60 patients (30 with epilepsy and 30 with non-epileptic paroxysmal events) were evaluated by three experts, who first marked IEDs solely based on expert opinion, and then, independently from the first session evaluated the presence of the IFCN criteria for each sharp-transient. The gold standard was derived from long-term video-EEG recordings of the patientś habitual paroxysmal episodes.

RESULTS: Presence of at least one discharge fulfilling five criteria provided a specificity of 100% (sensitivity: 70%). For discharges fulfilling fewer criteria, a higher number of discharges was needed to keep the specificity over 95% (5 discharges, when only 3 criteria were fulfilled). A sequential combination of these sets of criteria and thresholds provided a specificity of 97% and sensitivity of 80%.

CONCLUSIONS: Pattern-repetition and IED morphology influence diagnostic accuracy.

SIGNIFICANCE: Systematic application of these criteria will improve quality of clinical EEG interpretation.

OriginalsprogEngelsk
Sider (fra-til)1543-1549
Antal sider7
TidsskriftClinical Neurophysiology
Vol/bind132
Udgave nummer7
DOI
StatusUdgivet - jul. 2021

Bibliografisk note

Copyright © 2021 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

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