Abstracts

Rationale: There is a need for having EEG recordings in the emergency department and this need is insufficiently met. For example an improved ability to diagnose Non Convulsive Status Epilepticus would be of great value for Altered Mental Status patients who constitute a large fraction emergency visits. In fact, routine EEG recording of all emergency department patients would be desirable but is currently not available. Among the reasons responsible for this are the frequent lack of a knowledgeable technician who can attach electrodes and the time constraints in the emergency setting that make it difficult to make recordings even when the expertise is available. Methods: The feasibility and safety of a new miniature EEG recording device (microEEG) was investigated by making 30 minute or longer recordings from 40 volunteers in the emergency department. The microEEG measures impedance on each channel including ground and reference and accommodates conventional as well as rapidly deployable electrodes. The effectiveness of reduced montages to be part of microEEG was investigated through a retrospective analysis of EEG recordings from walk-in patients at the SUNY Downstate Comprehensive Epilepsy Center. We have used information theoretic and statistical measures in the selection of submontages for study. Results: Three neurologists who viewed each recording independently scored the microEEG's recording quality as good to excellent on average and of sufficient quality to determine epileptiform activity. The microEEG performed well with electrodes with a wide range of impedances ranging from less than 5 kOhms (conventional) to 90 kOhms (rapid application). Submontages containing approximately 4 channels, a small fraction of the full set of electrodes in the conventional 10/20 full montage, were found to have sufficiently high sensitivity and specificity to be used in detecting seizures and other neurological abnormalities in an emergency setting. Conclusions: Preliminary results from recordings with volunteers indicate that the system is able to record EEG data of high enough quality to promote the use of neurological diagnoses in the emergency department.