Efficacy of a Reduced-Montage Rapid-Response EEG System in a Pediatric Emergency Department Setting
Abstract number :
1.163
Submission category :
2. Translational Research / 2B. Devices, Technologies, Stem Cells
Year :
2025
Submission ID :
597
Source :
www.aesnet.org
Presentation date :
12/6/2025 12:00:00 AM
Published date :
Authors :
Presenting Author: Mark lehmkuhle, PhD – Epitel Inc.
Zoë Tosi, PhD – Epitel, Inc.
Mitchell Frankel, PhD – Epitel, Inc.
Maija Holsti, MD – University of Utah
Carey Wilson, MD – University of Utah
Audie Espinoza, MD – University of Utah School of Medicine
Matthew Sweney, MD – University of Utah
Rationale: There is a clear need for wireless, discreet EEG that can be deployed by non-specialized EEG technicians in an emergent setting, especially in community/rural hospitals that lack an EEG service. Only 27% of hospitals in the US have EEG whereby 40% of people who qualify for an EEG don’t get one due to a lack of access. Rapid neuro-screening with EEG is critical for situations when patients are at risk of under-treatment if they are having undetected subclinical or non-convulsive seizures, over-treatment if EEG is normal, and delayed treatment if they are transported to a tertiary hospital for EEG diagnosis. A rapid-response EEG system that enables patient monitoring in a primary center that lacks EEG services but is supported by a remote epileptologist (e.g. in a tertiary center) could have significant benefit to the timing and efficacy of patient care. We aim to evaluate whether, a rapid-response EEG system (REMITM, Epitel, Inc.) using a reduced-montage configuration, placed by staff without formal EEG system placement training, is effective for detecting electrographic seizures in emergent acute care.
Methods: Sixty-seven patients with a median age of 12 (52.2% male, 47.8% female) suspected of seizures and meeting the inclusion criteria upon arrival in the emergency department (ED) at Primary Children’s Hospital (PCH) were enrolled as part of a prospective clinical trial (NCT05818930). PCH is a tertiary center with 24/7 EEG coverage in the ED. Traditional wired EEG was ordered as standard-of-care and the REMI EEG system was placed concurrent with wired EEG. The primary outcome measure was to determine if seizures could be identified in REMI EEG as easily as traditional wired EEG, where the wired EEG is deemed the ground truth. Secondary measures were that REMI takes less time to deploy than wired EEG. Wired EEG was reviewed by 1 of 3 pediatric epileptologists at PCH as standard-of-care, whereas deidentified REMI EEG review was delayed by 6 months and randomly assigned to the same three epileptologist for review.
Results: Three patients were determined to be in status epilepticus, 12 were experiencing self-limiting seizures, and 52 did not demonstrate seizures in EEG as determined by epileptologist standard-of-care review of the traditional wired EEG. The mean time to place REMI was 35.4 +/- 27.5 min. as compared to wired EEG of 98.5 +/- 97.9 min. Of the 15 total patients with seizures, 13 (86.7%) had seizures visible in REMI EEG where 6 had their first electrographically-visible seizure identified within 20 minutes of REMI system placement. In two cases, seizures were likely verified in REMI EEG 20 minutes before wired EEG was placed and seizure events confirmed.
Conclusions: The results of this clinical trial demonstrate that rapid-response EEG could be useful for quickly assessing patients suspected of seizures in emergent acute care. Rapid-response EEG could be a cost-effective solution to EEG monitoring in hospitals that lack an EEG service or 24/7 EEG coverage. Identifying electrographic seizures at the point-of-care could reduce unnecessary transfers to tertiary centers.
Funding: Funding was supported by a NIH NINDS grant to Epitel, Inc. SB1NS100235.
Translational Research