Abstracts

Electroencephalography in Clinical Practice: Results from an AAN Practice Current Survey

Abstract number : 2.229
Submission category : 4. Clinical Epilepsy / 4B. Clinical Diagnosis
Year : 2024
Submission ID : 22
Source : www.aesnet.org
Presentation date : 12/8/2024 12:00:00 AM
Published date :

Authors :
Presenting Author: Naomi Kass, BA – Baylor College of Medicine

Sándor Beniczky, MD – Dianalund and Aarhus University Hospital
Joseph Sirven, MD – Mayo Clinic, Jacksonville, FL, USA
Brandon Westover, MD – Massachusetts General Hospital
Roohi Katyal, MD – Louisiana State University Health Shreveport
Fábio Nascimento, MD – Washington University School of Medicine

Rationale:
EEG is the most common procedure performed by practicing neurologists in the US, according to a 2011 AAN survey. Similarly, a large portion of EEGs are interpreted by neurologists without post-residency EEG training in many European countries. Given the major role of EEG in the diagnosis and management of epilepsy, coupled with the deleterious effects of EEG misinterpretation, it is vital to ensure that EEGs are interpreted accurately and reliably. We aimed to investigate the use of EEG in clinical practice.




Methods: A 20-question e-survey was developed targeting practicing and trainee neurologists. This survey, hosted by Neurology Practice Current, focused on participants' demographics, EEG reading experience, and clinical practices. The survey was distributed via social media and disseminated by the AAN, AES, ACNS, ILAE, YES-ILAE, and Synapse.


Results:
231 complete responses were included and evaluated in this preliminary analysis. Participants included general neurologists without (28%) and with (20%) EEG and/or epilepsy training, epileptologists (25%), trainees (26%), and advanced practice providers (1%). A majority practice in the US (27%) with over half based in academic settings (57%). There were more adult (58%) than pediatric (23%) neurologists, with 20% caring for both populations. 77% of respondents read EEG in their practice. Overall, 78% agree that an objective certification test should be required for all those who interpret EEG in clinical practice. Group analysis showed that 83% of epileptologists and neurologists with EEG/epilepsy training vs. 71% of neurologists without EEG/epilepsy training believe a certification test of ability is needed to interpret EEG in clinical practice (p=0.056). Overall, 74% believe that routine EEG (rEEG) should only be read by neurologists with EEG/epilepsy training. This figure was 83% among epileptologists and neurologists with EEG training, and 52% among neurologists without EEG training (p< 0.001).




Conclusions: Our results show that regardless of EEG training background, most neurology professionals agree on the need for a certification test to interpret EEG in clinical practice. Similarly, most believe that rEEGs should only be interpreted by neurologists with EEG/epilepsy training. It is notable that significantly more EEG/epilepsy trained neurologists held this belief in comparison to neurologists without such training. These data support considering a change in practice in which post-residency EEG/epilepsy training should be required for those who interpret EEG in clinical practice, and that a certification test should be necessary before doing so.


Funding: None

Clinical Epilepsy