Araştırma Makalesi
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The Analysis of Electroencephalography Requests in Clinical Neurophysiology Department

Yıl 2021, Cilt: 8 Sayı: 3, 163 - 166, 28.12.2021
https://doi.org/10.47572/muskutd.750450

Öz

Transient loss of consciousness (LOC) has an important place in emergency applications. Therefore, it is very important to define the etiology of LOC. In this study, we retrospectively analyzed our outpatient electroencephalography (EEG) records to evaluate whether the clinician ordering the test had a fulfilling result. EEG recordings between 01.07.2017 to 01.07.2018 in our outpatient clinic were reviewed. 1015 of EEGs were ordered by general neurologists (70.05%), 355 by epilepsy specialists (24.5%) and 79 by other departments (5.5%). The Department of Psychiatry was leading among other departments by one third. 281 out of 1449 EEGs were abnormal (19.4%). Only three patients had a seizure during EEG recording. Preliminary diagnosis for EEG record request were epilepsy in 829 patients (57.2%), syncope in 257 patients (17.8%), headache in 12 (0.8%), vertigo in 12 (0.8%), cognitive dysfunction in 71 (4.9%), sleep disorder in 16 (1.1%), intracranial mass lesion in 18 (1.0%), cerebrovascular diseases in 54 (3.7%), altered mental status in 26 (73.3%) and encephalitis in 15 patients (1.0%). Normal EEG recording results were 76.5% in the recordings with preliminary diagnosis of epilepsy. Abnormalities found in patients with preliminary diagnosis of epilepsy patients were sharp/spike in 45.1%, focal/generalied slowing in 41.5% and background slowing in 11.8%. Overall abnormality percentage was similar in EEGs requested by either general neurologists (76.0%) or epilepsy specialists (76.9%) but not by other departments (82.1%). As a result; EEG should not be interpreted as a screening test, patients’ details and clinical features during loss of consciousness episode have a priceless importance and preliminary diagnosis should be re- and reevaluated before EEG recording request.

Kaynakça

  • 1. Wardrope A, Newberry E, Reuber M. Diagnostic criteria to aid the differential diagnosis of patients presenting with transient loss of consciousness: Asystematic review. Seizure. 2018;61:139-48.
  • 2. Koutroumanidis M, Smith S. Use and abuse of EEG in the diagnosis of idiopathic generalized epilepsies. Epilepsia. 2005;46 (Suppl 9):96-107.
  • 3. Kerry HL, Patrick C. Handbook of clinical neurology, vol. 160 (3rd series), clinical neurophysiology: basis and technical aspects. Elsevier, 2019.
  • 4. Stone JL, Hughes JR. Early history of electroencephalography and establishment of the American Clinical Neurophysiology Society. J Clin Neurophysiol. 2013;30:28-44.
  • 5. Robin K, Modern Electroencephalography. J Neurol. 2012;259:783-9.
  • 6. 6. Hai C, Mohamad ZK, Electroencephalography in epilepsy evaluation. Continuum (minneap minn). 2019;25(2, epilepsy):431-53.
  • 7. So EL. Interictal epileptiform discharges in persons without a history of seizures: what do they mean? J Clin Neurophysiol. 2010;27(4):229-38.
  • 8. Badry R. Latency to the first epileptiform activity in the EEG of epileptic patients. Int J Neurosci. 2013;123(9):646-9.
  • 9. Wirrell EC. Prognostic significance of interictal epileptiform discharges in newly diagnosed seizure disorders. J Clin Neurophysiol. 2010;27(4):239-48.
  • 10. Heyer GL. Syncope is associated with electroencephalography changes. Clin Neurophysiol. 2018;129(7):1496-7.
  • 11. Philippe G, Anna S, Jean MD, et al. Video EEG in syncopal attack due to ocular compression in an adolescent mistreated for epilepsy. Epileptic Disord. 2007;9(2):174-8.
  • 12. Vi-Huong NM, Claude A, Vera D, et al. Characterization of seizure-induced syncopes: EEG, ECG and clinical features. Epilepsia. 2014;55(1):146–55.
  • 13. Michael B, Dawood D, Amir A, ve ark. Ictal asystole and ictal syncope: insights into clinical management. Circ Arrhythm Electrophysiol. 2015;8(1):159-64.
  • 14. Raffaele N, Luca S, Viviana V, et al. Usefulness of EEG techniques in distinguishing frontotemporal dementia from alzheimer’s disease and other dementias, dis markers. 2018;2018:6581490.
  • 15. Borislav R, Ratimir P, Anja G, et al. EEG analysis and spect imaging in alzheimer’s disease, vascular dementia and mild cognitive impairment. Psychiatria Danubina. 2019;31(1):111-5.

Klinik Nörofizyoloji Bölümünde Elektroensefalografi İstemlerinin Analizi

Yıl 2021, Cilt: 8 Sayı: 3, 163 - 166, 28.12.2021
https://doi.org/10.47572/muskutd.750450

Öz

Geçici bilinç kaybı (LOC) acil servis başvuruları içinde önemli bir yere sahiptir. Bu sebeple LOC etiyolojisini tanımlamak çok önemlidir. Bu çalışmada istek yapan klinisyenin ihtiyaçlarının karşılanıp karşılanmadığını değerlendirmek için poliklinik elektroensefalografi (EEG) kayıtlarımızı retrospektif olarak inceledik. Polikliniğimizdeki 01.07.2017 - 01.07.2018 arasındaki EEG kayıtları incelendi. EEG'lerin 1015'i genel nöroloji uzmanları (%70.05), 355'i epilepsi uzmanları (%24.5) ve 79'u diğer bölümler (5.5) tarafından istendi. Psikiyatri bölümü; diğer bölümler içinde üçte bir oranla çoğunluktaydı. 1449 EEG'den 281'i anormaldi (%19.4). EEG kaydı sırasında sadece üç hasta nöbet geçirdi. EEG kayıt istemi için ön tanı; 829 hastada (%57.2) epilepsi, 257 hastada (%17.8) senkop, 12’sinde baş ağrısı (%0.8), 12’sinde vertigo (%0.8), 71'inde bilişsel işlev bozukluğu (%4.9), 16'sında uyku bozukluğu (%1.1), 18'inde intrakraniyal kitle lezyonu (%1.0), 54'ünde serebrovasküler hastalıklar (%3.7), 26'sında zihinsel durum değişikliği (%73.3) ve 15 hastada (%1.0) ensefalitti. Epilepsi ön tanısı ile yapılan kayıtlarda normal EEG kaydı oranı %76.5 idi. Epilepsi ön tanısı olan hastaların %45.1'inde keskin/diken, %41.5'inde fokal/jeneralize yavaşlama ve %11.8'inde zemin aktivitesinde yavaşlama anormallikleri bulundu. Genel olarak anormallik yüzdesi diğer bölümlerin aksine (%82.1), genel nörologlar (%76.0) ve epilepsi uzmanları (%76.9) tarafından talep edilen EEG'lerde benzerdi. Sonuç olarak; EEG bir tarama testi olarak yorumlanmamalıdır, bilinç kaybı epizodu sırasında hastaların detayları ve klinik özellikleri paha biçilmez bir öneme sahiptir, EEG kaydı isteminden önce ön tanı tekrar tekrar değerlendirilmelidir. 

Kaynakça

  • 1. Wardrope A, Newberry E, Reuber M. Diagnostic criteria to aid the differential diagnosis of patients presenting with transient loss of consciousness: Asystematic review. Seizure. 2018;61:139-48.
  • 2. Koutroumanidis M, Smith S. Use and abuse of EEG in the diagnosis of idiopathic generalized epilepsies. Epilepsia. 2005;46 (Suppl 9):96-107.
  • 3. Kerry HL, Patrick C. Handbook of clinical neurology, vol. 160 (3rd series), clinical neurophysiology: basis and technical aspects. Elsevier, 2019.
  • 4. Stone JL, Hughes JR. Early history of electroencephalography and establishment of the American Clinical Neurophysiology Society. J Clin Neurophysiol. 2013;30:28-44.
  • 5. Robin K, Modern Electroencephalography. J Neurol. 2012;259:783-9.
  • 6. 6. Hai C, Mohamad ZK, Electroencephalography in epilepsy evaluation. Continuum (minneap minn). 2019;25(2, epilepsy):431-53.
  • 7. So EL. Interictal epileptiform discharges in persons without a history of seizures: what do they mean? J Clin Neurophysiol. 2010;27(4):229-38.
  • 8. Badry R. Latency to the first epileptiform activity in the EEG of epileptic patients. Int J Neurosci. 2013;123(9):646-9.
  • 9. Wirrell EC. Prognostic significance of interictal epileptiform discharges in newly diagnosed seizure disorders. J Clin Neurophysiol. 2010;27(4):239-48.
  • 10. Heyer GL. Syncope is associated with electroencephalography changes. Clin Neurophysiol. 2018;129(7):1496-7.
  • 11. Philippe G, Anna S, Jean MD, et al. Video EEG in syncopal attack due to ocular compression in an adolescent mistreated for epilepsy. Epileptic Disord. 2007;9(2):174-8.
  • 12. Vi-Huong NM, Claude A, Vera D, et al. Characterization of seizure-induced syncopes: EEG, ECG and clinical features. Epilepsia. 2014;55(1):146–55.
  • 13. Michael B, Dawood D, Amir A, ve ark. Ictal asystole and ictal syncope: insights into clinical management. Circ Arrhythm Electrophysiol. 2015;8(1):159-64.
  • 14. Raffaele N, Luca S, Viviana V, et al. Usefulness of EEG techniques in distinguishing frontotemporal dementia from alzheimer’s disease and other dementias, dis markers. 2018;2018:6581490.
  • 15. Borislav R, Ratimir P, Anja G, et al. EEG analysis and spect imaging in alzheimer’s disease, vascular dementia and mild cognitive impairment. Psychiatria Danubina. 2019;31(1):111-5.
Toplam 15 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular İç Hastalıkları
Bölüm Araştırma Makalesi
Yazarlar

Mahmut Bilal Çaman 0000-0001-7956-5677

Vedat Semai Bek 0000-0003-4913-976X

Yasemin Ünal 0000-0002-6110-9558

Gülnihal Kutlu 0000-0002-9325-4151

Yayımlanma Tarihi 28 Aralık 2021
Gönderilme Tarihi 10 Haziran 2020
Yayımlandığı Sayı Yıl 2021 Cilt: 8 Sayı: 3

Kaynak Göster

APA Çaman, M. B., Bek, V. S., Ünal, Y., Kutlu, G. (2021). The Analysis of Electroencephalography Requests in Clinical Neurophysiology Department. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, 8(3), 163-166. https://doi.org/10.47572/muskutd.750450
AMA Çaman MB, Bek VS, Ünal Y, Kutlu G. The Analysis of Electroencephalography Requests in Clinical Neurophysiology Department. MMJ. Aralık 2021;8(3):163-166. doi:10.47572/muskutd.750450
Chicago Çaman, Mahmut Bilal, Vedat Semai Bek, Yasemin Ünal, ve Gülnihal Kutlu. “The Analysis of Electroencephalography Requests in Clinical Neurophysiology Department”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 8, sy. 3 (Aralık 2021): 163-66. https://doi.org/10.47572/muskutd.750450.
EndNote Çaman MB, Bek VS, Ünal Y, Kutlu G (01 Aralık 2021) The Analysis of Electroencephalography Requests in Clinical Neurophysiology Department. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 8 3 163–166.
IEEE M. B. Çaman, V. S. Bek, Y. Ünal, ve G. Kutlu, “The Analysis of Electroencephalography Requests in Clinical Neurophysiology Department”, MMJ, c. 8, sy. 3, ss. 163–166, 2021, doi: 10.47572/muskutd.750450.
ISNAD Çaman, Mahmut Bilal vd. “The Analysis of Electroencephalography Requests in Clinical Neurophysiology Department”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 8/3 (Aralık 2021), 163-166. https://doi.org/10.47572/muskutd.750450.
JAMA Çaman MB, Bek VS, Ünal Y, Kutlu G. The Analysis of Electroencephalography Requests in Clinical Neurophysiology Department. MMJ. 2021;8:163–166.
MLA Çaman, Mahmut Bilal vd. “The Analysis of Electroencephalography Requests in Clinical Neurophysiology Department”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, c. 8, sy. 3, 2021, ss. 163-6, doi:10.47572/muskutd.750450.
Vancouver Çaman MB, Bek VS, Ünal Y, Kutlu G. The Analysis of Electroencephalography Requests in Clinical Neurophysiology Department. MMJ. 2021;8(3):163-6.