Abstracts

Rationale: To assess the sensitivity of Persyst version 12, seizure probability trend, asymmetry, FFT, Rhythmicity and amplitude integrated QEEG spectrograms to detect focal, focal with secondarily generalized and generalized onset seizures. Methods: A cohort of 562 seizures from 58 patients was analyzed. Successive recordings with 2 or more seizures during continuous EEG monitoring for clinical indications in the ICU or EMU between July 2016 and January 2017 were included. Patient ages ranged from 5 to 64 years (mean = 36 years). 125 focal, 187 secondarily generalized seizures each from 20 patient records and 250 generalized seizures from 18 patient records were analyzed. Seizures were identified and classified independently by two epileptologists. A correlate to the seizure pattern in the raw EEG was then sought in the QEEG spectrograms in 4-6 hour EEG epochs surrounding the identified seizures. A given spectrogram was interpreted as indicating a seizure, if at the time of a seizure it showed a visually significant departure from the pre-event baseline. Sensitivities for seizure detection using each spectrogram were determined for each seizure subtype. Results: Overall sensitivities of the QEEG spectrograms for detecting seizures ranged from 43% to 72%, with highest sensitivity (402/562, 72%) by the seizure detection trend (see table1 and figure 1). The asymmetry spectrogram had the highest sensitivity for detecting focal seizures (117/125, 94%). The FFT spectrogram was most sensitive for detecting secondarily generalized seizures (158/187, 84%). The seizure detection trend was the most sensitive for generalized onset seizures (197/250, 79%). Conclusions: Our study suggests that Persyst QEEG spectrograms vary in their sensitivities to identify focal, secondarily generalized and generalized onset seizures. Further research to assess the sensitivity of QEEG for seizure detection and the relative utility of these tools in EMU vs. ICU environments is ongoing and may increase our understanding of the utility of these tools for screening the raw EEG. Funding: No funding was received