EEG Cap for Identification of Non-Convulsive Status Epilepticus
| Status: | Completed |
|---|---|
| Conditions: | Neurology, Neurology, Neurology |
| Therapuetic Areas: | Neurology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 11/17/2018 |
| Start Date: | May 30, 2017 |
| End Date: | August 16, 2018 |
EEG Cap Placement for Expedited Identification of Non-Convulsive Status Epilepticus
Altered mental status (AMS) is one of the most common reasons for inpatient neurology
consultation. Non-convulsive status epilepticus (NCSE) is frequently on the differential
diagnosis of the patient with AMS. NCSE becomes more refractory to treatment after one hour
of seizure activity, making rapid identification and treatment of NCSE of great clinical
importance. Currently, an electroencephalogram (EEG) technologist must be called in from home
during non-workday hours in order to obtain a stat EEG. The investigators propose the time
required for diagnosis of NCSE at Mayo Clinic can be significantly decreased with rapid
placement of an EEG cap by the onsite neurology residents.
consultation. Non-convulsive status epilepticus (NCSE) is frequently on the differential
diagnosis of the patient with AMS. NCSE becomes more refractory to treatment after one hour
of seizure activity, making rapid identification and treatment of NCSE of great clinical
importance. Currently, an electroencephalogram (EEG) technologist must be called in from home
during non-workday hours in order to obtain a stat EEG. The investigators propose the time
required for diagnosis of NCSE at Mayo Clinic can be significantly decreased with rapid
placement of an EEG cap by the onsite neurology residents.
At the completion of neurology evaluation, if NCSE is in the differential diagnosis according
to institution best practice, then consented participants will undergo placement of a large
size, 20-channel EEG cap from Electro-Cap International with a Natus E-2-2520-26 electrode
board adapter with initiation of recording. The placement of the EEG cap will be restricted
to residents formally trained in its placement by an EEG tech. This study will only be
performed during times when EEG techs are not available onsite for rapid placement of
standard 21-channel EEG electrodes, such as during night-call shifts.
Prior to placement of EEG cap, evaluating staff member will request immediate
standard-electrode EEG. The investigators will record time from neurology consultation
request to placement of EEG cap as well as time from consultation request to obtaining a
standard EEG. The investigators will also record time to confirmation or exclusion of NCSE.
Initial diagnosis or exclusion of NCSE will be performed by on call resident, if the resident
received prior training regarding EEG cap placement, and attending. Secondary quality
assessment will be performed by two independent EEG interpreters blinded to clinical history.
Secondary assessment will be qualified as acceptable or inacceptable interpretation based on
whether greater or less than 50% of the recording is judged interpretable. Secondary
assessment will also include interpretation of NCSE by a third independent reader if there is
disagreement between first two. The number of patients excluded from the study will also be
recorded, including the reason for exclusion.
to institution best practice, then consented participants will undergo placement of a large
size, 20-channel EEG cap from Electro-Cap International with a Natus E-2-2520-26 electrode
board adapter with initiation of recording. The placement of the EEG cap will be restricted
to residents formally trained in its placement by an EEG tech. This study will only be
performed during times when EEG techs are not available onsite for rapid placement of
standard 21-channel EEG electrodes, such as during night-call shifts.
Prior to placement of EEG cap, evaluating staff member will request immediate
standard-electrode EEG. The investigators will record time from neurology consultation
request to placement of EEG cap as well as time from consultation request to obtaining a
standard EEG. The investigators will also record time to confirmation or exclusion of NCSE.
Initial diagnosis or exclusion of NCSE will be performed by on call resident, if the resident
received prior training regarding EEG cap placement, and attending. Secondary quality
assessment will be performed by two independent EEG interpreters blinded to clinical history.
Secondary assessment will be qualified as acceptable or inacceptable interpretation based on
whether greater or less than 50% of the recording is judged interpretable. Secondary
assessment will also include interpretation of NCSE by a third independent reader if there is
disagreement between first two. The number of patients excluded from the study will also be
recorded, including the reason for exclusion.
Inclusion criteria:
1. Patients with suspected NCSE in the Mayo Clinic Florida hospital, emergency room or
intensive care unit.
2. Age: Patients of 18 years or older will be included in this study
3. Education: All education levels will be included
Exclusion criteria:
1. Patients younger than 18 years of age.
2. Patients with open head trauma.
3. Patients with anatomy that would preclude EEG cap placement.
4. Patients excluded for anatomical or age-related reasons will be tracked to determine
applicability of the EEG cap to the patient population at Mayo Clinic.
5. Pregnant females
6. Large head size not amenable to cap placement
7. Scalp infection
8. Inability to obtain informed consent
We found this trial at
1
site
4500 San Pablo Rd S
Jacksonville, Florida 32224
Jacksonville, Florida 32224
(904) 953-2000
Phone: 904-953-8049
Mayo Clinic Florida Thousands of people come to Mayo Clinic in Jacksonville, Fla., annually for...
Click here to add this to my saved trials
