Quantitative electroencephalogram versus raw electroencephalogram in critical traumatic brain injury patients

doi:10.3877/cma.j.issn.2096-1537.2018.03.006

Abstract

Abstract:

Objective

To evaluate the sensitivity of quantitative electroencephalogram (QEEG) to detect electrographic seizure in critical traumatic brain injury patients in the intensive care unit (ICU) and further compare it to the raw electroencephalogram (REEG).

Methods

Six-hour QEEG epochs with 8 electrodes with international 10-20 system were performed in 18 critical traumatic brain injury patients with suspect seizure. REEG was performed during the same time. Each epoch was reviewed by two groups of physician independently. Two neurophysiologists reviewed REEGs and QEEG to identify seizures to serve as the gold standard. Analysis time and seizure detected frequency of REEG and QEEG were compared to identify the sensitivity and error rate for seizure identification.

Results

A significant different sensitivity for seizure identification was found between QEEG and REEG [82.75% (50.00%-91.67%) vs 59.83% (0-83.33%), P=0.002]. Analysis time was significant shorter in QEGG relative REEG [0.09 (0-0.67) h vs 0.06 (0~0.34) h,P<0.001]. No significant false rate was found between two groups [0.09 per hour (0-0.67) vs 0.06 per hour (0-0.34), P=0.131].

Conclusion

QEEG can be used by doctors to shorten EEG review time with better sensitivity for seizure identification in critical traumatic brain injury patients with seizure in ICU.

Key words: Critical traumatic brain injury patients, Quantitative electroencephalogram, Raw electroencephalogram, Sensitivity, False rate

Chunguang Zhao, Lina Zhang, Jian Wang, Li Huang, Yang Ning, Meilin Ai, Yimin Wang, Yuhang Ai. Quantitative electroencephalogram versus raw electroencephalogram in critical traumatic brain injury patients[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2018, 04(03): 238-244.

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URL: https://icu.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2096-1537.2018.03.006

https://icu.cma-cmc.com.cn/EN/Y2018/V04/I03/238

Figures/Tables 6

References 21

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编号	放电区域	典型样式	解读时间（min）		敏感度（%）		痫样放电				错误率（次数/h）
			解读时间（min）		敏感度（%）		临床医师		?	脑电医师	错误率（次数/h）
			QEEG	REEG	QEEG	REEG	QEEG	REEG	?	QEEG＋REEG	QEEG	REEG
1	部分脑叶	棘-慢复合波/爆发-抑制	7.50	12.00	81.82	31.82	18	7	?	22	0.34	0.67
2	部分脑叶	爆发棘波	9.00	19.00	100.00	0	1	0	?	1	0	0
3	部分脑叶	爆发棘波	5.00	11.50	100.00	100.00	1	1	?	1	0	0
4	部分脑叶	爆发棘波/低电压棘波短暂发作	5.50	12.00	100.00	100.00	3	3	?	3	0	0
5	全脑	棘-慢复合波	6.50	13.50	60.87	56.52	14	13	?	23	0	0.34
6	部分脑叶	棘-慢复合波/爆发-抑制	8.00	11.00	100.00	83.33	6	5	?	6	0.17	0
7	部分脑叶	爆发棘波	7.00	13.00	66.67	66.67	2	2	?	3	0	0
8	部分脑叶	爆发棘波	4.50	17.00	100.00	100.00	1	1	?	1	0	0
9	部分脑叶	棘-慢复合波	9.00	10.50	0	0	0	0	?	1	0	0
10	全脑	棘-慢复合波	5.00	15.00	91.67	50.00	11	6	?	12	0	0
11	全脑	棘-慢复合波	5.00	14.00	90.91	72.73	10	8	?	11	0.17	0.34
12	全脑	爆发棘波/低电压棘波短暂发作	7.50	11.00	87.50	62.50	7	5	?	8	0.17	0.17
13	部分脑叶	棘-慢复合波	5.00	13.00	100.00	100.00	1	1	?	1	0	0
14	部分脑叶	爆发棘波	6.00	12.50	100.00	100.00	1	1	?	1	0	0
15	部分脑叶	爆发棘波	6.50	10.50	60.00	20.00	3	1	?	5	0	0
16	部分脑叶	爆发棘波/低电压棘波短暂发作	7.50	18.00	100.00	33.33	3	1	?	3	0	0.17
17	部分脑叶	棘-慢复合波	5.00	17.00	50.00	0	1	0	?	2	0	0
18	部分脑叶	爆发棘波	7.00	16.00	100.00	100.00	1	1	?	1	0.17	0

编号	放电区域	典型样式	解读时间（min）		敏感度（%）		痫样放电				错误率（次数/h）
			解读时间（min）		敏感度（%）		临床医师		?	脑电医师	错误率（次数/h）
			QEEG	REEG	QEEG	REEG	QEEG	REEG	?	QEEG＋REEG	QEEG	REEG
1	部分脑叶	棘-慢复合波/爆发-抑制	7.50	12.00	81.82	31.82	18	7	?	22	0.34	0.67
2	部分脑叶	爆发棘波	9.00	19.00	100.00	0	1	0	?	1	0	0
3	部分脑叶	爆发棘波	5.00	11.50	100.00	100.00	1	1	?	1	0	0
4	部分脑叶	爆发棘波/低电压棘波短暂发作	5.50	12.00	100.00	100.00	3	3	?	3	0	0
5	全脑	棘-慢复合波	6.50	13.50	60.87	56.52	14	13	?	23	0	0.34
6	部分脑叶	棘-慢复合波/爆发-抑制	8.00	11.00	100.00	83.33	6	5	?	6	0.17	0
7	部分脑叶	爆发棘波	7.00	13.00	66.67	66.67	2	2	?	3	0	0
8	部分脑叶	爆发棘波	4.50	17.00	100.00	100.00	1	1	?	1	0	0
9	部分脑叶	棘-慢复合波	9.00	10.50	0	0	0	0	?	1	0	0
10	全脑	棘-慢复合波	5.00	15.00	91.67	50.00	11	6	?	12	0	0
11	全脑	棘-慢复合波	5.00	14.00	90.91	72.73	10	8	?	11	0.17	0.34
12	全脑	爆发棘波/低电压棘波短暂发作	7.50	11.00	87.50	62.50	7	5	?	8	0.17	0.17
13	部分脑叶	棘-慢复合波	5.00	13.00	100.00	100.00	1	1	?	1	0	0
14	部分脑叶	爆发棘波	6.00	12.50	100.00	100.00	1	1	?	1	0	0
15	部分脑叶	爆发棘波	6.50	10.50	60.00	20.00	3	1	?	5	0	0
16	部分脑叶	爆发棘波/低电压棘波短暂发作	7.50	18.00	100.00	33.33	3	1	?	3	0	0.17
17	部分脑叶	棘-慢复合波	5.00	17.00	50.00	0	1	0	?	2	0	0
18	部分脑叶	爆发棘波	7.00	16.00	100.00	100.00	1	1	?	1	0.17	0

方法	敏感度（%）	解读时间（min）	错误率（次/h）
QEEG	82.75±26.60	6.28±1.45	0.09±0.18
REEG	59.83±37.87	13.56±2.81	0.57±0.10
t值	3.32	-9.50	1.16
P值	0.004	0	0.262

方法	敏感度（%）	解读时间（min）	错误率（次/h）
QEEG	82.75±26.60	6.28±1.45	0.09±0.18
REEG	59.83±37.87	13.56±2.81	0.57±0.10
t值	3.32	-9.50	1.16
P值	0.004	0	0.262

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