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EEG in Suspected Syncope: Do EEGs Ordered by Neurologists Give a Higher Yield?

Published online by Cambridge University Press:  02 December 2014

Laurence Poliquin-Lasnier  and
Fraser G. A. Moore
Laurence Poliquin-Lasnier
Affiliation:
Department of Neurology and Neurosurgery, Centre for Medical Education, McGill University, Montreal, QC, Canada
Fraser G. A. Moore*
Affiliation:
Department of Neurology and Neurosurgery, Centre for Medical Education, McGill University, Montreal, QC, Canada
*
3755 CôSainte-Catherine E-005, Montré, Quebec, H3T 1E2, Canada.
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Abstract

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Background:

Prior studies have shown that the electroencephalogram (EEG) is of low diagnostic yield in the evaluation of syncope but have not looked at the yield according to referring physician specialty. The goals of this study were to determine if the yield of the EEG is higher when ordered by neurologists and whether EEGs with abnormal findings resulted in any significant change in patient management.

Methods:

We retrospectively reviewed the records of the EEGs requested for a clinical diagnosis of syncope, convulsive syncope, loss of consciousness, or falls from 2003 to 2007 at our institution. We obtained further information from the medical record of patients with an abnormal EEG.

Results:

Of 517 EEGs meeting our inclusion criteria, only 57 (11.0%) were read as abnormal. No EEG was positive for epileptiform activity and only 9 (1.6%) showed potentially epileptic activity. EEGs ordered by neurologists did not have a higher yield compared to non-neurologists. Five abnormal EEGs resulted in further investigations being ordered. One patient was ultimately started on phenytoin.

Conclusions:

EEGs requested for the evaluation of patients with suspected syncope have an extremely low diagnostic yield and do not significantly alter the management of the patients, regardless of the specialty of the referring physician.

Type
Other
Information
Canadian Journal of Neurological Sciences , Volume 36 , Issue 6 , November 2009 , pp. 769 - 773
Copyright
Copyright © The Canadian Journal of Neurological 2009

References

1.McKeonA, , Vaughan, C, Delanty, N.Seizure versus Syncope. Lancet Neurol. 2006;5:175–80.Google Scholar
2.Davis, TL, Freemon, FR.Electroencephalography should not be routine in the evaluation of syncope in adults. Arch Int Med. 1990;150:2027–9.Google Scholar
3.Pires, LA, Ganji, JR, Jarandila, R, Steele, R.Diagnostic patterns and temporal trends in the evaluation of adult patients hospitalized with syncope. Arch Int Med. 2001;161:1889–95.Google Scholar
4.Widdess-Walsh, P, Sweeney, BJ, Galvin, R, McNamara, B.Utilization and yield of EEG in the elderly population. J Clin Neurophysiol. 2005;22(4):253–5.Google Scholar
5.Abubakr, A, Wambacq, I.The diagnostic value of EEGs in patients with syncope. Epilepsy Behav. 2005;6:433–4.CrossRefGoogle ScholarPubMed
6.Schnipper, JL, Kapoor, WN.Diagnostic evaluation and management of patients with syncope. Med Clin NOrth Am. 2001;85:423–56.Google Scholar
7.Linzer, M, Yang, EH, Estes, NAM, Wang, P, Vorperian, VR, Kapoor, WN.Diagnosing syncope Part 1: Value of history, physical examination, and electrocardiography. Ann Int Med. 1997;126: 989–96.Google Scholar
8.Kapoor, WN.Syncope. New Eng J Med. 2000;343:1856–62.Google Scholar
9.Sheldon, R, Rose, S, Ritchie, D, Connolly, SJ, Koshman, M, Lee, M, et al.Historical criteria that distinguish syncope from seizures. J Am Coll Cardiol. 2002;40:142–8.CrossRefGoogle ScholarPubMed
10.King, MA, Newton, MR, Jackson, GD, Fitt, GJ, Mitchell, LA, Silvapulle, MJ, et al.Epileptology of the first seizure presentation: a clinical, electroencephalographic, and magnetic resonance imaging study of 300 consecutive patients. Lancet Neurol. 1998;352:1007–11.Google Scholar
11.Josephson, CB, Rahey, S, Sadler, RM.Neurocardiogenic syncope: frequency and consequences of its misdiagnosis as Epilepsy. Can J Neurol Sci. 2007;34:221–4.CrossRefGoogle ScholarPubMed
12.Smith, D, Bartolo, R, Pickles, RM, Tedman, BM.Requests for electroencephalography in a district general hospital: retrospective and prospective audit. BMJ. 2001;322:954–7.CrossRefGoogle Scholar