• Ayham Alkhachroum, GanesanSaptharishi LalgudiSLChildren's Hospital of Western Ontario, London Health Sciences Centre, London, ON, Canada.Department of Paediatrics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada., Johannes P Koren, Julie Kromm, Nina Massad, Renz A Reyes, Michael R Miller, David Roh, Sachin Agarwal, Soojin Park, and Jan Claassen.
• Department of Neurology, Columbia University and NewYork Presbyterian Hospital, New York, NY, USA.
• Neurocrit Care. 2022 Jun 1; 36 (3): 897904897-904.

BackgroundThe objective of this study was to evaluate the accuracy of seizure burden in patients with super-refractory status epilepticus (SRSE) by using quantitative electroencephalography (qEEG).MethodsEEG recordings from 69 patients with SRSE (2009-2019) were reviewed and annotated for seizures by three groups of reviewers: two board-certified neurophysiologists using only raw EEG (gold standard), two neurocritical care providers with substantial experience in qEEG analysis (qEEG experts), and two inexperienced qEEG readers (qEEG novices) using only a qEEG trend panel.ResultsRaw EEG experts identified 35 (51%) patients with seizures, accounting for 2950 seizures (3,126 min). qEEG experts had a sensitivity of 93%, a specificity of 61%, a false positive rate of 6.5 per day, and good agreement (κ = 0.64) between both qEEG experts. qEEG novices had a sensitivity of 98.5%, a specificity of 13%, a false positive rate of 15 per day, and fair agreement (κ = 0.4) between both qEEG novices. Seizure burden was not different between the qEEG experts and the gold standard (3,257 vs. 3,126 min), whereas qEEG novices reported higher burden (6066 vs. 3126 min).ConclusionsBoth qEEG experts and novices had a high sensitivity but a low specificity for seizure detection in patients with SRSE. qEEG could be a useful tool for qEEG experts to estimate seizure burden in patients with SRSE.© 2021. Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society.

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