Patterns of Abnormalities and Yield of Electroencephalograms in Young Adults in a Tertiary Care Medical center in Saudi Arabia

Abstract

Objectives: To determine the yield of electroencephalograms (EEG) in various clinical scenarios, including epilepsy, in young adults.
Methods: EEGs performed on adults of both genders aged between 18 and 50 years between January 2009 and December 2013 at King Abdulaziz Medical City, Riyadh were included. Clinical indication and EEG findings were determined and correlated.
Results: Of 2,631 EEGs, 1,351 (51.3%) were for females. The mean age was 29.9 ± 9.4 years. A total of 1,928 (73%) EEGs were outpatient. Indications included seizure/epilepsy, status epilepticus, altered level of consciousness, brain death, other indications, and unclear indications. Electroencephalograms were normal in 56.2% of the cases for seizure/epilepsy, 69.3% for altered consciousness, and 65.4% for other indications. When the indication was not clear, 50.6% of EEGs were normal. Epileptiform abnormalities were found in 22.3% of the EEGs for seizure/epilepsy (p <0.001). Slowing with or without epileptiform abnormalities was found in 23.1% of the EEGs for altered consciousness. Electroencephalograms for brain death confirmed diagnosis in 46.7% of the cases (p < 0.001). The highest frequency of abnormalities was seen in EEGs performed in the intensive care unit (91.2%), followed by wards (66.3%) and the emergency room (49.4%). Outpatient EEGs were abnormal only in 36.8% of the cases. Overall, 43% of EEGs showed some abnormality.
Conclusion: Electroencephalograms had a higher yield of abnormalities when appropriate clinical questions were asked. The greatest number of confirmatory EEGs was observed in brain death evaluations. Almost half of the EEGs for patients with suspected epilepsy were normal, with only 1 in 5 confirming it. Approximately 2 in 5 EEGs showed some abnormality regardless of the indication.

How to cite: BenOmran N., Alubied A., AlSehali A., AlBishi A., AlOtaibi H., Masuadi E., AlAnazi A., Khatri A.I. Patterns of abnormalities and yield of electroencephalograms in young adults in a tertiary care medical center in Saudi
Arabia. Esculapio 2021;17(02).