Poliquin-Lasnier Laurence, Moore Fraser G A
Department of Neurology and Neurosurgery, Centre for Medical Education, McGill University, Montreal, QC, Canada.
Can J Neurol Sci. 2009 Nov;36(6):769-73. doi: 10.1017/s0317167100008416.
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.
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.
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.
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.
先前的研究表明，脑电图（EEG）在晕厥评估中的诊断价值较低，但尚未根据转诊医生的专业来研究其诊断价值。本研究的目的是确定由神经科医生开具脑电图检查时其诊断价值是否更高，以及脑电图检查结果异常是否会导致患者管理出现任何重大变化。
我们回顾性分析了2003年至2007年在我院因临床诊断晕厥、惊厥性晕厥、意识丧失或跌倒而进行脑电图检查的记录。我们从脑电图异常患者的病历中获取了更多信息。
在符合我们纳入标准的517次脑电图检查中，只有57次（11.0%）被解读为异常。没有脑电图检查显示癫痫样活动呈阳性，只有9次（1.6%）显示潜在的癫痫活动。神经科医生开具的脑电图检查与非神经科医生开具的相比，诊断价值并未更高。5次脑电图检查结果异常导致进一步的检查被安排。1例患者最终开始服用苯妥英钠。
对于疑似晕厥患者进行的脑电图检查诊断价值极低，并且无论转诊医生的专业如何，都不会显著改变患者的管理。
