Rajan Nevedha, Kavanagh Toni, LaVega-Talbott Maite, Gangadharan Sandeep
Division of Pediatric Critical Care Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA.
Division of Pediatric Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Epilepsia Open. 2025 Feb;10(1):277-285. doi: 10.1002/epi4.13120. Epub 2025 Jan 4.
Pediatric status epilepticus (SE) carries a high risk of morbidity and mortality and can result in neurologic injury. Establishing seizure activity on conventional EEG (cEEG) is essential but can delay treatment of seizures due to technician limitations. Rapid response EEG (rrEEG) device Ceribell and its Brain Stethoscope function can be used and interpreted rapidly by bedside providers with minimal training. This retrospective pilot study examines the impact of rrEEG introduction at a quaternary care children's hospital on time to definitive diagnosis and treatment, as well as the accuracy of the Brain Stethoscope.
This was a single center retrospective observational cohort study that analyzed data from patients 2-18 years old who presented with concerns for SE. For rrEEG patients, the bedside physician used the Brain Stethoscope at four discrete points. TDEA (time to diagnosis of electrographic activity) and setup time were recorded and compared using Welch's T-test. Diagnostic specificity and sensitivity for SE using the Brain Stethoscope were calculated against the epileptologist's assessment.
Data were collected from 30 pediatric patients, 15 on each EEG modality. RrEEG decreased the average TDEA (132 min vs. 22 min, p < 0.001) and setup time (22 min vs. 9 min, p < 0.001), compared to the cEEG. Bedside physicians diagnosed electrographic activity using the Brain Stethoscope with 100% sensitivity (95% CI 63%-100%) and 92% specificity (95% CI 81%-97%). RrEEG ruled out seizures in 11 patients and changed clinical decision-making in five patients.
RrEEG allowed for earlier diagnosis of brain electrographic activity in pediatric patients when compared to cEEG. The bedside provider was able to initiate EEG monitoring, successfully diagnose patients using the Brain Stethoscope, and decrease delays associated with technician availability. This promising rrEEG technology can facilitate faster assessment of SE in pediatric acute care settings, potentially reducing ongoing neurologic injury.
Prolonged seizures in pediatric patients can cause death. Children can have seizures that are happening in the brain, but cannot be seen physically. They can be diagnosed by a machine that records the brain's electrical activity and the data can be interpreted by a specialized neurologist, but the process of getting the machine connected to the patient and getting the data often takes hours and delays diagnosis. This study evaluated a new machine called the Ceribell® and determined that it facilitated a much faster diagnosis than the conventional machine in children and helped the bedside physician interpret the data quickly.
小儿癫痫持续状态（SE）具有较高的发病率和死亡率风险，可导致神经损伤。在传统脑电图（cEEG）上确定癫痫活动至关重要，但由于技术人员的限制，可能会延迟癫痫治疗。快速反应脑电图（rrEEG）设备Ceribell及其脑听诊器功能可由床边医护人员在接受最少培训后快速使用和解读。这项回顾性试点研究考察了在一家四级医疗儿童医院引入rrEEG对明确诊断和治疗时间的影响，以及脑听诊器的准确性。
这是一项单中心回顾性观察队列研究，分析了2至18岁因SE就诊患者的数据。对于rrEEG患者，床边医生在四个不同时间点使用脑听诊器。记录并使用韦尔奇t检验比较确诊电活动时间（TDEA）和设置时间。根据癫痫专家的评估计算使用脑听诊器诊断SE的特异性和敏感性。
收集了30例儿科患者的数据，每种脑电图模式各15例。与cEEG相比，rrEEG缩短了平均TDEA（132分钟对22分钟，p<0.001）和设置时间（22分钟对9分钟，p<0.001）。床边医生使用脑听诊器诊断电活动的敏感性为100%（95%CI 63%-100%），特异性为92%（95%CI 81%-97%）。rrEEG排除了11例患者的癫痫发作，并改变了5例患者的临床决策。
与cEEG相比，rrEEG能够更早地诊断小儿患者的脑电活动。床边医护人员能够启动脑电图监测，使用脑听诊器成功诊断患者，并减少与技术人员可用性相关的延迟。这项有前景的rrEEG技术可促进小儿急性护理环境中对SE的更快评估，可能减少持续的神经损伤。
小儿患者的长时间癫痫发作可导致死亡。儿童可能会出现脑部癫痫发作，但身体上无法看到。可以通过记录脑电活动的机器进行诊断，数据可由专业神经科医生解读，但将机器连接到患者并获取数据的过程通常需要数小时，会延迟诊断。本研究评估了一种名为Ceribell®的新机器，确定它比传统机器能更快地诊断儿童癫痫，并帮助床边医生快速解读数据。
