The value of electroencephalography in differential diagnosis of altered mental status in emergency departments

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Duran L., Balci K., Yardan T., Katı C., Akdemir H. U., Karadas S., ...More

JOURNAL OF THE PAKISTAN MEDICAL ASSOCIATION, vol.64, no.8, pp.923-927, 2014 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 64 Issue: 8
  • Publication Date: 2014
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED)
  • Page Numbers: pp.923-927
  • Recep Tayyip Erdoğan University Affiliated: Yes



Objective: To evaluate the value of electroencephalography in patients with altered mental status in emergency departments.

Methods: Demographical characteristics, types and aetiologies of seizures, and clinical outcomes of the patients were recorded. Patients were divided into 4 groups according to the complaints of admission: findings and symptoms of seizure; stroke and symptoms of stroke-related seizures; syncope; and metabolic abnormalities and other causes of altered mental status. The electroencephalography findings were classified into 3 groups: epileptiform discharges; paroxysmal electroencephalography abnormalities; and background slowing. Electroencephalography abnormalities in each subgroup were evaluated. SPSS 21 was used for statistical analysis.

Results: Of the total 190 patients in the study, 117(61.6%) had pathological electroencephalography findings. The main reason for electroencephalography in the emergency department was the presence of seizure findings and symptoms in 98(51.6%) patients. The ratio of electroencephalography abnormality was higher in patients who were admitted with complaints of metabolic abnormality-related consciousness disturbances (p<0.001). A total of 124(65.3%) patients had neuroimagings. Electroencephalography abnormalities were found to be significantly higher in patients with neuroimagings compared to those without neuroimagings (p<0.003).

Conclusion: Despite advanced neuroimaging techniques, an electroencephalography is still an important tool in the differential diagnosis of altered mental status such as epileptic seizures, metabolic abnormalities, pseudo-seizures and syncope.

Keywords: EEG, Altered mental status, Emergency department. (JPMA 64: 923; 2014)