The difficulty of diagnosing NCSE in clinical practice; external validation of the Salzburg criteria.

Abstract:

:To improve the diagnostic accuracy of electroencephalography (EEG) criteria for nonconvulsive status epilepticus (NCSE), external validation of the recently proposed Salzburg criteria is paramount. We performed an external, retrospective, diagnostic accuracy study of the Salzburg criteria, using EEG recordings from patients with and without a clinical suspicion of having NCSE. Of the 191 EEG recordings, 12 (12%) was classified as an NCSE according to the reference standard. In the validation cohort, sensitivity was 67% and specificity was 89%. The positive predictive value was 47% and the negative predictive value was 95%. Ten patients in the control group (n = 93) were false positive, resulting in a specificity of 89.2%. The interrater agreement between the reference standards and between the scorers of the Salzburg criteria was moderate; disagreement occurred mainly in patients with an epileptic encephalopathy. The Salzburg criteria showed a lower diagnostic accuracy in our external validation study than in the original design, suggesting that they cannot replace the current practice of careful weighing of both clinical and EEG information on an individual basis.

journal_name

Epilepsia

journal_title

Epilepsia

authors

Goselink RJM,van Dillen JJ,Aerts M,Arends J,van Asch C,van der Linden I,Pasman J,Saris CGJ,Zwarts M,van Alfen N

doi

10.1111/epi.16289

subject

Has Abstract

pub_date

2019-08-01 00:00:00

pages

e88-e92

issue

8

eissn

0013-9580

issn

1528-1167

journal_volume

60

pub_type

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