Computer analysis of epileptiform EEG abnormalities
Richard C. Burgess, MD, PhD
Department of Neurology, The Cleveland Clinic Foundation, One Clinic Center, 9500 Euclid Avenue, Cleveland, Ohio 44195
Ernest C. Jacobs, MD
PROLONGED multichannel electroencephalographic (EEG) recordings are required for the evaluation of an epilepsy surgery candidate in order to define precisely the epileptogenic areas, the patient's suitability for surgical treatment, and the extent of a proposed resection. An adequate sample of ictal and interictal EEG abnormalities must be obtained to make these important clinical decisions. The minimal monitoring period required to obtain the sample varies from patient to patient, but should be as short as possible.
Minimizing the time away from home is especially important when recording from pediatric patients. Children do not understand the importance of the diagnostic test, may be less patient in a restricted and boring setting, and are more likely to interfere with the apparatus. Nevertheless, a positive diagnosis and definite classification are more important at this stage of life than at any other. In patients of any age requiring intensive inpatient EEG monitoring, a computer system can serve to shorten the total time of confinement while maximizing the information yield from the diagnostic evaluation. The storage and data reduction capabilities of a computer system ease the interpretation burden on the electroencephalographer, making it possible to record long enough to acquire an adequate sample of EEG abnormalities.
Although a limited amount of continuous monitoring can be carried out with essentially manual methods, the large amount of EEG data soon becomes a practical concern. A 16-channel EEG recorded at the normal paper speed for 24 hours would generate 1.6 miles of chart paper, weighing 230 pounds. Even for. . .