The Analysis of Electroencephalography Requests in Clinical Neurophysiology Department

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Abstract
Transient loss of consciousness (LOC) has an important place in emergency applications. Therefore, it is very important to define the etiology of LOC. In this study, we retrospectively analyzed our outpatient electroencephalography (EEG) records to evaluate whether the clinician ordering the test had a fulfilling result. EEG recordings between 01.07.2017 to 01.07.2018 in our outpatient clinic were reviewed. 1015 of EEGs were ordered by general neurologists (70.05%), 355 by epilepsy specialists (24.5%) and 79 by other departments (5.5%). The Department of Psychiatry was leading among other departments by one third. 281 out of 1449 EEGs were abnormal (19.4%). Only three patients had a seizure during EEG recording. Preliminary diagnosis for EEG record request were epilepsy in 829 patients (57.2%), syncope in 257 patients (17.8%), headache in 12 (0.8%), vertigo in 12 (0.8%), cognitive dysfunction in 71 (4.9%), sleep disorder in 16 (1.1%), intracranial mass lesion in 18 (1.0%), cerebrovascular diseases in 54 (3.7%), altered mental status in 26 (73.3%) and encephalitis in 15 patients (1.0%). Normal EEG recording results were 76.5% in the recordings with preliminary diagnosis of epilepsy. Abnormalities found in patients with preliminary diagnosis of epilepsy patients were sharp/spike in 45.1%, focal/generalied slowing in 41.5% and background slowing in 11.8%. Overall abnormality percentage was similar in EEGs requested by either general neurologists (76.0%) or epilepsy specialists (76.9%) but not by other departments (82.1%). As a result; EEG should not be interpreted as a screening test, patients’ details and clinical features during loss of consciousness episode have a priceless importance and preliminary diagnosis should be re- and reevaluated before EEG recording request.

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