Time is brain. That phrase has become a well-known rallying cry to waste no time in the treatment of stroke patients.
The quicker medical care is given, the more lives are saved and the less disability people suffer. What many do not know is that this phrase also applies to cases of epilepsy where EEG techs become a vital part of the fast-acting team.
That was a major message in a talk given by Leisha Osburn at the recent annual meeting of ASET–the Neurodiagnostic Society.
“I grew up in EEG hearing many times, ‘It can wait until tomorrow,’” said Osburn, who has been an EEG tech for many years and is now pursuing a Ph.D. studying the use of EEG in the emergency room. “There is never a STAT EEG. We don’t really know that it hurts patients to have seizures or be in status.’”
That has changed. Research over the last 10 years has shown that seizures are independently associated with morbidity and mortality, said Osburn who pointed to a study published in 2020 in the journal Pediatric Emergency Medicine Practice.
This study provides advice on managing seizures in neonates in the emergency room. Neonatal seizures are associated with high morbidity and mortality, the researchers note, but “they can be difficult to diagnose because they often present with subtle signs and symptoms.”
For this reason, it is critical to provide a STAT EEG – it’s by EEG that most of these cases are definitively diagnosed, providing information essential to treatment. Stopping the seizure as soon as possible, they write, “is important for improved patient outcomes.”
Another condition requiring the quick action of EEG techs is nonconvulsive status epilepticus. Here, seizures that are abnormally prolonged can cause permanent damage to neurons and their networks, as detailed in this 2019 paper.
The problem we are facing now, Osburn says, is that current hospital infrastructure isn’t set up to provide EEG testing as timely as it’s sometimes needed. It takes an average of four hours from when the EEG order is placed to when it is initiated.
“How well does it serve us and serve our patients and our physicians in getting this tool rapidly available for helping bedside diagnosis?” Osburn asks.
Reading a 2017 study done at Boston Children’s Hospital was a turning point for her. The study showed that time to EEG was one of the independent factors that could predict child and infant mortality.
“I read that and I got chills,” she said. “That’s why you’re hearing me talk here today. The bottom line is we know that time is brain for seizures too.”