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Comment & Response
February 1, 2021

Assessment of a Study of Continuous vs Repeat-Spot Electroencephalography in Patients With Critical Illness—Reply

Author Affiliations
  • 1Department of Clinical Neuroscience, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
  • 2Sleep-Wake-Epilepsy-Center, Department of Neurology, Inselspital, University Hospital, University of Bern, Bern, Switzerland
  • 3Department of Neurology, Hôpital du Valais, Sion, Switzerland
JAMA Neurol. 2021;78(3):369-370. doi:10.1001/jamaneurol.2020.5343

In Reply We thank Gaspard et al for their letter, which raises several relevant issues, some of which were already discussed in the article (eg, the limited generalizability to patients without recent seizures or status epilepticus1). They point to the median latency of electroencephalography (EEG) recordings (57.5 hours in the continuous EEG [cEEG] group and 60.3 hours in the repeat-spot EEG [rEEG] group) and infer that this prevented us from quickly identifying and managing seizures and status epilepticus. As stated in Table 1 in our article,1 this actually represents the time between acute hospital admission (not EEG request) and the EEG start; in participants after brain surgery, in the context of sepsis, or with brain tumors, EEG is often requested with some delay after admission. Of note, recordings started within 4 hours after the EEG request1; we feel that this represents a reasonable time frame. Also, we have now compared mortality distributions across patients recorded within 36 hours following admission (cEEG group: 38 of 67 patients; rEEG group: 26 of 60 patients; P = .13) and thereafter (cEEG group: 51 of 115 patients; rEEG group: 62 of 122 patients; P = .32), which remain very similar.

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