DUGi

Early 24/7 point-of-care EEG in the emergency department for suspected nonconvulsive status epilepticus: a multicenter randomized controlled trial protocol

http://dugi.udg.edu/item/http:@@@@hdl.handle.net@@10256@@28617

Objectives: Primary: To determine whether early 24/7 portable EEG in the ED increases the proportion of patients alive and returned to premorbid neurological function at Day 30 versus standard care. Secondary: To assess effects on NCSE detection, time to first EEG, EEG-driven diagnostic and therapeutic changes (including antiseizure medication initiation/adjustment/de-escalation and targeted testing prompted by encephalopathic patterns), admissions (including ICU), length of stay, and in-hospital outcomes. Design: Multicenter (Spain), randomized, controlled, open-label, superiority trial with parallel groups. Participants and methods: Consecutive adults (≥18 years) with acute unexplained AMS/ALOC after initial ED stabilization and clinical suspicion of NCSE will be randomized 1:1 to early portable EEG (CerebAir® reduced-montage wireless headset) or standard care (convEEG per local practice/availability). In the intervention arm, pocEEG will start as soon as possible (target ≤60 min; acceptable ≤90 min) and be interpreted by the on-call neurologist to guide immediate management; expert over-read will be performed during working hours when available. Primary outcome: alive and returning to premorbid function at Day 30 (mRS at Day 30 ≤ premorbid mRS; death classified as unfavorable). Analyses will follow intention-to-treat with center-adjusted models

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