Kane N, Grocott L, Kandler R, Lawrence S, Pang C. Hyperventilation during electroencephalography: safety and efficacy.
Seizure 2013;
23:129-34. [PMID:
24252807 DOI:
10.1016/j.seizure.2013.10.010]
[Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Revised: 10/22/2013] [Accepted: 10/24/2013] [Indexed: 10/26/2022] Open
Abstract
PURPOSE
To determine safety and efficacy of hyperventilation (HV) during electroencephalography (EEG).
METHODS
We report the findings of a prospective multicentre National Service Evaluation of the occurrence of adverse events, seizures and interictal epileptiform discharges seen in association with HV during EEG, in a relatively unselected, largely out patient population of 3475 being investigated predominantly for possible epileptic seizures.
RESULTS
Adverse events occurred rarely, and there were no reported significant cerebrovascular, cardiovascular or respiratory events. Of the 3170 patients suspected of 'epilepsy or possible epilepsy' 69 patients (2.2%) had seizures provoked by HV, but only one (0.03%) had a generalised tonic clonic seizure. The elicitation or increase of interictal epileptiform discharges (IEDs) was seen in 387 (12.2%) of the total 3170 patients with suspected epilepsy who hyperventilated. Furthermore 31 patients (0.9%) had psychogenic non-epileptic seizures.
CONCLUSION
HV is rarely associated with adverse events, but contributes to the diagnosis and classification of seizure disorders in an appreciable proportion of patients with epilepsy and non-epileptic attacks. These findings confirm that HV in selected patients is a valid activation technique in diagnostic EEG, where the potential benefits out weigh the risks, and also provide information that may assist the informed consent process.
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