Abstract
BESA Epilepsy (BESAE) is a software package that automatically detects spike-like activities and is expected to reduce the burden of EEG review by helping inexperienced reviewers accurately analyze EEGs. In this study, we investigated the concordance in BESAE-assisted spike detection by experienced and inexperienced reviewers. Eighty-three patients (13–64 years, 31 male) underwent an average of 80 hours of long-term video EEG monitoring (LTVEEG). Fifty-nine of 83 patients were diagnosed with localization-related epilepsy, 7 were diagnosed with generalized epilepsy, 10 were diagnosed with non-epilepsy disorders, and 7 were diagnosed with unclassified seizure disorders. BE-assisted EEG reviews were independently performed by EEG-tech trainees and a board-certified clinical neurophysiologist. We compared the interpretations and localizations of the interictal spikes between the two types of reviewers. In 91% of the cases, EEG-tech trainees and the board-certified clinical neurophysiologist reported the same interpretation and localization of spikes. The reasons for discordance were inaccurate interpretations (four patients) and overlooked spikes (four patients). BESAE-assisted EEG review was associated with a high rate of concordance between EEG-tech trainees and a board-certified clinical neurophysiologist. BESAE-assisted spike detection is a useful technique that helps inexperienced reviewers analyze EEGs with greater accuracy.
