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Abstract Details

Comparison of EEG utilization patterns in Dementia with Lewy Bodies versus Alzheimer Disease
Aging, Dementia, and Behavioral Neurology
P6 - Poster Session 6 (12:00 PM-1:00 PM)
Cognitive fluctuations, defined as spontaneous alterations in arousal, alertness, and attention, are a core clinical feature of DLB and could potentially be misdiagnosed as seizure activity. In actuality, co-morbid epilepsy is less frequent in DLB than in AD. We hypothesized that cognitive fluctuations lead to inappropriate utilization of outpatient EEG in DLB, with higher rates of EEGs performed in DLB compared to AD. Limited data exist on differences in diagnostic testing patterns for epilepsy between those two common neurodegenerative diseases.
Determining the rate of outpatient EEG utilization in dementia with Lewy bodies (DLB) versus Alzheimer's disease (AD).
Retrospective cohort study utilizing health information from the University of Colorado UCHealth System COMPASS database of all patients with a diagnosis of AD or DLB between 2011 and 2018. Each cohort underwent proportions analysis for number of EEGs performed following, and before, the neurodegenerative disease diagnosis.
Of 7814 patients with an AD diagnosis, 180 (2.30%) underwent at least one routine outpatient EEG after the AD diagnosis was established. Of 929 patients with a DLB diagnosis, 43 (4.63%) underwent at least one routine outpatient EEG after the DLB diagnosis was established. The difference was 2.33% (95% CI of 0.93-3.72%, p < 0.0001). For those same cohorts, 208 of 7814 AD patients (2.66%) underwent EEG before their AD diagnoses, and 48 of 929 DLB patients (5.17%) underwent EEG before their DLB diagnoses. The difference was 2.50% (95% CI 1.04-3.97%, p < 0.0001).
Despite a known lower prevalence of epilepsy in DLB compared AD, outpatient EEGs are performed at a significantly higher rate in DLB than AD patients – both before and after the relevant diagnosis. This suggests bias toward pre-DLB-diagnosis concern for epilepsy based on clinical presentation, as well as an unfamiliarity with DLB characteristics among patients’ clinicians even after the diagnosis is made.
Jakob Mrozewski, MD (Utah Valley Neurological Clinic)
No disclosure on file
Peter Pressman, MD (Univeristy of Colorado School of Medicine) The institution of Dr. Pressman has received research support from the Doris Duke Fund to Retain Clinical Scientists . Dr. Pressman has received personal compensation in the range of $100,000-$499,999 for serving as a Associate Professor with University of Colorado School of Medicine.
Samantha K. Holden, MD, MS, FAAN (University of Colorado School of Medicine) Dr. Holden has nothing to disclose.