Objective:

To compare the effectiveness of continuous EEG (cEEG) versus short EEG (sEEG) in detecting abnormalities and predicting post-stroke epilepsy (PSE) in ischemic stroke survivors.

Approach:

• Study Cohort: Retrospective analysis of 283 adults with acute ischemic stroke who underwent cEEG within 7 days of stroke onset, excluding those with prior seizures, transient ischemic attacks, or acute symptomatic seizures.
• EEG Comparison: Simulated sEEG as the first 60 minutes of cEEG to ensure controlled comparison. Both EEG types were analyzed for various abnormalities by blinded neurophysiologists.
• Prognostic Model: Utilized SeLECT-EEG model to assess the risk of PSE, incorporating EEG findings such as epileptiform activity and regional slowing.
• Statistical Analysis: Conducted statistical comparisons of EEG findings and analyzed long-term PSE risk using competing-risks framework and Fine–Gray subdistribution hazard models.

Key Findings:

• cEEG demonstrated higher sensitivity in detecting transient abnormalities compared to sEEG.
• EEG findings within 7 days post-stroke, particularly epileptiform activity and regional slowing, are strong predictors of PSE.
• Incorporating EEG findings into the SeLECT-EEG model significantly improved risk stratification for patients without acute symptomatic seizures.

Interpretation:

Limitations:

• The study is retrospective and may be subject to selection bias.
• Findings are based on a specific cohort and may not be generalizable to all stroke patients.

Conclusion: