Point-of-Care EEG for Non-Convulsive Seizure and Status Epilepticus: Advances, Limitations, and Future Directions

TL;DR

Point-of-care EEG is a promising tool for quickly detecting non-convulsive seizures and improving neurological care in emergency settings.

Contribution

This review highlights recent advances, limitations, and future directions of POC-EEG in detecting seizures and related conditions.

Findings

POC-EEG enables earlier seizure detection and faster treatment decisions in acute neurological care.

Recent improvements in portability and AI-assisted interpretation have increased accessibility for non-specialists.

Automated detection algorithms show high accuracy but require further validation for focal or low-burden seizure activity.

Abstract

Point-of-care electroencephalography (POC-EEG) has emerged as a practical tool for the rapid detection of non-convulsive seizures (NCS) and non-convulsive status epilepticus (NCSE) in acute neurological settings where access to conventional EEG is often delayed. This narrative review synthesizes current evidence on the clinical applications, tech-no-logical evolution, and limitations of POC-EEG systems across adult and pediatric populations. Available data suggest that POC-EEG is associated with earlier seizure identification, more timely antiseizure treatment decisions, and reduced dependence on inter-facility transfers in selected healthcare settings. Beyond seizure detection, POC-EEG has shown potential utility in the assessment of acute encephalopathy due to conditions such as stroke, traumatic brain injury, delirium, and post-cardiac arrest states. Recent advances in device portability and artificial intelligence-assisted interpretation have expanded accessibility, enabling use by non-specialist clinicians; however, reduced spatial resolution, artifact susceptibility, and variable performance in focal or low-burden epileptiform activity remain important limitations. Automated detection algorithms show high accuracy for sustained seizure burden but require cautious interpretation and further prospective validation. Ethical and health-system considerations, including equitable access, diagnostic stewardship, and data governance, are increasingly relevant as adoption grows. Overall, POC-EEG represents a promising adjunct to conventional EEG that may improve early diagnostic workflows in acute neurological care, while definitive impacts on long-term outcomes warrant further study.

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