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D W Klass

Publications and source records attributed to D W Klass.

78 records · Page 5Linked to original sources
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EEG and other early predictors of epilepsy remission: a community study.

The course of seizures was reviewed in all 306 residents of Rochester, Minnesota who had epilepsy diagnosed between 1935 and 1978, lived in the region greater than or equal to 5 years after diagnosis, and had an electroencephalogram (EEG). The life-table probability of having achieved 5 years seizure-free (FYSF) by 20 years after diagnosis was 75%. In a multivariable proportional hazards model, these three variables predicted a significantly higher rate of achieving FYSF: no early-life brain damage (remission rate ratio = 2.27, p less than 0.01), no generalized epileptiform activity (rate ratio = 1.58, p less than 0.05), and never having had a generalized tonic-clonic seizure (rate ratio = 1.4, p less than 0.05). The same three variables, plus age at diagnosis, were descriptors of the rate of reaching FYSF off medication. Gender, family history, type of seizure, and EEG findings other than generalized epileptiform activity were not significantly related to either end point. The predictor set did 15% better than prior probabilities in forecasting FYSF. Although informative about group experience, these predictors are weak clinical discriminators, singly or in a set. FYSF occurred in high proportion of even those persons whose history, clinical examination, or EEG findings placed them in a less favorable stratum of one or more predictors.

Brain↗
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Clinical diagnoses and EEG interpretation.

A sample of 62 electroencephalographers in the United States evaluated 10-second samples of eight electroencephalograms. The evaluations were performed with and without knowledge of the clinical history. Evaluations consisted of multiple choice questions related to electroencephalographic observations, clinical diagnosis, and requests for additional tests such as computerized tomography and cerebrospinal fluid studies. The results indicate that clinical history influences interpretation, with considerable variation among readers in the number and type of additional tests requested.

Brain Diseases↗