Electroencephalographic Abnormalities in the Screening for Pilot Applicants in Korea
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Background and Purpose Electroencephalography (EEG) is often used as a screening toolfor selecting pilots despite controversy regarding its contribution to aviation safety. We investigatedEEG abnormalities in Korean commercial pilot applicants in order to identify theusefulness of EEG screening in this population. Methods We retrospectively analyzed the EEG results of 740 unselected pilot applicants whounderwent waking EEG at Inha University Hospital from January 2013 to May 2017. EEG recordingwas performed for 30 minutes, which included 3 minutes of hyperventilation and intermittentphotic stimulation. Results The pilot applicants were predominantly male (95.3%) and had a mean age of 27.8years (range: 16–40 years). Nine of them (1.2%) exhibited EEG abnormalities; the most commonabnormality (six applicants) was a small amount of generalized irregular slow activities, while theother three applicants (0.4%) exhibited epileptiform discharges, with two showing generalizedspike-and-wave complexes and one showing a few spike-and-wave complexes in the left frontotemporalarea. The two applicants with generalized spike-and-wave complexes were found tohave experienced clinical seizures by a neurologist during detailed history-taking. Conclusions This study found that 2 of 740 pilot applicants (0.3%) were diagnosed with epilepsyby routine EEG screening in an unselected population. Considering the low predictive valueof EEG without the relevant clinical history in an unselected healthy young population, ourfindings raise questions regarding the cost-effectiveness of the current EEG screening protocolapplied to pilot applicants. We suggest that a more-targeted and standardized EEG screening approachbe applied to pilot applicants with epilepsy risk factors or a seizure history as determinedby thorough medical history-taking.
Abstract
Background and Purpose Electroencephalography (EEG) is often used as a screening toolfor selecting pilots despite controversy regarding its contribution to aviation safety. We investigatedEEG abnormalities in Korean commercial pilot applicants in order to identify theusefulness of EEG screening in this population. Methods We retrospectively analyzed the EEG results of 740 unselected pilot applicants whounderwent waking EEG at Inha University Hospital from January 2013 to May 2017. EEG recordingwas performed for 30 minutes, which included 3 minutes of hyperventilation and intermittentphotic stimulation. Results The pilot applicants were predominantly male (95.3%) and had a mean age of 27.8years (range: 16–40 years). Nine of them (1.2%) exhibited EEG abnormalities; the most commonabnormality (six applicants) was a small amount of generalized irregular slow activities, while theother three applicants (0.4%) exhibited epileptiform discharges, with two showing generalizedspike-and-wave complexes and one showing a few spike-and-wave complexes in the left frontotemporalarea. The two applicants with generalized spike-and-wave complexes were found tohave experienced clinical seizures by a neurologist during detailed history-taking. Conclusions This study found that 2 of 740 pilot applicants (0.3%) were diagnosed with epilepsyby routine EEG screening in an unselected population. Considering the low predictive valueof EEG without the relevant clinical history in an unselected healthy young population, ourfindings raise questions regarding the cost-effectiveness of the current EEG screening protocolapplied to pilot applicants. We suggest that a more-targeted and standardized EEG screening approachbe applied to pilot applicants with epilepsy risk factors or a seizure history as determinedby thorough medical history-taking.
참고문헌 (7)
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