Ronan D Kilbride1, Daniel J Costello, Keith H Chiappa. 1. Epilepsy Service, Department of Neurology, ACC 7, Massachusetts General Hospital, 15 Parkman St, Boston, MA 02114, USA. rkilbride@partners.org
Abstract
OBJECTIVES: To assess the effect of continuous electroencephalographic monitoring on the decision to treat seizures in the inpatient setting, particularly in the intensive care unit. DESIGN: Retrospective cohort study. SETTING: Medical and neuroscience intensive care units and neurological wards. PATIENTS: Three hundred consecutive nonelective continuous electroencephalographic monitoring studies, performed on 287 individual inpatients over a 27-month period. MAIN OUTCOME MEASURES: Epileptiform electroencephalographic abnormalities and changes in antiepileptic drug (AED) therapy based on the electroencephalographic findings. RESULTS: The findings from the continuous electroencephalographic monitoring led to a change in AED prescribing in 52% of all studies with initiation of an AED therapy in 14%, modification of AED therapy in 33%, and discontinuation of AED therapy in 5% of all studies. Specifically, the detection of electrographic seizures led to a change in AED therapy in 28% of all studies. CONCLUSIONS: The findings of continuous electroencephalographic monitoring resulted in a change in AED prescribing during or after half of the studies performed. Most AED changes were made as a result of the detection of electrographic seizures.
OBJECTIVES: To assess the effect of continuous electroencephalographic monitoring on the decision to treat seizures in the inpatient setting, particularly in the intensive care unit. DESIGN: Retrospective cohort study. SETTING: Medical and neuroscience intensive care units and neurological wards. PATIENTS: Three hundred consecutive nonelective continuous electroencephalographic monitoring studies, performed on 287 individual inpatients over a 27-month period. MAIN OUTCOME MEASURES: Epileptiform electroencephalographic abnormalities and changes in antiepileptic drug (AED) therapy based on the electroencephalographic findings. RESULTS: The findings from the continuous electroencephalographic monitoring led to a change in AED prescribing in 52% of all studies with initiation of an AED therapy in 14%, modification of AED therapy in 33%, and discontinuation of AED therapy in 5% of all studies. Specifically, the detection of electrographic seizures led to a change in AED therapy in 28% of all studies. CONCLUSIONS: The findings of continuous electroencephalographic monitoring resulted in a change in AED prescribing during or after half of the studies performed. Most AED changes were made as a result of the detection of electrographic seizures.
Authors: Iván Sánchez Fernández; Nicholas S Abend; Daniel H Arndt; Jessica L Carpenter; Kevin E Chapman; Karen M Cornett; Dennis J Dlugos; William B Gallentine; Christopher C Giza; Joshua L Goldstein; Cecil D Hahn; Jason T Lerner; Joyce H Matsumoto; Kristin McBain; Kendall B Nash; Eric Payne; Sarah M Sánchez; Korwyn Williams; Tobias Loddenkemper Journal: J Pediatr Date: 2013-10-22 Impact factor: 4.406
Authors: Susan T Herman; Nicholas S Abend; Thomas P Bleck; Kevin E Chapman; Frank W Drislane; Ronald G Emerson; Elizabeth E Gerard; Cecil D Hahn; Aatif M Husain; Peter W Kaplan; Suzette M LaRoche; Marc R Nuwer; Mark Quigg; James J Riviello; Sarah E Schmitt; Liberty A Simmons; Tammy N Tsuchida; Lawrence J Hirsch Journal: J Clin Neurophysiol Date: 2015-04 Impact factor: 2.177
Authors: J J Halford; D Shiau; J A Desrochers; B J Kolls; B C Dean; C G Waters; N J Azar; K F Haas; E Kutluay; G U Martz; S R Sinha; R T Kern; K M Kelly; J C Sackellares; S M LaRoche Journal: Clin Neurophysiol Date: 2014-11-20 Impact factor: 3.708