Melanie Boly1, Rama Maganti. 1. Department of Neurology, University of Wisconsin , Madison, WI , USA.
Abstract
PRIMARY OBJECTIVE: To assess the current state of the art of epilepsy monitoring in intensive care unit (ICU). RESEARCH DESIGN: Review article. METHODS AND PROCEDURES: A review of current scientific literature, as well as an illustrative case report. MAIN OUTCOMES AND RESULTS: Recent continuous electroencephalography (cEEG) monitoring studies revealed that non-convulsive seizures are very common in ICU. Conventional EEG is insufficient to detect them. However, very long recordings, of more than 24 hours, are needed to reach a good sensitivity. Even if cEEG improves monitoring of epileptic patients in the intensive care unit (ICU), studies using intracranial recordings show that conventional montage cEEG is, however, insufficient to detect all neurological deterioration in patients in the ICU. This review discusses the potential interest of dense array scalp EEG recordings to increase the sensitivity of detection of epileptic events in non-responsive patients in the ICU and to possibly help improve their prognosis, by allowing an earlier start of their treatment. CONCLUSIONS: Studies using dense array scalp EEG could potentially improve the detection and management of seizures in non-responsive patients in the ICU. Studies comparing this technique to conventional cEEG recordings are warranted.
PRIMARY OBJECTIVE: To assess the current state of the art of epilepsy monitoring in intensive care unit (ICU). RESEARCH DESIGN: Review article. METHODS AND PROCEDURES: A review of current scientific literature, as well as an illustrative case report. MAIN OUTCOMES AND RESULTS: Recent continuous electroencephalography (cEEG) monitoring studies revealed that non-convulsive seizures are very common in ICU. Conventional EEG is insufficient to detect them. However, very long recordings, of more than 24 hours, are needed to reach a good sensitivity. Even if cEEG improves monitoring of epilepticpatients in the intensive care unit (ICU), studies using intracranial recordings show that conventional montage cEEG is, however, insufficient to detect all neurological deterioration in patients in the ICU. This review discusses the potential interest of dense array scalp EEG recordings to increase the sensitivity of detection of epileptic events in non-responsive patients in the ICU and to possibly help improve their prognosis, by allowing an earlier start of their treatment. CONCLUSIONS: Studies using dense array scalp EEG could potentially improve the detection and management of seizures in non-responsive patients in the ICU. Studies comparing this technique to conventional cEEG recordings are warranted.