Literature DB >> 26679421

Rhythmic and periodic EEG patterns of 'ictal-interictal uncertainty' in critically ill neurological patients.

Johannes P Koren1, Johannes Herta2, Susanne Pirker1, Franz Fürbass3, Manfred Hartmann3, Tilmann Kluge3, Christoph Baumgartner4.   

Abstract

OBJECTIVES: To study periodic and rhythmic EEG patterns classified according to Standardized Critical Care EEG Terminology (SCCET) of the American Clinical Neurophysiology Society and their relationship to electrographic seizures.
METHODS: We classified 655 routine EEGs in 371 consecutive critically ill neurological patients into (1) normal EEGs or EEGs with non-specific abnormalities or interictal epileptiform discharges, (2) EEGs containing unequivocal ictal EEG patterns, and (3) EEGs showing rhythmic and periodic EEG patterns of 'ictal-interictal uncertainty' (RPPIIIU) according to SCCET.
RESULTS: 313 patients (84.4%) showed normal EEGs, non-specific or interictal abnormalities, 14 patients (3.8%) had EEGs with at least one electrographic seizure, and 44 patients (11.8%) at least one EEG containing RPPIIIU, but no EEG with electrographic seizures. Electrographic seizures occurred in 11 of 55 patients (20%) with RPPIIIU, but only in 3 of 316 patients (0.9%) without RPPIIIU (p⩽0.001). Conversely, we observed RPPIIIU in 11 of 14 patients (78.6%) with electrographic seizures, but only in 44 of 357 patients (12.3%) without electrographic seizures (p⩽0.001).
CONCLUSIONS: On routine-EEG in critically ill neurological patients RPPIIIU occur 3 times more frequently than electrographic seizures and are highly predictive for electrographic seizures. SIGNIFICANCE: RPPIIIU can serve as an indication for continuous EEG recordings.
Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Entities:  

Keywords:  EEG in coma; EEG patterns; Electrographic seizures; Periodic EEG patterns; Rhythmic EEG patterns; Standardized Critical Care EEG Terminology

Mesh:

Year:  2015        PMID: 26679421     DOI: 10.1016/j.clinph.2015.09.135

Source DB:  PubMed          Journal:  Clin Neurophysiol        ISSN: 1388-2457            Impact factor:   3.708


  10 in total

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4.  Early Epileptiform Discharges and Clinical Signs Predict Nonconvulsive Status Epilepticus on Continuous EEG.

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6.  Automated Long-Term EEG Review: Fast and Precise Analysis in Critical Care Patients.

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  10 in total

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