Color density spectral array of bilateral bispectral index system: Electroencephalographic correlate in comatose patients with nonconvulsive status epilepticus

Hernández-Hernández, Miguel A.; Fernández‐Torre, José L.

doi:10.1016/j.seizure.2015.11.001

Cited by 17 publications

(17 citation statements)

References 39 publications

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“…[100][101][102] The spike-and-wave discharges during NCSE (Fig. 3A) 103 vary in character depending on the aetiology. 102 These EEG complexes can be difficult to distinguish from triphasic waves (Fig.…”

Section: Triphasic Wavesmentioning

confidence: 99%

Electroencephalography and delirium in the postoperative period

Palanca

Wildes

et al. 2017

British Journal of Anaesthesia

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Delirium commonly manifests in the postoperative period as a clinical syndrome resulting from acute brain dysfunction or encephalopathy. Delirium is characterized by acute and often fluctuating changes in attention and cognition. Emergence delirium typically presents and resolves within minutes to hours after termination of general anaesthesia. Postoperative delirium hours to days after an invasive procedure can herald poor outcomes. Easily recognized when patients are hyperactive or agitated, delirium often evades diagnosis as it most frequently presents with hypoactivity and somnolence. EEG offers objective measurements to complement clinical assessment of this complex fluctuating disorder. Although EEG features of delirium in the postoperative period remain incompletely characterized, a shift of EEG power into low frequencies is a typical finding shared among encephalopathies that manifest with delirium. In aggregate, existing data suggest that serial or continuous EEG in the postoperative period facilitates monitoring of delirium development and severity and assists in detecting epileptic aetiologies. Future studies are needed to clarify the precise EEG features that can reliably predict or diagnose delirium in the postoperative period, and to provide mechanistic insights into this pathologically diverse neurological disorder.

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Section: Triphasic Wavesmentioning

confidence: 99%

Electroencephalography and delirium in the postoperative period

Palanca

Wildes

et al. 2017

British Journal of Anaesthesia

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“…In one study, using a 1-channel montage, authors found a sensitivity of 40% for the identification of seizure by nonexperts ICUs physicians [ 12 ]. Another type of quantitative EEG frequently used is compressed spectral array, which can identify seizure patterns with a very good accuracy [ 13 , 14 ]. However qEEG do not allow instantaneous diagnosis of seizure.…”

Section: Discussionmentioning

confidence: 99%

“…In ICU, BIS monitors are used in different contexts when patients have intracranial hypertension BIS and SR values are used to titrate barbiturate treatment [ 10 , 11 ]; when patients have refractory status epilepticus, BIS and SR values are used to guide the depth of sedation if cEEG is not available because there is a strong correlation between BIS and SR values and the burst rate monitored with conventional EEG [ 12 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

Early Diagnosis of Nonconvulsive Status Epilepticus Recurrence with Raw EEG of a Bispectral Index Monitor

Ntahe

2018

Case Reports in Critical Care

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Background Seizures are frequent in ICU and their diagnosis is challenging, often delayed or missed. Their diagnosis requires a conventional EEG recording. When cEEG is not available, there is no consensus on how patients should be monitored when there is high risk of seizure. This case illustrates how a bispectral index monitor allowed an early diagnosis of an NCSE recurrence. Case Presentation A NCSE was diagnosed at the admission. cEEG was not available and then a bispectral index (BIS) monitor was placed and processed parameters were monitored as usual. During the first and second day, both conventional and BIS's EEG showed patterns of burst suppression and the BIS value varied between 25 and 35 while the suppression ratio (SR) varied between 20 and 35. On the third day, while hypnotic drugs were withdrawn progressively, raw EEG of the BIS monitor showed spikes, spikes waves, and polyspikes without significant variation of BIS and SR values. Even if processed parameters stayed between their usual ranges, the typical aspect of the real time EEG raised concern for NCSE recurrence. An unplanned conventional EEG recording was urgently requested, and the diagnosis was confirmed and treated. Conclusion Primitive and secondary brain injuries can lead to seizures which are often purely electrical. Even though BIS monitors cannot substitute the conventional EEG, processed parameters and raw EEG should be always analysed jointly. In the present case, seizure was suspected only on the aspect of real time EEG which showed spikes, spikes waves, and polyspikes.

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“…CDSA uses Fourier transformation to process long-term EEG signals and converts EEG parameters (such as power, amplitude, and frequency) into visualized images, making it possible to evaluate the dynamic EEG changes in different-frequency bands. [9] Recently, CDSA has been widely used in the clinical evaluation of patients with sleep disorders and epilepsy. However, the application value of CDSA in brain function monitoring has not yet been well elucidated.…”

Section: Discussionmentioning

confidence: 99%

Color density spectral array for early evaluation of prognosis of patients with coma in pediatric intensive care unit

Wang¹,

Hao²,

Zhang³

et al. 2019

Medicine

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The aim of this study was to assess the bedside brain function monitoring of color density spectral array (CDSA) for early prognostic evaluation of coma patients in pediatric intensive care unit (PICU).Forty-two consecutive pediatric coma patients were enrolled. The individual conscious state was evaluated according to the Glasgow coma scale (GCS). CDSA parameters including CDSA pattern (CDSAP), sleep–wake cycle (SWC), sleep stage (SS), and drug-induced fast wave activity (DIFWA) were recorded. Three months later, prognosis was evaluated according to pediatric cerebral performance category (PCPC) score, based on which the patients were divided into FP-group (favorable prognosis) and PP-group (poor prognosis).The changeable type of CDSAP, appearance of SWC, SS, and DIFWA were significantly correlated with favorable prognosis. Both GCS and SWC were significantly correlated with the prognosis. However, there was substantial overlap in GCS between FP-group and PP-group. Although the absence of SWC was statistically an independent risk factor for poor prognosis but with a high false positive rate (0.143), a linear logistic regression showed the odds ratio of GCS for predicting prognosis was 0.93 (95% confidence interval: 0.48–1.80; P = .83) and that of SWC was 0.12 (95% confidence interval: 0.03–0.47; P = .03). Furthermore, the absence of SWC was correlated with poor prognosis in nonintracranial infection patients.Our study found that several CDSA factors are associated with prognosis of coma patients in PICU. SWC may be a potential indicator for evaluating the prognosis of coma patients in PICU.

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Color density spectral array of bilateral bispectral index system: Electroencephalographic correlate in comatose patients with nonconvulsive status epilepticus

Abstract: b-BIS monitoring system and, in particular, CDSA used by nonexpert NICU personnel may be helpful to follow-up episodes of NCSE, to detect recurrences of nonconvulsive seizures (NCSzs), and to monitor profound anesthetic therapy in comatose patients when cEEG is not available.

Cited by 17 publications

References 39 publications

Electroencephalography and delirium in the postoperative period

Electroencephalography and delirium in the postoperative period

Early Diagnosis of Nonconvulsive Status Epilepticus Recurrence with Raw EEG of a Bispectral Index Monitor

Color density spectral array for early evaluation of prognosis of patients with coma in pediatric intensive care unit

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