Continuous EEG Monitoring in Aneurysmal Subarachnoid Hemorrhage: A Systematic Review

Kondziella, Daniel; Friberg, Christian K.; Wellwood, Ian; Reiffurth, Clemens; Fabricius, Martin; Dreier, Jens P.

doi:10.1007/s12028-014-0068-7

Cited by 59 publications

(40 citation statements)

References 39 publications

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“…There is a broad range of seizure rates reported in SAH populations, from 7–19% (Claassen et al 2005; O’Connor et al 2014; Kondziella et al 2015; De Marchis et al 2016). Our rate of 5.6% is slightly lower than previous reports, though in concordance with previously recorded seizure rates using subdural electrodes (Dreier et al 2012).…”

Section: Discussionmentioning

confidence: 99%

Epileptiform abnormalities predict delayed cerebral ischemia in subarachnoid hemorrhage

Kim

Rosenthal

Biswal

et al. 2017

Clinical Neurophysiology

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Objective To identify whether abnormal neural activity, in the form of epileptiform discharges and rhythmic or periodic activity, which we term here ictal-interictal continuum abnormalities (IICAs), are associated with delayed cerebral ischemia (DCI). Methods Retrospective analysis of continuous electroencephalography (cEEG) reports and medical records from 124 patients with moderate to severe grade subarachnoid hemorrhage (SAH). We identified daily occurrence of seizures and IICAs. Using survival analysis methods, we estimated the cumulative probability of IICA onset time for patients with and without delayed cerebral ischemia (DCI). Results Our data suggest the presence of IICAs indeed increases the risk of developing DCI, especially when they begin several days after the onset of SAH. We found that all IICA types except generalized rhythmic delta activity occur more commonly in patients who develop DCI. In particular, IICAs that begin later in hospitalization correlate with increased risk of DCI. Conclusions Thus, IICAs represent a new marker for identifying early patients at increased risk for DCI. Moreover, IICAs might contribute mechanistically to DCI and therefore represent a new potential target for intervention to prevent secondary cerebral injury following SAH. Significance These findings imply that IICAs may be a novel marker for predicting those at higher risk for DCI development.

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Section: Discussionmentioning

confidence: 99%

Epileptiform abnormalities predict delayed cerebral ischemia in subarachnoid hemorrhage

Kim

Rosenthal

Biswal

et al. 2017

Clinical Neurophysiology

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“…A meta-analysis evaluating the diagnostic ability of continuous EEG in SAH found that non-convulsive seizure and/or epilepsy was diagnosed in 3 to 18 % of poor-grade SAH patients, most occurring by post-bleed day 9 (IQR 4–17 days). 21 In our study, poor neurologic-grade patients (n=79) who did not improve after 24-hours underwent continuous EEG monitoring, 22% of these patients suffered seizures (5 diagnosed clinically, 12 suffered electrographic seizures). Despite this increased seizure incidence, AEDs were not associated with lower risk in this patient subset, a finding corroborated by other reports.…”

Section: Discussionmentioning

confidence: 63%

“…Despite this increased seizure incidence, AEDs were not associated with lower risk in this patient subset, a finding corroborated by other reports. 21,22 Sensitivity analyses were also performed to evaluate and control for characteristics that may have increased the likelihood of having EEG monitoring (i.e. interaction effects).…”

Section: Discussionmentioning

confidence: 99%

Prophylactic Antiepileptics and Seizure Incidence Following Subarachnoid Hemorrhage

Panczykowski

Pease

Yin

et al. 2016

Stroke

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Background and Purpose The utility of prophylactic antiepileptic drug (AED) administration following spontaneous subarachnoid hemorrhage (SAH) remains controversial. AEDs have not clearly been associated with a reduction in seizure incidence and have been associated with both neurologic worsening and delayed functional recovery in this setting. Methods We retrospectively analyzed a prospectively collected database of SAH patients admitted to our institution between 2005 and 2010. Between 2005 and 2007, all patients received prophylactic AEDs upon admission. After 2007 no patients received prophylactic AEDs or had AEDs immediately discontinued if initiated at an outside hospital. A propensity score-matched analysis was then performed to compare the development of clinical and/or electrographic seizures in these two populations. Results 353 patients with spontaneous SAH were analyzed, 43% of whom were treated with prophylactic AEDs upon admission. Overall, 10% of patients suffered clinical and/or electrographic seizures, most frequently occurring within 24-hrs of ictus (47%). The incidence of seizures did not vary significantly based on the use of prophylactic AEDs (11 vs. 8%, p=0.33). Propensity score-matched analyses suggest that patients receiving prophylactic AEDs had a similar likelihood of suffering seizures as those who did not (p=0.49). Conclusions Propensity score-matched analysis suggests that prophylactic AEDs do not significantly reduce the risk of seizure occurrence in patients with spontaneous SAH.

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“…Сучасні методи дослідження, а саме, тривалий ЕЕГ-моніторинг, може виявити у таких пацієнтів субклінічні типи нападів. Із 108 пацієнтів, яким проводили ЕЕГ-моніторинг у відділеннях інтенсивної терапії, у 19% зафіксована епілептична активність (у 95% -"безсудомні" напади, а також, у 70% -"безсудомний епілептичний статус") [13][14][15]. Такі епілептичні напади слід розглядати як одну з причин низької оцінки за шкалами Hunt-Hess Scale, WFNS (the World Federation of Neurological Surgeons Scale), а також при коматозному стані, що не корелює з тяжкістю САК за шкалою Fisher, оскільки 8% пацієнтів із нез'ясованою комою при САК мали безсудомний епілептичний статус за даними ЕЕГ-моніторингу [16][17][18][19][20] (Рис.…”

Section: типи судомних нападів при субарахноїдальному крововиливіunclassified

Seizure in nontraumatic subarachnoid hemorrhage

Tsoma¹

2018

Ukr Neurosurg J

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Continuous EEG Monitoring in Aneurysmal Subarachnoid Hemorrhage: A Systematic Review

Cited by 59 publications

References 39 publications

Epileptiform abnormalities predict delayed cerebral ischemia in subarachnoid hemorrhage

Epileptiform abnormalities predict delayed cerebral ischemia in subarachnoid hemorrhage

Prophylactic Antiepileptics and Seizure Incidence Following Subarachnoid Hemorrhage

Seizure in nontraumatic subarachnoid hemorrhage

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