Electroencephalographic patterns in unresponsive pediatric patients

Hosain, Syed; Solomon, Gail E.; Kobylarz, Erik

doi:10.1016/j.pediatrneurol.2004.09.008

Cited by 89 publications

(65 citation statements)

References 11 publications

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“…Retrospective studies have demonstrated NCS or NCSE in 14% to 39% of children who underwent long-term EEG monitoring in PICU or emergency departments for a variety of etiologies of acute encephalopathies. 6,7,9,10 Retrospective studies may not identify all patients who had seizures, because not all patients underwent EEG monitoring. The current study may have identified a higher incidence of seizures because EEG was performed prospectively on all children undergoing TH.…”

Section: Figure Background Evolution and Seizure Occurrence By Subjectmentioning

confidence: 99%

See 1 more Smart Citation

Electroencephalographic monitoring during hypothermia after pediatric cardiac arrest

Abend¹,

Topjian²,

Ichord³

et al. 2009

Neurology

194

162

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Section: Figure Background Evolution and Seizure Occurrence By Subjectmentioning

confidence: 99%

“…[6][7][8][9][10][11] Further, patients treated with TH may require pharmacologic paralysis to manage shivering, clinically masking all electrographic seizures. Consequently, EEG monitoring is required for seizure detection.…”

mentioning

confidence: 99%

Electroencephalographic monitoring during hypothermia after pediatric cardiac arrest

Abend¹,

Topjian²,

Ichord³

et al. 2009

Neurology

194

162

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show abstract

“…[1][2][3][4][5][6][7][8][9][10][11][12] The majority of electrographic seizures were not accompanied by any clinical signs, 1,3,8,[10][11][12][13][14] even in nonparalyzed patients. 1,14 Therefore, accurate seizure identification requires CEEG.…”

mentioning

confidence: 91%

“…[1][2][3][4][5][6][7][8][9][10][11][12] This variability is likely due to the smaller size of these cohorts, variability in case mix across institutions, and interinstitution variability in CEEG indications. Furthermore, previous studies were performed over nearly a decade, during which CEEG indications and other components of critical care have evolved.…”

mentioning

confidence: 99%

Electrographic seizures in pediatric ICU patients

et al. 2013

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Objectives: We aimed to determine the incidence of electrographic seizures in children in the pediatric intensive care unit who underwent EEG monitoring, risk factors for electrographic seizures, and whether electrographic seizures were associated with increased odds of mortality.Methods: Eleven sites in North America retrospectively reviewed a total of 550 consecutive children in pediatric intensive care units who underwent EEG monitoring. We collected data on demographics, diagnoses, clinical seizures, mental status at EEG onset, EEG background, interictal epileptiform discharges, electrographic seizures, intensive care unit length of stay, and in-hospital mortality.Results: Electrographic seizures occurred in 162 of 550 subjects (30%), of which 61 subjects (38%) had electrographic status epilepticus. Electrographic seizures were exclusively subclinical in 59 of 162 subjects (36%). A multivariable logistic regression model showed that independent risk factors for electrographic seizures included younger age, clinical seizures prior to EEG monitoring, an abnormal initial EEG background, interictal epileptiform discharges, and a diagnosis of epilepsy. Subjects with electrographic status epilepticus had greater odds of in-hospital death, even after adjusting for EEG background and neurologic diagnosis category.Conclusions: Electrographic seizures are common among children in the pediatric intensive care unit, particularly those with specific risk factors. Electrographic status epilepticus occurs in more than one-third of children with electrographic seizures and is associated with higher in-hospital mortality. Neurology â 2013;81:383-391 GLOSSARY CEEG 5 continuous EEG; CI 5 confidence interval; IQR 5 interquartile range; OR 5 odds ratio; PICU 5 pediatric intensive care unit.

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“…They include patients with epilepsy, hypoxic-ischemic injury or stroke, TBI, and metabolic disease. The incidence of NCS in these studies varies widely from 16.3 to 39% [144,150,152,154]. Adding to this literature, 2 recent, prospective pediatric studies have been published.…”

Section: Neuromonitoring and Neuroprotection In The Picumentioning

confidence: 99%

Pediatric Neurocritical Care

Murphy

2012

Neurotherapeutics

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Pediatric neurocritical care is an emerging multidisciplinary field of medicine and a new frontier in pediatric critical care and pediatric neurology. Central to pediatric neurocritical care is the goal of improving outcomes in critically ill pediatric patients with neurological illness or injury and limiting secondary brain injury through optimal critical care delivery and the support of brain function. There is a pressing need for evidence based guidelines in pediatric neurocritical care, notably in pediatric traumatic brain injury and pediatric stroke. These diseases have distinct clinical and pathophysiological features that distinguish them from their adult counterparts and prevent the direct translation of the adult experience to pediatric patients. Increased attention is also being paid to the broader application of neuromonitoring and neuroprotective strategies in the pediatric intensive care unit, in both primary neurological and primary non-neurological disease states. Although much can be learned from the adult experience, there are important differences in the critically ill pediatric population and in the circumstances that surround the emergence of neurocritical care in pediatrics.

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Electroencephalographic patterns in unresponsive pediatric patients

Cited by 89 publications

References 11 publications

Electroencephalographic monitoring during hypothermia after pediatric cardiac arrest

Electroencephalographic monitoring during hypothermia after pediatric cardiac arrest

Electrographic seizures in pediatric ICU patients

Pediatric Neurocritical Care

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