Electrographic seizures and periodic discharges after intracerebral hemorrhage

Claassen, Jan; Jetté, Nathalie; Chum, F.; Green, R.; Schmidt, Michael; Choi, H. Alex; Jirsch, Jeffrey; Frontera, Jennifer A.; Connolly, E. Sander; Emerson, Ronald G.; Mayer, Stephan A.; Hirsch, Lawrence J.

doi:10.1212/01.wnl.0000281664.02615.6c

Cited by 410 publications

(332 citation statements)

References 25 publications

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“…Among one cohort of patients with intracerebral hemorrhage [14], 28% of seizures were detected after the first 24 h of recording, suggesting that EEG has a role beyond spot monitoring. In a more inclusive cohort of 570 critically ill patients undergoing continuous EEG monitoring [15], the first electrographic seizure was discovered after the first day of monitoring in 12% of all patients and in 20% of comatose patients.…”

Section: Duration Of Monitoringmentioning

confidence: 99%

“…In the setting of intracerebral hemorrhage, seizure rates up to 31% have been reported, more than half of which may have only nonconvulsive manifestation [14]. Almost half of seizures were detected beyond the first hour, whereas only 6% of seizures were detected after 48 h of monitoring.…”

Section: Patient Selectionmentioning

confidence: 99%

“…Seizures were more common with lobar hemorrhages (23%) than in deep hemorrhages (11%). Hemorrhage expansion and perihematomal edema resulting in midline shift have been associated with seizure, although the direction of causation is not established [14,17]. To best allocate resources, guidelines have been focusing on recommending prolonged EEG for the detection of seizures in patients who have depressed mental status or a neurological examination out of proportion to the degree of documented brain injury [16].…”

Section: Patient Selectionmentioning

confidence: 99%

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The Utility of EEG, SSEP, and Other Neurophysiologic Tools to Guide Neurocritical Care

Rosenthal

2012

Neurotherapeutics

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Neuromonitoring is an emerging field that aims to characterize real-time neurophysiology to tailor therapy for acute injuries of the central nervous system. While cardiac telemetry has been used for decades among patients requiring critical care of all kinds, neurophysiology and neurotelemetry has only recently emerged as a routine screening tool in comatose patients. The increasing utilization of electroencephalography in comatose patients is primarily due to the recognition of the common occurrence of nonconvulsive seizures among comatose patients, the development of quantitative measures to detect regional ischemia, and the appreciation of electroencephalography phenotypes that indicate prognosis after cardiac arrest. Other neuromonitoring tools, such as somatosensory evoked potentials have a complementary role, surveying the integrity of the neuroaxis as an indicator of prognosis or illness progression in both acute brain and spinal injuries.

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Section: Duration Of Monitoringmentioning

confidence: 99%

Section: Patient Selectionmentioning

confidence: 99%

Section: Patient Selectionmentioning

confidence: 99%

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The Utility of EEG, SSEP, and Other Neurophysiologic Tools to Guide Neurocritical Care

Rosenthal

2012

Neurotherapeutics

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“…The pathophysiology and clinical importance of PD in critically ill patients are still not clearly known. There are studies suggesting that PD is associated with seizures and poor outcome in patients with SE, ICH, and SAH (9,10). It is known that the presence of PD indicated the electrical activities caused by the acutely damaged brain tissue, with a high risk of clinical and/or electrographic seizures including NCS and NCSE (2).…”

Section: Discussionmentioning

confidence: 99%

Electroencephalographic Patterns Recorded by Continuous EEG Monitoring in Patients with Change of Consciousness in the Neurological Intensive Care Unit

Altindag

Okudan²,

Ozkan

et al. 2017

Arch Neuropsychiatr

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There is no consensus on the terminology for rhythmic and periodic patterns (RPP) detected by continuous electroencephalography (cEEG) monitoring of unconscious patients in the neurological intensive care unit (NICU) (1). The growth in cEEG utilization has led to an increase in the recognition of these EEG patterns of uncertain diagnostic and prognostic information. Furthermore, there is controversy regarding which electrographic patterns are associated with neuronal injury, which require treatment, and how aggressively to treat these patterns (2,3).We aimed to examine the frequency of some electroencephalographic patterns including periodic discharges (PD), repetitive spike waves (RSW), rhythmic delta activities (RDA), nonconvulsive seizures (NCS), and nonconvulsive status epilepticus (NCSE) recorded by cEEG in critically ill patients with a change of consciousness. This study was also aimed to detect clinical and laboratory correlates of these patterns. METHODSWe retrospectively identified all critically ill patients over the age of 18 years with a change of consciousness (Glasgow Coma Score [GCS] ≤14) who underwent cEEG monitoring in the NICU during two years. Clinical information was gathered from a review of inpatient medical notes, neuroimaging studies and reports, and discharge summaries. Baseline demographic data (age, gender), past medical history, duration of hospitalization in the NICU, clinical seizures at admission, in the emergency department, or during hospitalization prior to cEEG; treatment with continuous IV or intermittent antiepileptic drugs (AED) and other treatments such as antibiotics, sedatives and anesthetics, all radiology and laboratory findings were investigated. Premonitoring and postmonitoring scores including GCS, modified Rankin Scale score of the patients, and also National Institutes of Health Stroke Scale score for those with acute ischemic stroke

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“…EEG is necessary to exclude non-convulsive status epilepticus but continuous EEG (cEEG) is required to assess for intermittent non-convulsive seizures. It is fairly clear that nonconvulsive epileptiform activity is relatively common in comatose critically ill neurological patients (such as patients with subarachnoid hemorrhage, intracerebral hematomas, and severe traumatic brain injury), and it is associated with worse outcomes in this population [1][2][3]. However, the incidence and impact of clinically occult epileptiform activity in critically ill patients without a primary brain insult has been less well defined.…”

mentioning

confidence: 99%

Continuous Electroencephalography in the Medical ICU

Rabinstein

2009

Neurocrit Care

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Electrographic seizures and periodic discharges after intracerebral hemorrhage

Cited by 410 publications

References 25 publications

The Utility of EEG, SSEP, and Other Neurophysiologic Tools to Guide Neurocritical Care

The Utility of EEG, SSEP, and Other Neurophysiologic Tools to Guide Neurocritical Care

Electroencephalographic Patterns Recorded by Continuous EEG Monitoring in Patients with Change of Consciousness in the Neurological Intensive Care Unit

Continuous Electroencephalography in the Medical ICU

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