Recommandations françaises sur l’électroencéphalogramme

Obadia, Nathalie; Sauleau, Paul; Chéliout-Héraut, F.; Convers, Philippe; Debs, Rachel; Eisermann, Monika; Gavaret, Martine; Isnard, Jean; Jung, Julien; Kamińska, Anna; Kubis, Nathalie; Lemesle, M.; Maillard, Louis; Mazzola, Laure; Michel, Véronique; Montavont, Alexandra; Nguyen, Sylvie; Navarro, Vincent; Parain, D.; Périn, Bertille; Rosenberg, Sarah; Sediri, H.; Soufflet, Christine; Szurhaj, William; Taussig, Delphine; Villepin, A. Touzery de; Vercueil, Laurent; Lamblin, M.D.

doi:10.1016/j.neucli.2014.10.001

Cited by 35 publications

(15 citation statements)

References 556 publications

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“…The lack of continuous EEG: In comparison to continuous EEG or recording of longer duration (30 to 60 minutes), we used EEG recording of short duration (20 minutes) which does not allow to provide an accurate prevalence of EEG changes in septic patients, notably of ESZ [ 26 ]. However, we would like to emphasize that our study was a pragmatic one, and that the conditions complied with the recommendations of EEG use for ICU patients in France [ 24 , 25 , 45 ]. Our results indicate that a 20 min EEG recording (which is the most frequent duration of EEG recording for ICU patients in France) is helpful for predicting the outcome of septic patients admitted in ICU.…”

Section: Discussionmentioning

confidence: 90%

Early Standard Electroencephalogram Abnormalities Predict Mortality in Septic Intensive Care Unit Patients

et al. 2015

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IntroductionSepsis is associated with increased mortality, delirium and long-term cognitive impairment in intensive care unit (ICU) patients. Electroencephalogram (EEG) abnormalities occurring at the acute stage of sepsis may correlate with severity of brain dysfunction. Predictive value of early standard EEG abnormalities for mortality in ICU septic patients remains to be assessed.MethodsIn this prospective, single center, observational study, standard EEG was performed, analyzed and classified according to both Synek and Young EEG scales, in consecutive patients acutely admitted in ICU for sepsis. Delirium, coma and the level of sedation were assessed at the time of EEG recording; and duration of sedation, occurrence of in-ICU delirium or death were assessed during follow-up. Adjusted analyses were carried out using multiple logistic regression.ResultsOne hundred ten patients were included, mean age 63.8 (±18.1) years, median SAPS-II score 38 (29–55). At the time of EEG recording, 46 patients (42%) were sedated and 22 (20%) suffered from delirium. Overall, 54 patients (49%) developed delirium, of which 32 (29%) in the days after EEG recording. 23 (21%) patients died in the ICU. Absence of EEG reactivity was observed in 27 patients (25%), periodic discharges (PDs) in 21 (19%) and electrographic seizures (ESZ) in 17 (15%). ICU mortality was independently associated with a delta-predominant background (OR: 3.36; 95% CI [1.08 to 10.4]), absence of EEG reactivity (OR: 4.44; 95% CI [1.37–14.3], PDs (OR: 3.24; 95% CI [1.03 to 10.2]), Synek grade ≥ 3 (OR: 5.35; 95% CI [1.66–17.2]) and Young grade > 1 (OR: 3.44; 95% CI [1.09–10.8]) after adjustment to Simplified Acute Physiology Score (SAPS-II) at admission and level of sedation. Delirium at the time of EEG was associated with ESZ in non-sedated patients (32% vs 10%, p = 0.037); with Synek grade ≥ 3 (36% vs 7%, p< 0.05) and Young grade > 1 (36% vs 17%, p< 0.001). Occurrence of delirium in the days after EEG was associated with a delta-predominant background (48% vs 15%, p = 0.001); absence of reactivity (39% vs 10%, p = 0.003), Synek grade ≥ 3 (42% vs 17%, p = 0.001) and Young grade >1 (58% vs 17%, p = 0.0001).ConclusionsIn this prospective cohort of 110 septic ICU patients, early standard EEG was significantly disturbed. Absence of EEG reactivity, a delta-predominant background, PDs, Synek grade ≥ 3 and Young grade > 1 at day 1 to 3 following admission were independent predictors of ICU mortality and were associated with occurence of delirium. ESZ and PDs, found in about 20% of our patients. Their prevalence could have been higher, with a still higher predictive value, if they had been diagnosed more thoroughly using continuous EEG.

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Section: Discussionmentioning

confidence: 90%

Early Standard Electroencephalogram Abnormalities Predict Mortality in Septic Intensive Care Unit Patients

et al. 2015

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“…The overall methodology was based on the methodology used to produce the French recommendations on electroencephalography [2,3]. However, this had to be adapted for the present work because of the specificity of SEEG.…”

Section: Methodsmentioning

confidence: 99%

“…The agreement, disagreement or unresolved status was deemed ''weak'' if the median interval overlapped a grading area (e.g. interval [1][2][3][4] or interval [6][7][8]). Authors had the possibility of not grading an item if they felt that their opinion was not relevant for a specific question.…”

Section: Methodsmentioning

confidence: 99%

French guidelines on stereoelectroencephalography (SEEG)

Isnard

Taussig

Bartolomei

et al. 2018

Neurophysiologie Clinique

252

179

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“…In addition, the role of rTMS in the therapeutic armamentarium against neuropathic pain remains to be established. On the other hand, it has been shown that HF rTMS of M1could predict the outcome of epidural motor cortex stimulation (EMCS) (64–68). However, rTMS tests can be used only to confirm the indication of EMCS therapy but not to exclude patients from implantation (56, 58).…”

Section: Current Nibs Therapeutic Applicationsmentioning

confidence: 99%

Is There a Future for Non-invasive Brain Stimulation as a Therapeutic Tool?

et al. 2019

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Several techniques and protocols of non-invasive transcranial brain stimulation (NIBS), including transcranial magnetic and electrical stimuli, have been developed in the past decades. These techniques can induce long lasting changes in cortical excitability by promoting synaptic plasticity and thus may represent a therapeutic option in neuropsychiatric disorders. On the other hand, despite these techniques have become popular, the fragility and variability of the after effects are the major challenges that non-invasive transcranial brain stimulation currentlyfaces. Several factors may account for such a variability such as biological variations, measurement reproducibility, and the neuronal state of the stimulated area. One possible strategy, to reduce this variability is to monitor the neuronal state in real time using EEG and trigger TMS pulses only at pre-defined state. In addition, another strategy under study is to use the spaced application of multiple NIBS protocols within a session to improve the reliability and extend the duration of NIBS effects. Further studies, although time consuming, are required for improving the so far limited effect sizes of NIBS protocols for treatment of neurological or psychiatric disorders.

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Recommandations françaises sur l’électroencéphalogramme

Cited by 35 publications

References 556 publications

Early Standard Electroencephalogram Abnormalities Predict Mortality in Septic Intensive Care Unit Patients

Early Standard Electroencephalogram Abnormalities Predict Mortality in Septic Intensive Care Unit Patients

French guidelines on stereoelectroencephalography (SEEG)

Is There a Future for Non-invasive Brain Stimulation as a Therapeutic Tool?

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