Adult Critical Care Electroencephalography Monitoring for Seizures: A Narrative Review

Abstract

Electroencephalography (EEG) is an important and relatively inexpensive tool that allows intensivists to monitor cerebral activity of critically ill patients in real time. Seizure detection in patients with and without acute brain injury is the primary reason to obtain an EEG in the Intensive Care Unit (ICU). In response to the increased demand of EEG, advances in quantitative EEG (qEEG) created an approach to review large amounts of data instantly. Finally, rapid response EEG is now available to reduce the time to detect electrographic seizures in limited-resource settings. This review article provides a concise overview of the technical aspects of EEG monitoring for seizures, clinical indications for EEG, the various available modalities of EEG, common and challenging EEG patterns, and barriers to EEG monitoring in the ICU.

Non-invasive technology for brain monitoring: definition and meaning of the principal parameters for the International PRactice On TEChnology neuro-moniToring group (I-PROTECT)

“…Different qEEG monitors are available and able to generate several graphs/trends, allowing ICU physicians to rapidly screen long periods of EEG to detect changes over time [19]. Commonly used trends include [19][20][21]:…”

“…Definitions CDSA is a three-dimensional, EEG frequencybased graphical display with time reported on the x-axis and frequency on the y-axis [20]. Specifically, spectrograms utilize an algorithm (FFT) to process the raw EEG signal and display the power of the identified frequencies (y-axis) according to a color code (z-axis) over time (x-axis) [20]. Colors may vary according to the manufacturer [19,20].…”

“…Specifically, spectrograms utilize an algorithm (FFT) to process the raw EEG signal and display the power of the identified frequencies (y-axis) according to a color code (z-axis) over time (x-axis) [20]. Colors may vary according to the manufacturer [19,20]. CDSA is generally utilized for seizure detection [21][22][23][24] (Fig.…”

Altered Functional Brain Network Structure between Patients with High and Low Generalized Anxiety Disorder

“…Among them, EEG technology has the advantages of low cost, good portability, and strong portability [ 13 , 14 , 15 , 16 ]. The electrical signals sent by the human brain through the EEG instrument are captured by placing electrodes on the scalp through EEG technology to record brain activity [ 17 , 18 , 19 , 20 ]. The potential of the brain cell group is used as the vertical axis, and the time is used as the horizontal axis.…”

“…Brain waves can be decomposed into waves ranging from small to large in frequency, which are collectively referred to as biological rhythm waves [ 21 ]. They could be classified with the frequency range as delta, theta, alpha, beta, and gamma rhythms [ 18 , 20 , 22 , 23 , 24 , 25 ]. For GAD, it has been proven that the beta rhythm has significant changes in power spectrum density (PSD), complexity, and FC based on EEG signals [ 4 ].…”