Continuous EEG monitoring in adults in the intensive care unit (ICU)

Obadia, Nathalie; Parain, D.; Szurhaj, William

doi:10.1016/j.neucli.2014.11.003

Cited by 25 publications

(11 citation statements)

References 85 publications

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“…There is consensus among neuro-intensivists and neurophysiologists that these injury-induced seizures should be detected and treated. [3][4][5][6][7][8] However, the mechanism of injury-induced SE and appropriate therapies are unknown.…”

Section: Introductionmentioning

confidence: 99%

Neocortical injury–induced status epilepticus

2020

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Objective: To characterize neocortical onset status epilepticus (SE) in the C57BL/6J mouse. Methods: We induced SE by administering homocysteine 16-18 hours after cobalt (Co) implantation. SE was monitored by video and electroencephalography (EEG). We evaluated brain structure with magnetic resonance imaging (MRI). Neurodegeneration was evaluated 72 hours after SE using Fluoro-Jade C staining. Results: Cobalt triggered seizures in a dose-dependent manner (median effective dose, ED 50 = 0.78 mg) and the latency to peak seizure frequency shortened with increased dose. Animals developed SE after homocysteine administration. SE began with early intermittent focal seizures, consisting of frontal onset rhythmic spikewave discharges manifested as focal dystonia with clonus. These focal seizures then evolved into generalized continuous convulsive activity. Behavioral manifestations of SE included tonic stiffening, bilateral limb clonus, and bilateral tonic-clonic movements, which were accompanied by generalized rhythmic spike-wave discharges on EEG. After prolonged seizures, animals became comatose with intermittent bilateral myoclonic seizures or jerks. During this period, EEG showed seizures interspersed with generalized periodic discharges on a suppressed background. MRI obtained when animals were in a coma revealed edema, midline shift in frontal lobe around the Co implantation site, and ventricular effacement. Fluoro-Jade C staining revealed neurodegeneration in the cortex, amygdala, and thalamus. Significance: We have developed a mouse model of severe, refractory cortical-onset SE, consisting of convulsions merging into a coma, EEG patterns of cortical seizures, and injury, with evidence of widespread neocortical edema and damage. This model replicates many features of acute seizures and SE resulting from traumatic brain injury, subarachnoid, and lobar hemorrhage.

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Section: Introductionmentioning

confidence: 99%

Neocortical injury–induced status epilepticus

2020

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“…Due to these features and its simple utilization, use of continuous EEG (cEEG) recording in critically ill patients has increased over the past decade [2,3]. Recently, it was recommended by international guidelines with well-defined indications [4][5][6]. Nonetheless, few academic centers use it, and the expertise of neurointensivists for continuous real-time interpretation of EEG patterns is uncommon [7].…”

Section: Introductionmentioning

confidence: 99%

Continuous Electroencephalography Monitoring in Adults in the Intensive Care Unit

Caricato¹,

Melchionda²,

Antonelli³

2018

Annual Update in Intensive Care and Emergency Medicine 2018

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“…Tanı sorunu yaşanan hastalarda mümkünse uzun süreli EEG veya yoğun bakımda sürekli EEG monitorizasyonu yapılması önerilmektedir. [25] Bizim çalışmamızda da EBN grubunda takiplerde dört hastada NKSE saptandı.…”

Section: Discussionunclassified

Clinical Characteristics of Seizures in Epilepsy after Stroke: Prognosis and Treatment

Göksu¹

2015

Epilepsi

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SummaryObjectives: The aim of the present study was to determine demographic properties and risk factors for early-and late-onset seizures, as well as the effects of these factors on prognosis of patients with post-stroke epilepsy. Methods: Only patients with post-stroke epilepsy were included in this retrospective study. Demographic properties, stroke type, time interval between stroke and onset of seizure, neuroimaging, EEG characteristics, antiepileptic therapy, and prognosis were assessed. Results: Forty-five patients were included; 23 (51%) were female, and 22 (49%) were male. Mean age of study population was 64. 6±1.3 (23-84). Sixty percent (n=27) of patients had early-onset seizures, and 40% (n=18) had late-onset seizures. Thirty-four patients had an ischemic stroke, and 11 had a hemorrhagic stroke. Most prevalent etiologic factor in the ischemic strokes was a cardioembolic stroke (15%). Middle-cerebral-artery infarcts were the most frequently observed arterial stroke region. In hemorrhagic stroke lobar, hemorrhages (54%) were more prevalent, and 87% of patients received monotherapy. Levetiracetam was the most commonly preferred medication, followed by carbamazepine, valproic acid, and oxcarbazepine, in descending order. Of the early-onset seizures, 63% were controlled with medication, as were 55% of the late-onset seizures. A statistically significant difference was observed between post-stroke localization and timing of seizure. Conclusion: Post-stroke seizures may present as early-or late-onset due to various underlying pathophysiologic mechanisms and prognostic properties. These seizures are affected by a variety of factors and are frequently controlled with monotherapy.Keywords: Epilepsy; cerebrovascular disease. ÖzetAmaç: Bu çalışmanın amacı inme sonrası nöbet (İSN) geçiren hastaların klinik özelliklerini, inme sonrası erken ve geç başlangıçlı nöbetlerin risk faktörlerini ve bu faktörlerin prognozla ilişkisini değerlendirmektir. Gereç ve Yöntem: Bu geriye dönük çalışmaya İSN geçirdiği tespit edilen hastalar dahil edildi. Hastaların demografik özellikleri, inme tipi, inme ve nöbet başlangıç zamanı (erken veya geç başlangıçlı), nörogörüntüleme bulguları, elektroensefalografi (EEG) özellikleri, tedavide kullanılan antiepileptik ilaçlar ve prognozları değerlendirildi. Bulgular: Çalışmaya dahil edilen 45 hastadan 23'ü kadın (%51), 22'si erkek idi (%49). Hastaların yaş ortalaması 64.6±1.3 (23-84) idi. Hastaların %60'ında (n=27) erken, %40'ında (n=18) geç başlangıçlı nöbetler saptandı. Otuz dört hastada (20 kadın, 14 erkek) iskemik inme tespit edilirken 11 hastada (üç kadın, sekiz erkek) hemorajik inme tespit edildi. İskemik inme grubunda etiyolojide en sık kardiyoembolik iskemik inme (%15) gözlenirken arter sulama alanına göre en sık orta serebral arter (OSA) lokalizasyon infarktları (%53) gözlendi. Hemorajik inme grubunda ise lober kanamalar (%54) ön plandaydı. Hastaların %87'si monoterapi almaktaydı. En sık levetirasetam (LEV) kullanılırken bu sırasıyla karbamazepin (CBZ), valproik asid (VPA), okskarba...

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Continuous EEG monitoring in adults in the intensive care unit (ICU)

Cited by 25 publications

References 85 publications

Neocortical injury–induced status epilepticus

Neocortical injury–induced status epilepticus

Continuous Electroencephalography Monitoring in Adults in the Intensive Care Unit

Clinical Characteristics of Seizures in Epilepsy after Stroke: Prognosis and Treatment

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