Nonconvulsive Seizure Detection by Reduced-Lead Electroencephalography in Children with Altered Mental Status in the Emergency Department

Yamaguchi, Hiroshi; Nagase, Hiroaki; Nishiyama, Masahiro; Tokumoto, Shoichi; Ishida, Yusuke; Tomioka, Kazumi; Tanaka, Tsukasa; Fujita, Kyoko; Toyoshima, Daisaku; Nishimura, Noriyuki; Kurosawa, Hiroshi; Nozu, Kandai; Maruyama, Azusa; Tanaka, Ryojiro; Iijima, Kazumoto

doi:10.1016/j.jpeds.2018.11.019

Cited by 17 publications

(16 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…al reported a similar proportion of NCSE in patients presenting with altered mental status. 10 Our study varied slightly in placement of electrodes, other studies reported various posterior electrode placements from parietal (P3/P4) 11 , occipital (O1-A1/O2-A2) 13 or both inion/occipital (O1-A1/O2-A2) 10 placement (3 and 4 leads total respectively); we chose a temporal (T5/T6) location instead for ease of application and avoiding scalp hair. Parietal and occipital non-invasive leads also impair patient comfort and staff efficiency as the patient's head has to be held by a member of staff.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and usefulness of rapid 2-channel-EEG-monitoring (point-of-care EEG) for acute CNS disorders in the paediatric emergency department: an observational study

2020

View full text Add to dashboard Cite

IntroductionThe aim of this study was to determine the feasibility and clinical utility of point-of-care electroencephalogram (pocEEG) in the paediatric emergency department (ED) for children presenting with acute non-traumatic central nervous system (CNS) disorders.MethodsRetrospective observational study of prospectively collected data in paediatric patients (0–16 years) with acute non-traumatic CNS-disorders presenting between April 2014 and February 2017 to a single paediatric ED in Switzerland.The 2-channel EEG was applied to all patients presenting with acute seizures or impaired consciousness to the ED. For a pocEEG, scalp surface electrodes are applied in five locations, thus allowing registration of fronto-temporal bilateral cortical activity. Neurology consultants assisted with interpretation of readings. EEG findings and clinical characteristics were collected. Feasibility and usefulness were rated via Likert scale.Results36 patients with acute seizures or altered mental status were analysed. Age range was 9 months to 15 years, median age of 34 months. 21 of 36 (58%) patients arrived out of hours. Application of electrodes was rated as ‘easy’ in 28 (77.8%) patients and rated as ‘difficult’ in 8 (22.2%). The utility of the EEG was rated by physicians as ‘very useful/diagnostic’ in 13 cases (36%), ‘useful’ in 21 cases (58%), ‘not useful’ in two cases (8%). None were rated ‘negative.’ConclusionUptake of pocEEG introduction has been very encouraging. Provider ratings were overwhelmingly positive. Recognition of non-convulsive status epilepticus was improved and pocEEG facilitated more targeted interventions.

show abstract

Section: Discussionmentioning

confidence: 99%

Feasibility and usefulness of rapid 2-channel-EEG-monitoring (point-of-care EEG) for acute CNS disorders in the paediatric emergency department: an observational study

2020

View full text Add to dashboard Cite

show abstract

“…Another study evaluated simultaneous recordings from a 23-electrode EEG and a six-electrode EEG in 12 adult ICU patients to detect non-convulsive seizures, with two neurophysiologists achieving consensus regarding the seizure activity in all 12 patients [ 80 ]. Thus the importance of fewer electrodes has been emphasized [ 61 ], especially in neonatal ICUs [ 81 ]. However, a recent systematic review of amplitude-integrated EEG (aEEG), which uses just two to four electrodes to diagnose neonatal seizures, highlighted the relatively low sensitivity and specificity and called for future studies to address this concern [ 82 ].…”

Section: Benefits Of Reduced Electrodes/channelsmentioning

confidence: 99%

Seizure detection with reduced electroencephalogram channels: research trends and outlook

et al. 2023

View full text Add to dashboard Cite

Epilepsy is a prevalent condition characterized by recurrent, unpredictable seizures. Monitoring with surface electroencephalography (EEG) is the gold standard for diagnosing epilepsy, but a time-consuming, uncomfortable and sometimes ineffective process for patients. Further, using EEG over a brief monitoring period has variable success, dependent on patient tolerance and seizure frequency. The availability of hospital resources and hardware and software specifications inherently restrict the options for comfortable, long-term data collection, resulting in limited data for training machine-learning models. This mini-review examines the current patient journey, providing an overview of the current state of EEG monitoring with reduced electrodes and automated channel reduction methods. Opportunities for improving data reliability through multi-modal data fusion are suggested. We assert the need for further research in electrode reduction to advance brain monitoring solutions towards portable, reliable devices that simultaneously offer patient comfort, perform ultra-long-term monitoring and expedite the diagnosis process.

show abstract

“…The BSP was defined here as visually repeating burst (high-voltage slow waves) and suppression (depressed electrographic activity). The time required to reach the BSP was judged by the clinician based on the continuous EEG of the simple electrodes at the bedside [33]. After reaching the BSP, continuous administration of maximal 6 mg/kg/H of thiamylal for 48-72 h was carried out with targeted temperature management (TTM) (36℃).…”

Section: Barbiturate Anaesthetic Therapy Protocolmentioning

confidence: 99%

Thiamylal anaesthetic therapy for febrile refractory status epilepticus in children

Ishida

Nishiyama

Yamaguchi

et al. 2020

Seizure

Self Cite

View full text Add to dashboard Cite

To evaluate barbiturate anaesthetic therapy using thiamylal for febrile refractory status epilepticus (fRSE) in children. Methods: This was a review of a prospectively-collected database between April 2012-March 2016 for fRSE cases treated with thiamylal anaesthetic therapy in a single paediatric hospital in Japan. The sample comprised 23 children (median age, 23 months) with fRSE that underwent thiamylal anaesthetic therapy for convulsive seizures lasting longer than 60 min, sustained after intravenous administration of benzodiazepine and non-benzodiazepine anticonvulsants. The intervention comprised protocol-based thiamylal anaesthetic therapy with bolus administration. We measured the dose and time required to achieve the burst suppression pattern (BSP) on electroencephalography, seizure recurrence, death, neurological sequelae, and complications. Results: All patients except one reached the BSP. The thiamylal median dose until reaching the BSP was 27.5 mg/kg, and the median time from thiamylal administration to reaching the BSP was 109.5 min. There was one case of immediate treatment failure and one of withdrawal seizure, but no breakthrough seizure. No deaths occurred during treatment, and neurological sequelae occurred in four cases (17%). Vasopressors were administered in all cases. Other complications included 11 cases of pneumonia and one of enterocolitis. Conclusion:We revealed the time and dose required to reach the BSP with thiamylal anaesthetic therapy using bolus administration in children. Our results suggested that reaching the BSP with bolus administration requires markedly less time than without bolus administration, rarely causes seizure recurrence in paediatric fRSE, and causes haemodynamic dysfunction and infections as often as observed without bolus administration.

show abstract

Nonconvulsive Seizure Detection by Reduced-Lead Electroencephalography in Children with Altered Mental Status in the Emergency Department

Cited by 17 publications

References 29 publications

Feasibility and usefulness of rapid 2-channel-EEG-monitoring (point-of-care EEG) for acute CNS disorders in the paediatric emergency department: an observational study

Feasibility and usefulness of rapid 2-channel-EEG-monitoring (point-of-care EEG) for acute CNS disorders in the paediatric emergency department: an observational study

Seizure detection with reduced electroencephalogram channels: research trends and outlook

Thiamylal anaesthetic therapy for febrile refractory status epilepticus in children

Contact Info

Product

Resources

About