Therapeutically induced EEG burst-suppression pattern to treat refractory status epilepticus—what is the evidence?

Fisch, Urs; Jünger, Anja L.; Hert, Lisa; Rüegg, Stephan; Sutter, Raoul

doi:10.1007/s10309-022-00539-z

Cited by 3 publications

(4 citation statements)

References 58 publications

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“…If status epilepticus persists and becomes refractory, current guidelines in human medicine recommend continuously administered anesthetics to induce artificial coma. 24 For monitoring the depth of the artificial coma, the appearance of a burst-suppression pattern in the EEG is used. 24 Our study had some limitations, including its retrospective design, 2 different species and a small case number of cats.…”

Section: Discussionmentioning

confidence: 99%

“…24 For monitoring the depth of the artificial coma, the appearance of a burst-suppression pattern in the EEG is used. 24 Our study had some limitations, including its retrospective design, 2 different species and a small case number of cats. Because the number of cats was much smaller than the number of dogs, statistical analysis of both species was combined.…”

Section: Discussionmentioning

confidence: 99%

“…The animals were intubated and inhalant anesthesia was maintained with isoflurane (1%‐2% MAC) for 12 hours. If status epilepticus persists and becomes refractory, current guidelines in human medicine recommend continuously administered anesthetics to induce artificial coma 24 . For monitoring the depth of the artificial coma, the appearance of a burst‐suppression pattern in the EEG is used 24 …”

Section: Discussionmentioning

confidence: 99%

“… 24 For monitoring the depth of the artificial coma, the appearance of a burst‐suppression pattern in the EEG is used. 24 …”

Section: Discussionmentioning

confidence: 99%

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Prevalence of nonconvulsive seizures and nonconvulsive status epilepticus in dogs and cats with a history of cluster seizures: A retrospective study

Tästensen,

Gutmann,

Loderstedt

et al. 2023

Veterinary Internal Medicne

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BackgroundNonconvulsive seizures (NCS) and nonconvulsive status epilepticus (NCSE) are frequently observed in human patients. Diagnosis of NCS and NCSE only can be achieved by the use of electroencephalography (EEG). Electroencephalographic monitoring is rare in veterinary medicine and consequently there is limited data on frequency of NCS and NCSE.ObjectivesDetermine the prevalence of NCS and NCSE in dogs and cats with a history of cluster seizures.AnimalsTwenty‐six dogs and 12 cats.MethodsRetrospective study. Medical records of dogs and cats with cluster seizures were reviewed. Electroencephalography was performed in order to identify electrographic seizure activity after the apparent cessation of convulsive seizure activity.ResultsNonconvulsive seizures were detected in 9 dogs and 2 cats out of the 38 patients (29%). Nonconvulsive status epilepticus was detected in 4 dogs and 2 cats (16%). Five patients had both NCS and NCSE. A decreased level of consciousness was evident in 6/11 patients with NCS, 3/6 also had NCSE. Mortality rate for patients with NCS (73%) and NCSE (67%) was much higher than that for patients with no seizure activity on EEG (27%).Conclusion and Clinical ImportancePrevalence of NCS and NCSE is high in dogs and cats with a history of cluster seizures. Nonconvulsive seizures and NCSE are difficult to detect clinically and are associated with higher in hospital mortality rates. Results indicate that prompt EEG monitoring should be performed in dogs and cats with cluster seizures.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“… 24 For monitoring the depth of the artificial coma, the appearance of a burst‐suppression pattern in the EEG is used. 24 …”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Prevalence of nonconvulsive seizures and nonconvulsive status epilepticus in dogs and cats with a history of cluster seizures: A retrospective study

Tästensen,

Gutmann,

Loderstedt

et al. 2023

Veterinary Internal Medicne

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Hundert Jahre EEG, 6 Monate neue Leitlinie „Erster epileptischer Anfall und Epilepsien im Erwachsenenalter“ und 1 Jahr Clinical Epileptology

Schmitt,

Haberlandt,

Rüegg

et al. 2024

Clin Epileptol

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Clinical characteristics and outcomes of patients with recurrent status epilepticus episodes

Bauer

Rosenow

Knake

et al. 2023

Neurol. Res. Pract.

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Background Multiple studies have focused on medical and pharmacological treatments and outcome predictors of patients with status epilepticus (SE). However, a sufficient understanding of recurrent episodes of SE is lacking. Therefore, we reviewed recurrent SE episodes to investigate their clinical characteristics and outcomes in patients with relapses. Methods In this retrospective, multicenter study, we reviewed recurrent SE patient data covering 2011 to 2017 from the university hospitals of Frankfurt and Marburg, Germany. Clinical characteristics and outcome variables were compared among the first and subsequent SE episodes using a standardized form for data collection. Results We identified 120 recurrent SE episodes in 80 patients (10.2% of all 1177 episodes). The mean age at the first SE episode was 62.2 years (median 66.5; SD 19.3; range 21–91), and 42 of these patients were male (52.5%). A mean of 262.4 days passed between the first and the second episode. Tonic–clonic seizure semiology and a cerebrovascular disease etiology were predominant in initial and recurrent episodes. After subsequent episodes, patients showed increased disability as indicated by the modified Rankin Scale (mRS), and 9 out of 80 patients died during the second episode (11.3%). Increases in refractory and super-refractory SE (RSE and SRSE, respectively) were noted during the second episode, and the occurrence of a non-refractory SE (NRSE) during the first SE episode did not necessarily provide a protective marker for subsequent non-refractory episodes. An increase in the use of intravenous-available anti-seizure medication (ASM) was observed in the treatment of SE patients. Patients were discharged from hospital with a mean of 2.8 ± 1.0 ASMs after the second SE episode and 2.1 ± 1.2 ASMs after the first episode. Levetiracetam was the most common ASM used before admission and on discharge for SE patients. Conclusions This retrospective, multicenter study used the mRS to demonstrate worsened outcomes of patients at consecutive SE episodes. ASM accumulations after subsequent SE episodes were registered over the study period. The study results underline the necessity for improved clinical follow-ups and outpatient care to reduce the health care burden from recurrent SE episodes.

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Therapeutically induced EEG burst-suppression pattern to treat refractory status epilepticus—what is the evidence?

Cited by 3 publications

References 58 publications

Prevalence of nonconvulsive seizures and nonconvulsive status epilepticus in dogs and cats with a history of cluster seizures: A retrospective study

Prevalence of nonconvulsive seizures and nonconvulsive status epilepticus in dogs and cats with a history of cluster seizures: A retrospective study

Hundert Jahre EEG, 6 Monate neue Leitlinie „Erster epileptischer Anfall und Epilepsien im Erwachsenenalter“ und 1 Jahr Clinical Epileptology

Clinical characteristics and outcomes of patients with recurrent status epilepticus episodes

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