Loading…

Conventional and quantitative EEG in status epilepticus

•CEEG is recommended to detect NCS after CSE.•High seizure burden has been associated with poor neurodevelopmental outcome.•A minimum of 24 h is suggested to exclude electrographic seizures.•QEEG is being used more frequently to detect NCS in children.•The sensitivity and specificity of QEEG to dete...

Full description

Saved in:
Bibliographic Details
Published in:Seizure (London, England) England), 2019-05, Vol.68, p.38-45
Main Authors: Sansevere, Arnold J., Hahn, Cecil D., Abend, Nicholas S.
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:•CEEG is recommended to detect NCS after CSE.•High seizure burden has been associated with poor neurodevelopmental outcome.•A minimum of 24 h is suggested to exclude electrographic seizures.•QEEG is being used more frequently to detect NCS in children.•The sensitivity and specificity of QEEG to detect NCS ranges from 65 to 83% and 65–92%. To summarize the use of continuous electroencephalographic monitoring (cEEG) in the diagnosis and management of pediatric convulsive status epilepticus (CSE) and subsequent non-convulsive seizures (NCS) with a focus on available guidelines and infrastructure. In addition, we provide an overview of quantitative EEG (QEEG) for the identification of NCS in critically ill children. We performed a review of the medical literature on the use of cEEG and QEEG in pediatric CSE. This included published guideline, consensus statements, and literature focused on the use of cEEG and QEEG to detect NCS. cEEG monitoring is recommended for prompt recognition of ongoing seizures that may be subtle, masked by pharmacologic paralysis, and or converted from convulsive seizures to NCS after administration of anti-seizure medications. Evidence indicating that high seizure burden is associated with worse outcome has motivated prompt recognition and management of NCS. The American Clinical Neurophysiology Society’s consensus statement recommends a minimum of 24 h to exclude electrographic seizures, while the Neurocritical Care Society’s guideline suggests 48 h in patients that are comatose. The use of QEEG amongst electroencephalographers and critical care medicine providers is increasing for NCS detection in critically ill children. The sensitivity and specificity of QEEG to detect NCS ranges from 65 to 83% and 65–92%, respectively. The use of cEEG is important to the diagnosis and treatment of NCS or subtle clinical seizures after pediatric CSE. QEEG allows cEEG data to be reviewed and interpreted quickly and is a useful tool for detection of NCS after CSE.
ISSN:1059-1311
1532-2688
DOI:10.1016/j.seizure.2018.09.011