Continuous video EEG for patients with acute encephalopathy in a pediatric intensive care unit.

Neurocritical Care
John M SchreiberJessica L Carpenter

Abstract

In this study, we aimed to determine the incidence of electrographic seizures among patients in a pediatric intensive care unit (PICU) presenting with acute encephalopathy. Risk factors and duration of continuous EEG monitoring needed to capture electrographic seizures were also assessed. Based on a NeuroICU clinical care pathway, all patients with acute encephalopathy admitted to the PICU are monitored with continuous video electroencephalogram (cVEEG) for 48 h or until the encephalopathy improves. Ninety-four consecutive patients included on the pathway over a year were identified. Mean age was 6.7 years (range 32 days-17.9 years). Data pertaining to patient clinical information and electrographic seizures, including non-convulsive seizures (NCS) and non-convulsive status epilepticus (NCSE), were extracted from a prospective database. Thirty percent (28/94) had seizures captured on cVEEG including 17 patients (18%) with NCSE. Variables associated with electrographic seizures were age <24 months and clinical seizure(s) prior to EEG placement. The first seizure captured on cVEEG occurred in the first 24 h for the majority of patients (97%). Acute brain injury and electrographic seizures were associated with worse outcome. Elect...Continue Reading

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