Document Detail


Use of EEG monitoring and management of non-convulsive seizures in critically ill patients: a survey of neurologists.
MedLine Citation:
PMID:  20198513     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Continuous EEG monitoring (cEEG) of critically ill patients is frequently utilized to detect non-convulsive seizures (NCS) and status epilepticus (NCSE). The indications for cEEG, as well as when and how to treat NCS, remain unclear. We aimed to describe the current practice of cEEG in critically ill patients to define areas of uncertainty that could aid in designing future research. METHODS: We conducted an international survey of neurologists focused on cEEG utilization and NCS management. RESULTS: Three-hundred and thirty physicians completed the survey. 83% use cEEG at least once per month and 86% manage NCS at least five times per year. The use of cEEG in patients with altered mental status was common (69%), with higher use if the patient had a prior convulsion (89%) or abnormal eye movements (85%). Most respondents would continue cEEG for 24 h. If NCS or NCSE is identified, the most common anticonvulsants administered were phenytoin/fosphenytoin, lorazepam, or levetiracetam, with slightly more use of levetiracetam for NCS than NCSE. CONCLUSIONS: Continuous EEG monitoring (cEEG) is commonly employed in critically ill patients to detect NCS and NCSE. However, there is substantial variability in current practice related to cEEG indications and duration and to management of NCS and NCSE. The fact that such variability exists in the management of this common clinical problem suggests that further prospective study is needed. Multiple points of uncertainty are identified that require investigation.
Authors:
Nicholas S Abend; Dennis J Dlugos; Cecil D Hahn; Lawrence J Hirsch; Susan T Herman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurocritical care     Volume:  12     ISSN:  1556-0961     ISO Abbreviation:  Neurocrit Care     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-03     Completed Date:  2010-08-03     Revised Date:  2010-09-27    
Medline Journal Info:
Nlm Unique ID:  101156086     Medline TA:  Neurocrit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  382-9     Citation Subset:  IM    
Affiliation:
Division of Neurology, The Children's Hospital of Philadelphia, 34th Street and Civic Center Blvd, Philadelphia, PA 19104, USA. abend@email.chop.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Anticonvulsants / therapeutic use
Attitude of Health Personnel
Child
Conscious Sedation
Critical Care / utilization*
Data Collection
Electroencephalography / utilization*
Epilepsy, Generalized / diagnosis*,  drug therapy,  physiopathology
Humans
Monitoring, Physiologic / utilization*
Neurology
Signal Processing, Computer-Assisted*
Status Epilepticus / diagnosis*,  drug therapy,  physiopathology
Grant Support
ID/Acronym/Agency:
K12 NS049453-06/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
0/Anticonvulsants

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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