The diagnostic value of continuous EEG for the detection of non-convulsive status epilepticus in neurosurgical patients – A prospective cohort study

• Published in: Clinical neurophysiology practice Vol. 4; pp. 81 - 84
• Main Authors: Krøigård, Thomas, Forsse, Axel, Bülow, Karsten, Broesby, Jesper, Poulsen, Frantz R., Kjaer, Troels W., Høgenhaven, Hans
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01-01-2019; Elsevier
• Subjects: cEEG; Clinical and; Continuous electroencephalography; NCSE; Non-convulsive status epilepticus; cEEG; NCSE; Non-convulsive status epilepticus; Continuous electroencephalography
• ISSN: 2467-981X; 2467-981X
• DOI: 10.1016/j.cnp.2019.04.001

•The incidence of seizure activity was 10%.•Seizure activity was detected within the first 30 min in three of the five patients.•Markers for patient selection for cEEG in neurosurgical patients are needed.
To prospectively compare the diagnostic yields of standard EEG and continuous EEG (cEEG) monitoring for the diagnosis of non-convulsive status epilepticus (NCSE) in neurosurgical patients in the intensive care unit.
We included 50 consecutive patients with clinical suspicion of NCSE due to unexplained coma or subtle clinical phenomena such as discrete myoclonus. The initial 30-minute EEG recording and the following cEEG were analyzed separately for seizure activity. Data were collected on neurosurgical diagnosis, previous diagnosis of epilepsy, current medication, level of consciousness, and outcome at discharge from the neurosurgical department.
Recurrent electrographic seizure activity was detected in five patients. This was within the first 30 mins for three patients and on the following cEEG for two patients. Antiepileptic treatment had been initiated in three of these patients. Most of the 50 patients had severe newly acquired neurological disability at discharge.
The prospective finding of a 10% seizure incidence was lower than reports from retrospective studies.
Use of cEEG led to detection of seizure activity in 2 of 50 patients (4%) and was thus a low-yield method in neurosurgical patients with suspicion of NCSE. Specific markers for patient selection for cEEG are needed.