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Robert D Bolen, Jonathan J Halford, Jonathan C Edwards
INTRODUCTION: Digital EEG has brought about greater flexibility in data interpretation but has also resulted in new and unique artifacts. As digital EEG has evolved, an increase in ICU monitoring has occurred, bringing more sources of artifact to light. Aliasing due to a combination of compressed timebase and display monitor resolution can result in appearance of spurious waveforms that can potentially skew interpretation. METHODS: A portion of a digital EEG from an ICU patient acquired at a sample rate of 1024 Hz was reviewed at a timebase of 15 mm/sec on a monitor with a resolution of 1920x1080...
October 5, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Santoshi Billakota, Saurabh R Sinha
INTRODUCTION: Continuous EEG (cEEG) monitoring is used in the intensive care unit (ICU) setting to detect seizures, especially nonconvulsive seizures and status epilepticus. The utility and impact of such monitoring in non-ICU patients are largely unknown. METHODS: Hospitalized patients who were not in an ICU and underwent cEEG monitoring in the first half of 2011 and 2014 were identified. Reason for admission, admitting service (neurologic and nonneurologic), indication for cEEG, comorbid conditions, duration of recording, EEG findings, whether an event/seizure was recorded, and impact of EEG findings on management were reviewed...
October 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Sebastian Pollandt, Bichun Ouyang, Thomas P Bleck, Katharina M Busl
PURPOSE: Subdural hematomas (SDH) are associated with seizures and epileptiform discharges, but little is known about the prevalence and impact of seizures, status epilepticus and epileptiform discharges on outcomes in patients with isolated acute SDH (aSDH). METHODS: Continuous EEG reports from 76 adult patients admitted to Rush University Medical Center with aSDH between 01/2009 and 03/2012 were reviewed. Clinical and radiographic findings, comorbidities, treatment, and outcome parameters mortality, discharge destination, need for tracheostomy/percutaneous endoscopic gastrostomy (PEG) placement and length of stay (LOS) were assessed...
June 20, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Christopher R Newey, Dolora Wisco, Premkumar Nattanmai, Aarti Sarwal
BACKGROUND: Refractory status epilepticus is often treated with third-line therapy, such as pentobarbital coma. However, its use is limited by side effects. Recognizing and preventing major and minor adverse effects of prolonged pentobarbital coma may increase good outcomes. This study retrospectively reviewed direct and indirect medical and surgical pentobarbital coma. METHODS: Retrospective chart review of all patients with refractory status epilepticus treated with pentobarbital over a 1 year period at a large tertiary care center...
October 2016: Therapeutic Advances in Drug Safety
Marleen C Tjepkema-Cloostermans, Elisabeth T Wijers, Michel J A M van Putten
OBJECTIVE: To report on a distinct effect of auditory and sensory stimuli on the EEG in comatose patients with severe postanoxic encephalopathy. METHODS: In two comatose patients admitted to the Intensive Care Unit (ICU) with severe postanoxic encephalopathy and burst-suppression EEG, we studied the effect of external stimuli (sound and touch) on the occurrence of bursts. RESULTS: In patient A bursts could be induced by either auditory or sensory stimuli...
August 26, 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Kapil Gururangan, Babak Razavi, Josef Parvizi
OBJECTIVE: To investigate the utility of electroencephalography (EEG) for evaluation of patients with altered mental status (AMS). METHODS: We retrospectively reviewed 200 continuous EEGs (cEEGs) obtained in ICU and non-ICU wards and 100 spot EEGs (sEEGs) obtained from the emergency department (ED) of a large tertiary medical center. Main outcomes were access time (from study request to hookup), and diagnostic yield (percentage of studies revealing significant abnormality)...
October 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Sarah E Schmitt
INTRODUCTION: Seizures in the intensive care unit (ICU) are often subtle, and may have little or no clinical correlate. This study attempts to determine what clinical features are most strongly associated with the presence of electrographic seizures on continuous EEG (cEEG) monitoring. METHODS: A retrospective review for all patients who underwent cEEG monitoring between Jan. 2003 and Mar. 2009 for either characterization of clinical events or altered mental status was performed...
August 26, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Brian Appavu, Lisa Vanatta, John Condie, John F Kerrigan, Randa Jarrar
PURPOSE: We aimed to study whether ketogenic diet (KD) therapy leads to resolution of super-refractory status epilepticus in pediatric patients without significant harm. METHOD: A retrospective review was performed at Phoenix Children's Hospital on patients with super-refractory status epilepticus undergoing ketogenic diet therapy from 2011 to 2015. RESULTS: Ten children with super-refractory status epilepticus, ages 2-16 years, were identified...
October 2016: Seizure: the Journal of the British Epilepsy Association
Hiba A Haider, Rosana Esteller, Cecil D Hahn, M Brandon Westover, Jonathan J Halford, Jong W Lee, Mouhsin M Shafi, Nicolas Gaspard, Susan T Herman, Elizabeth E Gerard, Lawrence J Hirsch, Joshua A Ehrenberg, Suzette M LaRoche
OBJECTIVE: To evaluate the sensitivity of quantitative EEG (QEEG) for electrographic seizure identification in the intensive care unit (ICU). METHODS: Six-hour EEG epochs chosen from 15 patients underwent transformation into QEEG displays. Each epoch was reviewed in 3 formats: raw EEG, QEEG + raw, and QEEG-only. Epochs were also analyzed by a proprietary seizure detection algorithm. Nine neurophysiologists reviewed raw EEGs to identify seizures to serve as the gold standard...
August 30, 2016: Neurology
Zachary M Grinspan, Yonina C Eldar, Daniel Gopher, Amihai Gottlieb, Rotem Lammfromm, Halinder S Mangat, Nimrod Peleg, Steven Pon, Igal Rozenberg, Nicholas D Schiff, David E Stark, Peter Yan, Hillel Pratt, Barry E Kosofsky
BACKGROUND: Physicians caring for children with serious acute neurologic disease must process overwhelming amounts of physiological and medical information. Strategies to optimize real time display of this information are understudied. OBJECTIVES: Our goal was to engage clinical and engineering experts to develop guiding principles for creating a pediatric neurology intensive care unit (neuroPICU) monitor that integrates and displays data from multiple sources in an intuitive and informative manner...
2016: Applied Clinical Informatics
Hoi Ki Kate Lui, Kwok Fai Hui, Wing Chi Fong, Chun Tak Ip, Hiu Tung Colin Lui
PURPOSE: To identify predictors of poor clinical outcome in patients presenting to the intensive care units with status epilepticus (SE), in particular for patients presenting with de novo status epileptics. METHODS: A retrospective review was performed on patients admitted to the intensive care units with status epilepticus in two hospitals in Hong Kong over an 11-year period from 2003 to 2013. RESULTS: A total of 87 SE cases were analyzed...
August 2016: Seizure: the Journal of the British Epilepsy Association
I Rodini, M Papaioannou, D Kazis, M Konoglou, V Theodoridou, G Vassiliadou, M Bitzani
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
Ellis Wickering, Nicolas Gaspard, Sahar Zafar, Valdery J Moura, Siddharth Biswal, Sophia Bechek, Kathryn OʼConnor, Eric S Rosenthal, M Brandon Westover
The purpose of this study is to evaluate automated implementations of continuous EEG monitoring-based detection of delayed cerebral ischemia based on methods used in classical retrospective studies. We studied 95 patients with either Fisher 3 or Hunt Hess 4 to 5 aneurysmal subarachnoid hemorrhage who were admitted to the Neurosciences ICU and underwent continuous EEG monitoring. We implemented several variations of two classical algorithms for automated detection of delayed cerebral ischemia based on decreases in alpha-delta ratio and relative alpha variability...
June 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Susana Vacas, Erin McInrue, Michael A Gropper, Mervyn Maze, Rochelle Zak, Eunjung Lim, Jacqueline M Leung
BACKGROUND: Sleep disruption in critically ill adults can result in acute decrements in cognitive function, including delirium, but it is underdiagnosed in the setting of the intensive care unit (ICU). Although sleep stages can be assessed by polysomnography (PSG), acquisition and interpretation of PSG is costly, is labor intensive, is difficult to do over an extended period of time with critically ill patients (multiple days of continuous recording), and may interfere with patient care...
July 2016: Anesthesia and Analgesia
J G Bogaarts, D M W Hilkman, E D Gommer, V H J M van Kranen-Mastenbroek, J P H Reulen
Continuous electroencephalographic monitoring of critically ill patients is an established procedure in intensive care units. Seizure detection algorithms, such as support vector machines (SVM), play a prominent role in this procedure. To correct for inter-human differences in EEG characteristics, as well as for intra-human EEG variability over time, dynamic EEG feature normalization is essential. Recently, the median decaying memory (MDM) approach was determined to be the best method of normalization. MDM uses a sliding baseline buffer of EEG epochs to calculate feature normalization constants...
April 6, 2016: Medical & Biological Engineering & Computing
Nicolas Weiss, Frédéric Faugeras, Benjamin Rohaut, Jocelyne Leconte, Emilie Lafeuille, Florence Brossier, Julie Bourmaleau, Sandrine Lefebvre, Catherine Lafaye, Marion Quirins, Mélanie Valente, Hélène Brisson, Julien Mayaux, Marika Rudler, Nicolas Bréchot, Sophie Demeret, Francis Bolgert, Jérome Robert, Lionel Naccache
PURPOSE: Prevention of multidrug resistant (MDR) bacterial contamination remains a major challenge in ICUs. Many hospital outbreaks involving MDR transmitted through environmental contamination have been reported. Bedside high-density EEG allow for dynamic cognitive evaluation in brain-injured patients and is used more and more frequently in clinical practice to evaluate brain function and predict outcome in severely neurologically impaired patients. Unfortunately, the material used for this procedure is not entirely disposable...
April 2016: Seizure: the Journal of the British Epilepsy Association
Ryan P Williams, Brenda Banwell, Robert A Berg, Dennis J Dlugos, Maureen Donnelly, Rebecca Ichord, Sudha Kilaru Kessler, Jane Lavelle, Shavonne L Massey, Jennifer Hewlett, Allison Parker, Alexis A Topjian, Nicholas S Abend
OBJECTIVES: We aimed to determine whether implementation of a structured multidisciplinary electroencephalography (EEG) monitoring pathway improved the timeliness of administration of antiseizure medication in response to electrographic seizures in encephalopathic critically ill children. METHODS: A multidisciplinary team developed a pathway to standardize EEG monitoring and seizure management in encephalopathic critically ill children, aiming to decrease the time from electrographic seizure onset to antiseizure medication administration...
May 2016: Epilepsia
Jong Woo Lee, Suzette LaRoche, Hyunmi Choi, Andres A Rodriguez Ruiz, Evan Fertig, Jeffrey M Politsky, Susan T Herman, Tobias Loddenkemper, Arnold J Sansevere, Pearce J Korb, Nicholas S Abend, Joshua L Goldstein, Saurabh R Sinha, Keith E Dombrowski, Eva K Ritzl, Michael B Westover, Jay R Gavvala, Elizabeth E Gerard, Sarah E Schmitt, Jerzy P Szaflarski, Kan Ding, Kevin F Haas, Richard Buchsbaum, Lawrence J Hirsch, Courtney J Wusthoff, Jennifer L Hopp, Cecil D Hahn
PURPOSE: The rapid expansion of the use of continuous critical care electroencephalogram (cEEG) monitoring and resulting multicenter research studies through the Critical Care EEG Monitoring Research Consortium has created the need for a collaborative data sharing mechanism and repository. The authors describe the development of a research database incorporating the American Clinical Neurophysiology Society standardized terminology for critical care EEG monitoring. The database includes flexible report generation tools that allow for daily clinical use...
April 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Jennifer Wu, Ramesh Srinivasan, Erin Burke Quinlan, Ana Solodkin, Steven L Small, Steven C Cramer
EEG has been used to study acute stroke for decades; however, because of several limitations EEG-based measures rarely inform clinical decision-making in this setting. Recent advances in EEG hardware, recording electrodes, and EEG software could overcome these limitations. The present study examined how well dense-array (256 electrodes) EEG, acquired with a saline-lead net and analyzed with whole brain partial least squares (PLS) modeling, captured extent of acute stroke behavioral deficits and varied in relation to acute brain injury...
June 1, 2016: Journal of Neurophysiology
Riccardo Carrai, Antonello Grippo, Maenia Scarpino, Maddalena Spalletti, Cesarina Cossu, Giovanni Lanzo, Adriano Peris, Giovanni Cianchi, Stefano Batacchi, Serafina Valente, Gianfranco Gensini, Aldo Amantini
BACKGROUND: Evaluation of prognostic value of electroencephalography (EEG) and somatosensory evoked potentials (SEP) according to different recording times. METHODS: A retrospective cohort study performed at the medical ICU of the AOU Careggi Teaching Hospital (Florence, Italy) of comatose adults (>18 years) after cardiac arrest (CA) and treated with therapeutic hypothermia (TH). We evaluated the Glasgow Coma Scale, EEG, and SEP performed at 12, 24, and 72 hrs after CA...
September 2016: Minerva Anestesiologica
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