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Critical Care EEG

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https://www.readbyqxmd.com/read/29897141/swedish-consensus-reached-on-recording-interpretation-and-reporting-of-neonatal-continuous-simplified-electroencephalography-that-is-supported-by-amplitude-integrated-trend-analysis
#1
Sofia Backman, Ingmar Rosén, Mats Blennow, Thomas Andersson, Marita Englund, Roland Flink, Boubou Hallberg, Lars-Johan Liedholm, Elisabeth Norman, Alexandra Sailer, Magnus Thordstein
Continuous monitoring of electroencephalography (EEG), with a focus on amplitude-integrated EEG (aEEG), has been used in neonatal intensive care for decades. A number of systems have been suggested for describing and quantifying aEEG patterns. Extensive full-montage EEG monitoring is used in specialised intensive care units. The American Clinical Neurophysiology Society published recommendations for defining and reporting EEG findings in critically ill adults and infants. Swedish neonatologists and clinical neurophysiologists collaborated to optimise simplified neonatal continuous aEEG and EEG recordings based on these American documents...
June 13, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29891575/education-research-variation-in-priorities-for-neurocritical-care-education-expressed-across-role-groups
#2
Abigail S Cohen, Saef Izzy, Monisha A Kumar, Cara J Joyce, Stephen A Figueroa, Matthew B Maas, Christiana E Hall, David L McDonagh, David P Lerner, Paul M Vespa, Lori A Shutter, Eric S Rosenthal
OBJECTIVE: To define expectations for neurocritical care (NCC) core competencies vs competencies considered within the domain of other subspecialists. METHODS: An electronic survey was disseminated nationally to NCC nurses, physicians, fellows, and neurology residents through Accreditation Council for Graduate Medical Education neurology residency program directors, United Council for Neurologic Subspecialties neurocritical care fellowship program directors, and members of the Neurocritical Care Society...
June 12, 2018: Neurology
https://www.readbyqxmd.com/read/29756499/machine-learning-for-outcome-prediction-in-electroencephalograph-eeg-monitored-children-in-the-intensive-care-unit
#3
Iván Sánchez Fernández, Arnold J Sansevere, Marina Gaínza-Lein, Kush Kapur, Tobias Loddenkemper
The aim of this study was to evaluate the performance of models predicting in-hospital mortality in critically ill children undergoing continuous electroencephalography (cEEG) in the intensive care unit (ICU). We evaluated the performance of machine learning algorithms for predicting mortality in a database of 414 critically ill children undergoing cEEG in the ICU. The area under the receiver operating characteristic curve (AUC) in the test subset was highest for stepwise selection/elimination models (AUC = 0...
January 1, 2018: Journal of Child Neurology
https://www.readbyqxmd.com/read/29750358/a-population-based-cost-effectiveness-study-of-early-genetic-testing-in-severe-epilepsies-of-infancy
#4
Katherine B Howell, Stefanie Eggers, Kim Dalziel, Jessica Riseley, Simone Mandelstam, Candace T Myers, Jacinta M McMahon, Amy Schneider, Gemma L Carvill, Heather C Mefford, Ingrid E Scheffer, A Simon Harvey
OBJECTIVE: The severe epilepsies of infancy (SEI) are a devastating group of disorders that pose a major care and economic burden on society; early diagnosis is critical for optimal management. This study sought to determine the incidence and etiologies of SEI, and model the yield and cost-effectiveness of early genetic testing. METHODS: A population-based study was undertaken of the incidence, etiologies, and cost-effectiveness of a whole exome sequencing-based gene panel (targeted WES) in infants with SEI born during 2011-2013, identified through electroencephalography (EEG) and neonatal databases...
May 11, 2018: Epilepsia
https://www.readbyqxmd.com/read/29746721/melatonin-for-the-promotion-of-sleep-in-adults-in-the-intensive-care-unit
#5
REVIEW
Sharon R Lewis, Michael W Pritchard, Oliver J Schofield-Robinson, Phil Alderson, Andrew F Smith
BACKGROUND: Patients in the intensive care unit (ICU) experience sleep deprivation caused by environmental disruption, such as high noise levels and 24-hour lighting, as well as increased patient care activities and invasive monitoring as part of their care. Sleep deprivation affects physical and psychological health, and patients perceive the quality of their sleep to be poor whilst in the ICU. Artificial lighting during night-time hours in the ICU may contribute to reduced production of melatonin in critically ill patients...
May 10, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29733464/randomized-trial-of-lacosamide-vs-fosphenytoin-for-nonconvulsive-seizures
#6
Aatif M Husain, Jong W Lee, Bradley J Kolls, Lawrence J Hirsch, Jonathan J Halford, Puneet K Gupta, Yafa Minazad, Jennifer M Jones, Suzette M LaRoche, Susan T Herman, Christa B Swisher, Saurabh R Sinha, Adriana Palade, Keith E Dombrowski, William B Gallentine, Cecil D Hahn, Elizabeth E Gerard, Manjushri Bhapkar, Yuliya Lokhnygina, M Brandon Westover
OBJECTIVE: The optimal treatment of nonconvulsive seizures in critically ill patients is uncertain. We evaluated the comparative effectiveness of antiseizure drugs (ASD) lacosamide (LCM) and fosphenytoin (fPHT) in this population. METHODS: The Treatment of Recurrent Electrographic Nonconvulsive Seizures (TRENdS) study was a non-inferiority, prospective, multicenter, randomized treatment trial of patients diagnosed with NCS by continuous electroencephalography (cEEG)...
May 7, 2018: Annals of Neurology
https://www.readbyqxmd.com/read/29729532/how-do-we-diagnose-and-treat-epilepsy-with-myoclonic-atonic-seizures-doose-syndrome-results-of-the-pediatric-epilepsy-research-consortium-survey
#7
Katherine Nickels, Ronald Thibert, Stephanie Rau, Scott Demarest, Elaine Wirrell, Eric H Kossoff, Charuta Joshi, Srishti Nangia, Renee Shellhaas
OBJECTIVE: To obtain and assess opinions on EMAS diagnostic criteria, recommended investigations, and therapeutic options, from a large group of physicians who care for children with EMAS. METHODS: The EMAS focus group of PERC created a survey to assess the opinions of pediatric neurologists who care for children with EMAS regarding diagnosis and treatment of this condition, which was sent to members of PERC, AES, and CNS. A Likert scale was used to assess the respondents' opinions on the importance of diagnostic and exclusion criteria (five point scale), investigations (four point scale), and treatment (six point scale) of EMAS...
August 2018: Epilepsy Research
https://www.readbyqxmd.com/read/29702712/development-of-a-neuronicu-with-a-broader-focus-on-all-newborns-at-risk-of-brain-injury-the-first-2-years
#8
Krisa P Van Meurs, Elisabeth S Yan, Kathi S Randall, Valerie Y Chock, Alexis S Davis, Cecelia S Glennon, Catherine L Clark, Courtney J Wusthoff, Sonia L Bonifacio
OBJECTIVE:  Many critically ill neonates have an existing brain injury or are at risk of neurologic injury. We developed a "NeuroNICU" (neurologic neonatal intensive care unit) to better provide neurologically focused intensive care. STUDY DESIGN:  Demographic and clinical variables, services delivered, and patient outcomes were recorded in a prospective database for all neonates admitted to the NeuroNICU between April 23, 2013, and June 25, 2015. RESULTS:  In total, 546 neonates were admitted to the NeuroNICU representing 32% of all NICU admissions...
April 27, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29677014/continuous-electroencephalography-in-the-critically-ill-clinical-and-continuous-electroencephalography-markers-for-targeted-monitoring
#9
Christopher R Newey, Tyler G Kinzy, Vineet Punia, Stephen Hantus
PURPOSE: Electrographic seizures detected by continuous electroencephalography (CEEG) in critically ill patients with altered mental status is becoming increasingly recognized. Data guiding the appropriate selection of patients to be monitored on CEEG are lacking. The aims of this article were to study the incidence of seizures in the critical care setting and to evaluate for clinical predictors to improve the efficiency of CEEG monitoring. METHODS: Retrospective review of the CEEG and clinical data on 1,123 consecutive patients who had continuous video EEG over a 24-month period...
April 17, 2018: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/29597185/diazepam-for-outpatient-treatment-of-nonconvulsive-status-epilepticus-in-pediatric-patients-with-angelman-syndrome
#10
Lila Worden, Olivia Grocott, Amanda Tourjee, Fonda Chan, Ronald Thibert
Nonconvulsive status epilepticus (NCSE) is present in multiple pediatric neurogenetic syndromes with epileptic encephalopathies. While intravenous (IV) medications are used inpatient for treatment of critical illness-related NCSE, there is no consensus on treatment of ambulatory NCSE. Up to 50% of patients with Angelman syndrome (AS) have NCSE with myoclonic or atypical absence status. Here we report our experience in pediatric patients with AS and NCSE treated outpatient with a tapering course of oral diazepam...
May 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29465895/-clinical-neurophysiological-methods-in-diagnosis-and-treatment-of-cerebrovascular-diseases
#11
REVIEW
Ildikó Nagy, Dániel Fabó
Neurophysiological methods are gaining ground in the diagnosis and therapy of cerebrovascular disease. While the role of the EEG (electroencephalography) in the diagnosis of post-stroke epilepsy is constant, quantitative EEG para-meters, as new indicators of early efficiency after thrombolysis or in prognosis of patient's condition have proved their effectiveness in several clinical studies. In intensive care units, continuous EEG monitoring of critically ill patients became part of neurointenzive care protocols...
January 30, 2018: Ideggyógyászati Szemle
https://www.readbyqxmd.com/read/29464512/feasibility-of-continuous-sedation-monitoring-in-critically-ill-intensive-care-unit-patients-using-the-neurosense-wav-cns-index
#12
Nicholas West, Paul B McBeth, Sonia M Brodie, Klaske van Heusden, Sarah Sunderland, Guy A Dumont, Donald E G Griesdale, J Mark Ansermino, Matthias Görges
Sedation in the intensive care unit (ICU) is challenging, as both over- and under-sedation are detrimental. Current methods of assessment, such as the Richmond Agitation Sedation Scale (RASS), are measured intermittently and rely on patients' behavioral response to stimulation, which may interrupt sleep/rest. A non-stimulating method for continuous sedation monitoring may be beneficial and allow more frequent assessment. Processed electroencephalography (EEG) monitors have not been routinely adopted in the ICU...
February 20, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29438177/eeg-factors-after-pediatric-cardiac-arrest
#13
Nicholas S Abend, Douglas J Wiebe, Rui Xiao, Shavonne L Massey, Mark Fitzgerald, France Fung, Alexis A Topjian
PURPOSE: We aimed to determine whether conventional standardized EEG features could be consolidated into a more limited number of factors and whether the derived factor scores changed during the acute period after pediatric cardiac arrest. METHODS: Children resuscitated after cardiac arrest underwent conventional continuous EEG monitoring. The EEG was scored in 12-hour epochs for up to 72-hours after return of circulation by an electroencephalographer using standardized critical care EEG terminology...
May 2018: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/29432248/neurologic-complications-in-the-pediatric-intensive-care-unit
#14
Mark S Wainwright
PURPOSE OF REVIEW: All critical care is directed at maintaining brain health, but recognizing neurologic complications of critical illness in children is difficult, and limited data exist to guide practice. This article discusses an approach to the recognition and management of seizures, stroke, and cardiac arrest as complications of other critical illnesses in the pediatric intensive care unit. RECENT FINDINGS: Convulsive and nonconvulsive seizures occur frequently in children after cardiac arrest or traumatic brain injury and during extracorporeal membrane oxygenation...
February 2018: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/29399791/proposed-consensus-definitions-for-new-onset-refractory-status-epilepticus-norse-febrile-infection-related-epilepsy-syndrome-fires-and-related-conditions
#15
REVIEW
Lawrence J Hirsch, Nicolas Gaspard, Andreas van Baalen, Rima Nabbout, Sophie Demeret, Tobias Loddenkemper, Vincent Navarro, Nicola Specchio, Lieven Lagae, Andrea O Rossetti, Sara Hocker, Teneille E Gofton, Nicholas S Abend, Emily J Gilmore, Cecil Hahn, Houman Khosravani, Felix Rosenow, Eugen Trinka
We convened an international group of experts to standardize definitions of New-Onset Refractory Status Epilepticus (NORSE), Febrile Infection-Related Epilepsy Syndrome (FIRES), and related conditions. This was done to enable improved communication for investigators, physicians, families, patients, and other caregivers. Consensus definitions were achieved via email messages, phone calls, an in-person consensus conference, and collaborative manuscript preparation. Panel members were from 8 countries and included adult and pediatric experts in epilepsy, electroencephalography (EEG), and neurocritical care...
April 2018: Epilepsia
https://www.readbyqxmd.com/read/29328980/consequence-of-intraventricular-hemorrhage-on-neurovascular-coupling-evoked-by-speech-syllables-in-preterm-neonates
#16
Mahdi Mahmoudzadeh, Ghislaine Dehaene-Lambertz, Guy Kongolo, Marc Fournier, Sabrina Goudjil, Fabrice Wallois
Intraventricular Hemorrhage (IVH) is the leading cause of neurological and cognitive impairment in preterm neonates with an incidence that increases with increasing prematurity. In the present study, we tested how preterm neonates with IVH react to external stimulation (i.e. speech syllables). We compared their neural responses measured by electroencephalography (EEG), and hemodynamic responses measured by functional near-infrared spectroscopy (fNIRS), with those of healthy preterms. A neural response to syllables was observed in these infants, but did not induce a vascular response in contrast with healthy neonates...
January 5, 2018: Developmental Cognitive Neuroscience
https://www.readbyqxmd.com/read/29324406/a-novel-multi-class-eeg-based-sleep-stage-classification-system
#17
Pejman Memar, Farhad Faradji
Sleep stage classification is one of the most critical steps in effective diagnosis and the treatment of sleep-related disorders. Visual inspection undertaken by sleep experts is a time-consuming and burdensome task. A computer-assisted sleep stage classification system is thus essential for both sleep-related disorders diagnosis and sleep monitoring. In this paper, we propose a system to classify the wake and sleep stages with high rates of sensitivity and specificity. The EEG signals of 25 subjects with suspected sleep-disordered breathing, and the EEG signals of 20 healthy subjects from three data sets are used...
January 2018: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/29322820/reevaluation-of-the-critically-ill-patients-with-nonconvulsive-status-epilepticus-by-using-salzburg-consensus-criteria
#18
Ozlem Gungor Tuncer, Ebru Altindag, Sevda Ozel Yildiz, Mecbure Nalbantoglu, Mehmet Eren Acik, Sedef Tavukcu Ozkan, Betul Baykan
OBJECTIVE: We aimed to assess the usefulness of the Salzburg Consensus Criteria (SCC) for determining the prognosis of critically ill patients with nonconvulsive status epilepticus (NCSE). METHODS: We retrospectively reviewed consecutive patients with unconsciousness followed up in the intensive care unit (ICU). Three clinical neurophysiologists, one of them blinded to clinical and laboratory data, reevaluated all EEG data independently and determined NCSE according to SCC...
January 1, 2018: Clinical EEG and Neuroscience: Official Journal of the EEG and Clinical Neuroscience Society (ENCS)
https://www.readbyqxmd.com/read/29262437/ictal-interictal-continuum-when-to-worry-about-the-continuous-electroencephalography-pattern
#19
Justine Cormier, Carolina B Maciel, Emily J Gilmore
Continuous electroencephalography (cEEG) monitoring is an invaluable tool in the evaluation of encephalopathy and coma in critically ill patients. Marked increases in cEEG monitoring, coinciding with several societal guideline statements in the last decade, have allowed earlier detection and treatment of clearly harmful patterns, including nonconvulsive seizures (NCSz) and nonconvulsive status epilepticus (NCSE). However, it has also unmasked a range of EEG patterns of less clear clinical significance, with some more "malignant" than others given their potential association with increased neuronal stress and secondary brain injury...
December 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29248799/early-withdrawal-of-non-anesthetic-antiepileptic-drugs-after-successful-termination-of-nonconvulsive-seizures-and-nonconvulsive-status-epilepticus
#20
Jennifer A Creed, Jake Son, Alfredo E Farjat, Christa B Swisher
PURPOSE: Multiple antiepileptic drugs (AEDs) are often necessary to treat nonconvulsive seizures (NCS) and nonconvulsive status epilepticus (NCSE). AED polypharmacy places patients at risk for adverse side effects and drug-drug interactions. Identifying the likelihood of seizure relapse when weaning non-anesthetic AEDs may provide guidance in the critical care unit. METHOD: Ninety-nine adult patients with successful treatment of electrographic-proven NCS or NCSE on continuous critical care EEG (CCEEG) monitoring were identified retrospectively...
January 2018: Seizure: the Journal of the British Epilepsy Association
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