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Critical Care EEG

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https://www.readbyqxmd.com/read/28207600/advancements-in-the-critical-care-management-of-status-epilepticus
#1
Andrew Bauerschmidt, Andrew Martin, Jan Claassen
PURPOSE OF REVIEW: Status epilepticus has a high morbidity and mortality. There are little definitive data to guide management; however, new recent data continue to improve understanding of management options of status epilepticus. This review examines recent advancements regarding the critical care management of status epilepticus. RECENT FINDINGS: Recent studies support the initial treatment of status epilepticus with early and aggressive benzodiazepine dosing...
February 14, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28160596/continuous-electroencephalography-ceeg-monitoring-and-outcomes-of-critically-ill-patients
#2
Ayaz M Khawaja, Guoqiao Wang, Gary R Cutter, Jerzy P Szaflarski
BACKGROUND It is not clear whether performing continuous EEG (cEEG) in critically ill patients during intensive care unit (ICU) treatment affects outcomes at discharge. MATERIAL AND METHODS We prospectively matched 234 patients who received cEEG (cases) by admission diagnosis and sex to 234 patients who did not receive cEEG (controls) and followed them until discharge. Patients admitted due to seizures were excluded. The primary measures of outcome were Glasgow Coma Scale at Discharge (GCSD) and disposition at discharge, and the secondary measures of outcome were AED modifications, Glasgow Outcomes Scale, and Modified-Rankin Scale...
February 4, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28145850/characterization-of-end-of-life-electroencephalographic-surges-in-critically-ill-patients
#3
Lakhmir S Chawla, Megan Terek, Christopher Junker, Seth Akst, Bona Yoon, Ermira Brasha-Mitchell, Michael G Seneff
BACKGROUND: Neuromonitoring devices to assess level of sedation are now used commonly in many hospital settings. We previously reported that electro-encephalic-graphic (EEG) spikes frequently occurred after the time of death in patients being neuro-monitored at the time of cessation of circulation. In addition to our initial report, end of life electrical surges (ELES) have been subsequently documented in animal and human studies by other investigators. The frequency, character, intensity, and significance of ELES are unknown...
February 1, 2017: Death Studies
https://www.readbyqxmd.com/read/28118746/frontal-intermittent-rhythmic-delta-activity-firda-in-the-neurological-intensive-care
#4
Nese Dericioglu, Farid Khasiyev, E Murat Arsava, M Akif Topcuoglu
INTRODUCTION: Frontal intermittent rhythmic delta activity (FIRDA), a transient rhythmic slow wave pattern over the anterior EEG leads, has been reported in a wide variety of cerebral lesions and different metabolic disturbances. Few authors have analyzed the frequency and clinical significance of FIRDA in the critical care setting. We aimed to better understand these issues in our intensive care cohort and if possible, try to delineate its underlying mechanisms. METHODS: Video-EEG reports of consecutive adult patients in the neurological intensive care unit (NICU) since 2009 were retrospectively reviewed to identify cases with FIRDA...
January 1, 2017: Clinical EEG and Neuroscience: Official Journal of the EEG and Clinical Neuroscience Society (ENCS)
https://www.readbyqxmd.com/read/28110410/neurophysiological-assessment-of-brain-dysfunction-in-critically-ill-patients-an-update
#5
REVIEW
Eric Azabou, Catherine Fischer, Jean Michel Guerit, Djillali Annane, François Mauguiere, Fréderic Lofaso, Tarek Sharshar
The aim of this review was to provide up-to-date information about the usefulness of clinical neurophysiology testing in the management of critically ill patients. Evoked potentials (EPs) and electroencephalogram (EEG) are non-invasive clinical neurophysiology tools that allow an objective assessment of the central nervous system's function at the bedside in intensive care unit (ICU). These tests are quite useful in diagnosing cerebral complications, and establishing the vital and functional prognosis in ICU...
January 21, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28044337/the-role-and-limitations-of-eeg-based-depth-of-anaesthesia-monitoring-in-theatres-and-intensive-care
#6
REVIEW
Z Hajat, N Ahmad, J Andrzejowski
In this article we will look at some of the principles in processed EEG monitoring as applied to bispectral index (BIS). We outline why BIS should be regarded as a 'memory' monitor which in most circumstances reflects the depth of sedation or anaesthesia in particular patients. Its limitation in paralysed and non-paralysed patients must be understood in order for this monitor to be used safely. Finally, its emerging use in critical care will be explored.
January 2017: Anaesthesia
https://www.readbyqxmd.com/read/28030932/usage-of-perioperative-anxiety-neuromarker-for-improving-the-quality-of-life-of-a-patient-operated-on-for-critical-stenosis-of-the-internal-carotid-artery
#7
Mariusz Trystuła, Paweł Półrola, Juri Kropotov
OBJECTIVE: The aim of the study was to find a neuromarker of perioperative anxiety in a patient with critical carotid stenosis through the use of neuromarkers in Quantitative EEG (QEEG) and Event Related Potentials (ERPs). The indirect purpose of the research was evaluation of improvement in the patient's quality of life. CASE STUDY: A 45-year-old woman was admitted to the Department of Vascular Surgery and Endovascular Interventions at the John Paul II Hospital in Krakow, with the diagnosis of critical internal carotid stenosis (over 80%), confirmed by Doppler Ultrasound and Angio-CT examinations...
23, 2016: Annals of Agricultural and Environmental Medicine: AAEM
https://www.readbyqxmd.com/read/28002714/hypothermia-for-neuroprotection-in-convulsive-status-epilepticus
#8
RANDOMIZED CONTROLLED TRIAL
Stephane Legriel, Virginie Lemiale, Maleka Schenck, Jonathan Chelly, Virginie Laurent, Fabrice Daviaud, Mohamed Srairi, Aicha Hamdi, Guillaume Geri, Thomas Rossignol, Julia Hilly-Ginoux, Julie Boisramé-Helms, Benjamin Louart, Isabelle Malissin, Nicolas Mongardon, Benjamin Planquette, Marina Thirion, Sybille Merceron, Emmanuel Canet, Fernando Pico, Yves-Roger Tran-Dinh, Jean-Pierre Bedos, Elie Azoulay, Matthieu Resche-Rigon, Alain Cariou
Background Convulsive status epilepticus often results in permanent neurologic impairment. We evaluated the effect of induced hypothermia on neurologic outcomes in patients with convulsive status epilepticus. Methods In a multicenter trial, we randomly assigned 270 critically ill patients with convulsive status epilepticus who were receiving mechanical ventilation to hypothermia (32 to 34°C for 24 hours) in addition to standard care or to standard care alone; 268 patients were included in the analysis. The primary outcome was a good functional outcome at 90 days, defined as a Glasgow Outcome Scale (GOS) score of 5 (range, 1 to 5, with 1 representing death and 5 representing no or minimal neurologic deficit)...
22, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27992625/association-of-periodic-and-rhythmic-electroencephalographic-patterns-with-seizures-in-critically-ill-patients
#9
Andres Rodriguez Ruiz, Jan Vlachy, Jong Woo Lee, Emily J Gilmore, Turgay Ayer, Hiba Arif Haider, Nicolas Gaspard, J Andrew Ehrenberg, Benjamin Tolchin, Tadeu A Fantaneanu, Andres Fernandez, Lawrence J Hirsch, Suzette LaRoche
Importance: Periodic and rhythmic electroencephalographic patterns have been associated with risk of seizures in critically ill patients. However, specific features that confer higher seizure risk remain unclear. Objective: To analyze the association of distinct characteristics of periodic and rhythmic patterns with seizures. Design, Setting, and Participants: We reviewed electroencephalographic recordings from 4772 critically ill adults in 3 academic medical centers from February 2013 to September 2015 and performed a multivariate analysis to determine features associated with seizures...
February 1, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/27930420/performance-of-spectrogram-based-seizure-identification-of-adult-eegs-by-critical-care-nurses-and-neurophysiologists
#10
Edilberto Amorim, Craig A Williamson, Lidia M V R Moura, Mouhsin M Shafi, Nicolas Gaspard, Eric S Rosenthal, Mary M Guanci, Venkatakrishna Rajajee, M Brandon Westover
PURPOSE: Continuous EEG screening using spectrograms or compressed spectral arrays (CSAs) by neurophysiologists has shorter review times with minimal loss of sensitivity for seizure detection when compared with visual analysis of raw EEG. Limited data are available on the performance characteristics of CSA-based seizure detection by neurocritical care nurses. METHODS: This is a prospective cross-sectional study that was conducted in two academic neurocritical care units and involved 33 neurointensive care unit nurses and four neurophysiologists...
January 25, 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27922904/utilization-of-quantitative-eeg-trends-for-critical-care-continuous-eeg-monitoring-a-survey-of-neurophysiologists
#11
Christa B Swisher, Saurabh R Sinha
PURPOSE: Quantitative EEG (QEEG) can be used to assist with review of large amounts of data generated by critical care continuous EEG monitoring. This study aimed to identify current practices regarding the use of QEEG in critical care continuous EEG monitoring of critical care patients. METHODS: An online survey was sent to 796 members of the American Clinical Neurophysiology Society (ACNS), instructing only neurophysiologists to participate. RESULTS: The survey was completed by 75 neurophysiologists that use QEEG in their practice...
December 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27905073/critical-comments-on-eeg-sensor-space-dynamical-connectivity-analysis
#12
Frederik Van de Steen, Luca Faes, Esin Karahan, Jitkomut Songsiri, Pedro A Valdes-Sosa, Daniele Marinazzo
Many different analysis techniques have been developed and applied to EEG recordings that allow one to investigate how different brain areas interact. One particular class of methods, based on the linear parametric representation of multiple interacting time series, is widely used to study causal connectivity in the brain. However, the results obtained by these methods should be interpreted with great care. The goal of this paper is to show, both theoretically and using simulations, that results obtained by applying causal connectivity measures on the sensor (scalp) time series do not allow interpretation in terms of interacting brain sources...
November 30, 2016: Brain Topography
https://www.readbyqxmd.com/read/27772777/status-epilepticus-in-the-elderly-prognostic-implications-of-rhythmic-and-periodic-patterns-in-electroencephalography-and-hyperintensities-on-diffusion-weighted-imaging
#13
Hajime Yoshimura, Riki Matsumoto, Hiroyuki Ueda, Koichi Ariyoshi, Michi Kawamoto, Junko Ishii, Akio Ikeda, Ryosuke Takahashi, Nobuo Kohara
OBJECTIVE: To delineate the clinical characteristics and functional outcome of status epilepticus (SE) in elderly people, and elucidate prognostic implications of SE-associated rhythmic and periodic patterns (RPPs) in electroencephalography and hyperintensities on diffusion-weighted imaging. METHODS: We retrospectively investigated 107 consecutive patients with SE aged≥65years in a comprehensive community hospital. RPPs were classified using the 2012 American Clinical Neurophysiology Society's Standardized Critical Care EEG Terminology...
November 15, 2016: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/27771198/yield-of-repeated-intermittent-eeg-for-seizure-detection-in-critically-ill-adults
#14
Yannick Fogang, Benjamin Legros, Chantal Depondt, Nicolas Mavroudakis, Nicolas Gaspard
INTRODUCTION: Seizures are common in critically ill patients and prevalence can exceed 30% in the neuro-intensive care unit (ICU). Continuous EEG monitoring (cEEG) is the gold standard for seizure detection in critically ill patients. OBJECTIVES: To determine the yield of intermittent EEG (iEEG) to detect critically ill adult patients with seizures and to identify the factors that affect this yield. METHODS: We retrospectively analyzed cEEG data and medical records from 977 consecutive critically ill patients undergoing cEEG...
October 19, 2016: Neurophysiologie Clinique, Clinical Neurophysiology
https://www.readbyqxmd.com/read/27478444/vague-neuroglycopenic-complaints-camouflage-diagnosis-of-adolescent-insulinoma-a-case-report
#15
Kelsee Halpin, Ryan McDonough, Patria Alba, Jared Halpin, Vivekanand Singh, Yun Yan
BACKGROUND: Insulinoma is a rare diagnosis in the general population with estimates of 1 in 250,000 people per year. Reports of these pancreatic islet cell tumors are even more unusual in children and adolescents. Chronic hypoglycemia due to an insulinoma often presents with neuroglycopenic symptoms that can easily be overlooked, especially in adolescents where nonspecific complaints are common. This may result in delayed diagnosis with prolonged periods of untreated hypoglycemia and associated complications...
2016: International Journal of Pediatric Endocrinology
https://www.readbyqxmd.com/read/27466474/sensitivity-of-quantitative-eeg-for-seizure-identification-in-the-intensive-care-unit
#16
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
https://www.readbyqxmd.com/read/27453817/bedside-functional-brain-imaging-in-critically-ill-children-using-high-density-eeg-source-modeling-and-multi-modal-sensory-stimulation
#17
Danny Eytan, Elizabeth W Pang, Sam M Doesburg, Vera Nenadovic, Bojan Gavrilovic, Peter Laussen, Anne-Marie Guerguerian
Acute brain injury is a common cause of death and critical illness in children and young adults. Fundamental management focuses on early characterization of the extent of injury and optimizing recovery by preventing secondary damage during the days following the primary injury. Currently, bedside technology for measuring neurological function is mainly limited to using electroencephalography (EEG) for detection of seizures and encephalopathic features, and evoked potentials. We present a proof of concept study in patients with acute brain injury in the intensive care setting, featuring a bedside functional imaging set-up designed to map cortical brain activation patterns by combining high density EEG recordings, multi-modal sensory stimulation (auditory, visual, and somatosensory), and EEG source modeling...
2016: NeuroImage: Clinical
https://www.readbyqxmd.com/read/27364336/invasive-seizure-monitoring-in-the-critically-ill-brain-injury-patient-current-practices-and-a-review-of-the-literature
#18
REVIEW
Charles B Mikell, Timothy G Dyster, Jan Claassen
Seizures commonly occur in a variety of serious neurological illnesses, and lead to additional morbidity and worsened outcomes. Recently, it has become clear that not all seizures in the acute brain injury setting are evident on scalp EEG. To address this, we have developed a protocol for depth electrode placement in the neuro-intensive care unit for patients in whom the clinical suspicion of occult seizures is high. In the current manuscript, we review the literature on depth EEG monitoring for ictal events in critically-ill, unconscious patients, focusing on the incidence of seizures not detected with scalp EEG in various conditions...
October 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/27271341/cerebral-function-monitoring-on-a-general-paediatric-ward-feasibility-and-potential
#19
Vivek Kalra, Shahul Sikkander Shaw, Stacey Dixon, Divyen K Shah, Paul Clarke
UNLABELLED: Cerebral function monitoring is widely used in neonatal intensive care, but its potential role in assessment of older infants is scarcely reported. We reviewed the use of cerebral function monitoring on a general paediatric ward in a series of young infants admitted with abnormal movements. Review of the amplitude-integrated EEG obtained by cerebral function monitoring revealed electrographic seizures in four of seven infants monitored. We also surveyed general paediatric wards in hospitals in our region of the UK to ask about current use of cerebral function monitoring and local availability of formal electroencephalography services...
August 2016: European Journal of Pediatrics
https://www.readbyqxmd.com/read/27187485/managing-status-epilepticus-in-the-older-adult
#20
REVIEW
Stephane Legriel, Gretchen M Brophy
The aim of this systematic review was to describe particularities in epidemiology, outcome, and management modalities in the older adult population with status epilepticus. There is a higher incidence of status epilepticus in the older adult population, and it commonly has a nonconvulsive presentation. Diagnosis in this population may be difficult and requires an unrestricted use of EEG. Short and long term associated-mortality are high, and age over 60 years is an independent factor associated with poor outcome...
2016: Journal of Clinical Medicine
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