[Continuous EEG for monitoring on the neurological intensive care unit. New applications and uses for therapeutic decision making].
Fifteen patients at our neurological intensive care unit were monitored with continuous EEG (cEEG: 10 channels EEG and ECG) for a total of 109 days. Primary indications for monitoring were nonconvulsive seizures in patients with altered consciousness (AC, n = 9) and control of therapy in generalized/partial status epilepticus (SE, n = 5). The cEEG findings influenced therapeutic management of patients in almost 50% of monitoring days (50/109), with decisive decisions (changes in medication) being made in 31/109 days. In 5/9 patients with AC, cEEG revealed findings that could not be demonstrated in previous EEG recordings. Identification of repetitive, nonepileptic, involuntary movements was guided by cEEG in four patients. Aside from the established application of cEEG monitoring in SE, the usefulness of clarifying the differential diagnosis in patients with AC was demonstrated particularly by the finding of nonconvulsive seizures in three patients. In two of these, intermittent EEG recordings did not demonstrate the seizures.
Claassen
J
J
Neurologische Klinik, Universitätskrankenhaus Eppendorf, Hamburg. jaclaassen@aol.com
Baeumer
T
T
Hansen
H C
HC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects; D003128:Coma / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D003422:Critical Care; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011379:Prognosis; D013226:Status Epilepticus / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology
D000927:Anticonvulsants