title: Predictors of nonconvulsive seizures among critically ill children.
abstract: OBJECTIVE
  Continuous electroencephalography (EEG) monitoring is a valuable tool for the detection of seizures among critically ill children, in particular when these seizures occur without clinical signs: termed nonconvulsive seizures. Continuous EEG monitoring is a limited resource in many centers. We sought to identify which critically ill children most frequently experience nonconvulsive seizures, and thus may particularly benefit from continuous EEG monitoring.
  
  
  METHODS
  Single-center review was undertaken of consecutive diagnostic continuous EEG (cEEG) recordings performed in our pediatric and neonatal intensive care units (ICUs). We examined the indications for monitoring, the clinical characteristics of monitored patients, the occurrence and timing of seizures, and clinical and EEG characteristics associated with nonconvulsive seizures.
  
  
  RESULTS
  One hundred twenty-one patients underwent diagnostic continuous EEG monitoring, for a mean duration of 26 h. Seizures were detected in 32% of these patients, of which 90% experienced some nonconvulsive seizures, and 72% experienced exclusively nonconvulsive seizures. Patients with nonconvulsive seizures had significantly greater odds of having acute epilepsy, acute structural brain injury, prior in-hospital convulsive seizures, and the presence of interictal epileptiform abnormalities on EEG.
  
  
  CONCLUSIONS
  Seizures are common among critically ill children undergoing diagnostic cEEG monitoring. The great majority of these seizures are nonconvulsive, requiring EEG for their detection. Predictors of nonconvulsive seizures include acute epilepsy, acute structural brain injury, prior in-hospital convulsive seizures, and interictal epileptiform abnormalities on EEG. These findings can help inform future allocation of limited cEEG monitoring resources to those patients at greatest risk for nonconvulsive seizures.
authors: Division of Neurology, The Hospital for Sick Children, and University of Toronto, Toronto, Ontario, Canada.
authors: Bláthnaid
authors: B
authors: McCoy
authors: Rohit
authors: R
authors: Sharma
authors: Ayako
authors: A
authors: Ochi
authors: Cristina
authors: C
authors: Go
authors: Hiroshi
authors: H
authors: Otsubo
authors: James S
authors: JS
authors: Hutchison
authors: Eshetu G
authors: EG
authors: Atenafu
authors: Cecil D
authors: CD
authors: Hahn
mesh_terms: D000367:Age Factors; D001921:Brain / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D004829:Epilepsy, Generalized / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008991:Monitoring, Physiologic; D015995:Prevalence; D012189:Retrospective Studies; D012737:Sex Factors; D013997:Time Factors