title: Electrophysiologic monitoring in acute brain injury.
abstract: To determine the optimal use and indications of electroencephalography (EEG) in critical care management of acute brain injury (ABI). An electronic literature search was conducted for articles in English describing electrophysiological monitoring in ABI from January 1990 to August 2013. A total of 165 studies were included. EEG is a useful monitor for seizure and ischemia detection. There is a well-described role for EEG in convulsive status epilepticus and cardiac arrest (CA). Data suggest EEG should be considered in all patients with ABI and unexplained and persistent altered consciousness and in comatose intensive care unit (ICU) patients without an acute primary brain condition who have an unexplained impairment of mental status. There remain uncertainties about certain technical details, e.g., the minimum duration of EEG studies, the montage, and electrodes. Data obtained from both EEG and EP studies may help estimate prognosis in ABI patients, particularly following CA and traumatic brain injury. Data supporting these recommendations is sparse, and high quality studies are needed. EEG is used to monitor and detect seizures and ischemia in ICU patients and indications for EEG are clear for certain disease states, however, uncertainty remains on other applications.
authors.affiliation: Division of Critical Care Neurology and Comprehensive Epilepsy Center, College of Physicians and Surgeons, Neurological Institute, Columbia University, 177 Fort Washington Avenue, MHB 8 Center, Room 300, New York, NY, 10032, USA, jc1439@columbia.edu.
authors.forename: Jan
authors.initials: J
authors.lastname: Claassen
authors.forename: Paul
authors.initials: P
authors.lastname: Vespa
mesh_terms: D001930:Brain Injuries / Q000175:diagnosis* / Q000503:physiopathology* / Q000628:therapy; D002545:Brain Ischemia / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D003422:Critical Care; D004569:Electroencephalography; D006323:Heart Arrest / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D018579:Patient Selection; D012640:Seizures / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy