Analysis of routine EEG usage in a general adult ICU

Abstract

Background: Non-convulsive seizures and status epilepticus are common in brain-injured patients in intensive care units. Continuous electroencephalography (cEEG) monitoring is the most sensitive means of their detection. In centres where cEEG is unavailable, routine EEG is often utilized for diagnosis although its sensitivity is lower.

Aims: To establish the rate of electrographic seizure detection in ICU using routine EEG.

Methods: We identified all routine EEGs performed within a general adult ICU in Ireland over 3 years, and analyzed the clinical and EEG data.

Results: Fifty-two patients underwent single or repeated EEG evaluation during the time period. Epileptiform abnormalities were evident in 15%, periodic abnormalities in 14%, and electrographic seizures in just one patient (2%) in their first or only routine EEG recording.

Conclusion: The rate of electrographic seizure detection by routine EEG in a general ICU is lower than anticipated. Earlier and more prolonged recordings are needed in this setting.