Electrographic status epilepticus in children with critical illness: Epidemiology and outcome

Abstract

Electrographic seizures and electrographic status epilepticus are common in children with critical illness with acute encephalopathy, leading to increasing use of continuous EEG monitoring. Many children with electrographic status epilepticus have no associated clinical signs, so EEG monitoring is required for seizure identification. Further, there is increasing evidence that high seizure burdens, often classified as electrographic status epilepticus, are associated with worse outcomes. This review discusses the incidence of electrographic status epilepticus, risk factors for electrographic status epilepticus, and associations between electrographic status epilepticus and outcomes, and it summarizes recent guidelines and consensus statements addressing EEG monitoring in children with critical illness. This article is part of a Special Issue entitled "Status Epilepticus".

Keywords: EEG monitoring; Nonconvulsive seizure; Pediatric; Seizure; Status epilepticus.

Figure 1

Proportions of subjects with electrographic seizures and electrographic status epilepticus from studies in which critically ill children underwent continuous EEG monitoring.

Figure 2

Incidence of electrographic seizures reported in studies of continuous EEG monitoring of critically ill children. The 95% confidence interval bars were generally not reported by the publications and were calculated based on the number of subjects with seizures and the total number of subjects in the study (Stata-12, immediate confidence interval command).

Figure 3

Proportion of subjects in whom electrographic seizures were identified by continuous EEG monitoring for 1 hour, 24 hours, and 48 hours.