Continuous electroencephalogram monitoring in the critically ill

The use of continuous electroencephalogram (cEEG) monitoring in the intensive care unit is becoming more widespread, with improvements in data storage capability and networking and the increasing awareness of nonconvulsive seizures. Current and potential uses for this technology include seizure detection, ischemia detection, and prognostication. Nonconvulsive seizures are common in the critically ill, particularly those with acute brain injury and those who are comatose. The implications of some of the electrographical patterns observed in critically ill patients are not yet clear. This article discusses findings with cEEG to date, pitfalls in performing and interpreting these studies, and where we should turn our attention with this underutilized brain monitoring technique.