[Continuous electroencephalogram monitoring in a pediatric intensive care unit]
Azusa Maruyama1, Hiroaki Nagase
1Department of Pediatric Neurology, Kobe Children's Hospital, Kobe, Hyogo. maruyama_kch@hp.pref.hyogo.jp
Insights
Continuous electroencephalogram (cEEG) monitoring effectively predicts neurological outcomes in pediatric intensive care unit (PICU) patients with status epilepticus or altered consciousness. Low voltage readings or nonconvulsive seizures on cEEG indicate a higher likelihood of poor neurological outcomes.
Area of Science:
- Pediatric Neurology
- Critical Care Medicine
- Neurophysiology
Context:
- Status epilepticus and altered consciousness in children admitted to the pediatric intensive care unit (PICU) present diagnostic and prognostic challenges.
- Continuous electroencephalogram (cEEG) monitoring is increasingly utilized in critical care settings.
Purpose:
- To evaluate the effectiveness of cEEG monitoring in predicting neurological outcomes for pediatric patients experiencing status epilepticus or altered consciousness.
- To identify specific electroencephalogram (EEG) features associated with neurological outcomes in this patient population.
Summary:
- Nonconvulsive seizures were detected in approximately 30% of 79 pediatric patients undergoing cEEG monitoring.
- A significant finding was that all patients with initial low voltage EEG readings (< or = 10 micro V) experienced poor neurological outcomes.
- Among patients without low voltage readings, the presence of nonconvulsive seizures correlated with poorer neurological outcomes.
Impact:
- cEEG monitoring provides early predictive value for neurological outcomes in critically ill children.
- Findings can guide clinical management and therapeutic interventions for children with status epilepticus or altered consciousness in the PICU.
Abstract:
This study sought to determine the effectiveness of continuous electroencephalogram (cEEG) monitoring for predicting neurological outcome among children with status epilepticus or altered consciousness in a pediatric intensive care unit (PICU). We detected nonconvulsive seizures and evaluated the relationship between electroencephalogram features and neurological outcome. Nonconvulsive seizures were detected in nearly 30% of the 79 patients who underwent cEEG monitoring, a rate that was similar to those seen in studies of adults. All patients who showed low voltage readings (< or = 10 micro V) at the time cEEG monitoring was started had poor neurological outcome (any changes in Pediatric Cerebral Performance Category Scale). Among patients who did not show low voltage readings, those who exhibited nonconvulsive seizures were more likely to have poor neurological outcome than those who did not. In a PICU, cEEG monitoring can help to predict neurological outcome in the early stage of treatment for children with status epilepticus or altered consciousness.
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