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Conventional and quantitative EEG in status epilepticus.

Arnold J Sansevere1, Cecil D Hahn2, Nicholas S Abend3

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Seizure
|December 12, 2018
PubMed
Summary

Continuous electroencephalographic monitoring (cEEG) is crucial for diagnosing non-convulsive seizures (NCS) after pediatric convulsive status epilepticus (CSE). Quantitative EEG (QEEG) aids in rapid NCS detection in critically ill children.

Keywords:
Convulsive status epilepticusElectroencephalographyPediatricQuantitative EEGSeizurecEEG

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Area of Science:

  • Pediatric Neurology
  • Neurocritical Care
  • Clinical Electrophysiology

Background:

  • Pediatric convulsive status epilepticus (CSE) can lead to subtle or non-convulsive seizures (NCS) that are difficult to detect clinically.
  • Prompt recognition and management of NCS are critical due to their association with worse outcomes.

Purpose of the Study:

  • To summarize the role of continuous electroencephalographic monitoring (cEEG) in diagnosing and managing pediatric CSE and subsequent NCS.
  • To review guidelines and infrastructure for cEEG use.
  • To overview quantitative EEG (QEEG) for NCS detection in critically ill children.

Main Methods:

  • A review of medical literature, including guidelines and consensus statements, on cEEG and QEEG in pediatric CSE.
  • Focus on literature concerning the detection of NCS using cEEG and QEEG.

Main Results:

  • cEEG is recommended for recognizing subtle or masked seizures, especially after anti-seizure medication administration.
  • Guidelines suggest 24-48 hours of cEEG monitoring to exclude electrographic seizures.
  • Quantitative EEG (QEEG) is increasingly used for NCS detection in critically ill children, with reported sensitivities of 65-83% and specificities of 65-92%.

Conclusions:

  • Continuous electroencephalographic monitoring (cEEG) is essential for diagnosing and treating NCS or subtle seizures following pediatric CSE.
  • Quantitative EEG (QEEG) offers a rapid method for reviewing and interpreting cEEG data, proving valuable for NCS detection post-CSE.