Quantified EEG for the Characterization of Epileptic Seizures versus Periodic Activity in Critically Ill Patients

Epileptic seizures (ES) are frequent in critically ill patients and their detection and treatment are mandatory. However, sometimes it is quite difficult to discriminate between ES and non-epileptic bursts of periodic activity (BPA). Our aim was to characterize ES and BPA by means of quantified electroencephalography (qEEG). Records containing either ES or BPA were visually identified and divided into 1 s windows that were 10% overlapped. Differential channels were grouped by frontal, parieto-occipital and temporal lobes. For every channel and window, the power spectrum was calculated and the area for delta (0-4 Hz), theta (4-8 Hz), alpha (8-13 Hz), and beta (13-30 Hz) bands and spectral entropy (Se) were computed. Mean values of percentage changes normalized to previous basal activity and standardized mean difference (SMD) for every lobe were computed. We have observed that BPA are characterized by a selective increment of delta activity and decrease in Se along the scalp. Focal seizures (FS) always propagated and were similar to generalized seizures (GS). In both cases, although delta and theta bands increased, the faster bands (alpha and beta) showed the highest increments (more than 4 times) without modifications in Se. We have defined the numerical features of ES and BPA, which can facilitate its clinical identification.