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Continuous Electroencephalography Monitoring in Critically Ill Infants and Children
Jennifer L Griffith1, Stuart T Tomko1, Réjean M Guerriero1
1Department of Neurology, Washington University School of Medicine, St. Louis, Missouri.
Insights
Continuous video electroencephalography (CEEG) monitoring helps detect seizures in critically ill children. Further research is needed to understand how CEEG patterns impact patient outcomes.
Area of Science:
- Pediatric Neurology
- Critical Care Medicine
- Clinical Neurophysiology
Background:
- Continuous video electroencephalography (CEEG) monitoring is increasingly used for critically ill infants and children.
- Indications include altered mental status, paroxysmal events, and seizure detection in high-risk populations.
- Electrographic seizures occur in 7-46% and status epilepticus in 1-23% of pediatric patients.
Purpose of the Study:
- To review the expanding role and clinical utility of CEEG in critically ill pediatric populations.
- To highlight the diagnostic and prognostic information derived from CEEG.
- To emphasize the need for further research into CEEG's impact on outcomes.
Main Methods:
- Review of current literature and clinical practices regarding CEEG in pediatric critical care.
- Analysis of reported incidence rates for electrographic seizures and status epilepticus.
- Discussion of emerging quantitative EEG techniques.
Main Results:
- CEEG is valuable for evaluating altered mental status and detecting electrographic seizures in critically ill children.
- CEEG patterns, including epileptiform and background activity, may offer prognostic insights.
- Quantitative EEG shows promise for real-time data acquisition and patient management.
Conclusions:
- CEEG is an essential tool in pediatric critical care for seizure detection and neurological assessment.
- Further research is required to fully elucidate the clinical significance of CEEG findings on patient outcomes.
- Quantitative EEG advancements may enhance the utility of CEEG in managing critically ill children.
Abstract:
Continuous video electroencephalography (CEEG) monitoring of critically ill infants and children has expanded rapidly in recent years. Indications for CEEG include evaluation of patients with altered mental status, characterization of paroxysmal events, and detection of electrographic seizures, including monitoring of patients with limited neurological examination or conditions that put them at high risk for electrographic seizures (e.g., cardiac arrest or extracorporeal membrane oxygenation cannulation). Depending on the inclusion criteria and clinical characteristics of the population studied, the percentage of pediatric patients with electrographic seizures varies from 7% to 46% and with electrographic status epilepticus from 1% to 23%. There is also evidence that epileptiform and background CEEG patterns may provide important information about prognosis in certain clinical populations. Quantitative EEG techniques are emerging as a tool to enhance the value of CEEG to provide real-time bedside data for management and prognosis. Continued research is needed to understand the clinical value of seizure detection and identification of other CEEG patterns on the outcomes of critically ill infants and children.
