Review of Noninvasive Neuromonitoring Modalities in Children II: EEG, qEEG
Giulia M Benedetti1,2, Rejéan M Guerriero3, Craig A Press4
1Division of Pediatric Neurology, Department of Neurology, Seattle Children's Hospital and the University of Washington School of Medicine, Seattle, WA, USA. gbenedet@med.umich.edu.
Insights
Continuous electroencephalography (cEEG) and quantitative EEG (qEEG) help monitor critically ill children. These tools detect seizures, assess brain injury, and track neurological changes, aiding in patient management.
Area of Science:
- Pediatric critical care medicine
- Neuroscience
- Medical technology
Background:
- Critically ill children with acute neurologic dysfunction face potential complications.
- Noninvasive bedside neuromonitoring is crucial for early detection.
- Continuous electroencephalography (cEEG) is a primary neuromonitoring tool in pediatric intensive care units (PICUs).
Purpose of the Study:
- To review the established role of cEEG in critically ill children.
- To explore the emerging utility of quantitative electroencephalography (qEEG) in this population.
- To discuss the application of both cEEG and qEEG as biomarkers for cerebral dysfunction and neurological status.
Main Methods:
- Review of current literature on cEEG and qEEG in pediatric critical care.
- Discussion of cEEG's established applications: seizure detection, treatment response assessment, background activity evaluation, and neuroprognostication.
- Exploration of qEEG's potential as a biomarker for cerebral dysfunction and neurological change.
Main Results:
- cEEG is the gold standard for seizure detection and treatment response in critically ill children.
- cEEG aids in background assessment and neuroprognostication following brain injury.
- Emerging evidence suggests both cEEG and qEEG can serve as biomarkers for the degree of cerebral dysfunction and detect neurologic deterioration or improvement.
Conclusions:
- cEEG remains essential for managing critically ill children with neurological dysfunction.
- qEEG shows promise as a complementary tool for assessing cerebral dysfunction and monitoring neurological status.
- Combined use of cEEG and qEEG may enhance neuromonitoring capabilities in the PICU.
Abstract:
Critically ill children with acute neurologic dysfunction are at risk for a variety of complications that can be detected by noninvasive bedside neuromonitoring. Continuous electroencephalography (cEEG) is the most widely available and utilized form of neuromonitoring in the pediatric intensive care unit. In this article, we review the role of cEEG and the emerging role of quantitative EEG (qEEG) in this patient population. cEEG has long been established as the gold standard for detecting seizures in critically ill children and assessing treatment response, and its role in background assessment and neuroprognostication after brain injury is also discussed. We explore the emerging utility of both cEEG and qEEG as biomarkers of degree of cerebral dysfunction after specific injuries and their ability to detect both neurologic deterioration and improvement.
