Division of Neurology, The Children's Hospital of Philadelphia, 34th Street and Civic Center Blvd, Philadelphia, PA 19104, USA.
Neurocrit Care. 2010 Jun;12(3):382-9. doi: 10.1007/s12028-010-9337-2.
Continuous EEG monitoring (cEEG) of critically ill patients is frequently utilized to detect non-convulsive seizures (NCS) and status epilepticus (NCSE). The indications for cEEG, as well as when and how to treat NCS, remain unclear. We aimed to describe the current practice of cEEG in critically ill patients to define areas of uncertainty that could aid in designing future research.
We conducted an international survey of neurologists focused on cEEG utilization and NCS management.
Three-hundred and thirty physicians completed the survey. 83% use cEEG at least once per month and 86% manage NCS at least five times per year. The use of cEEG in patients with altered mental status was common (69%), with higher use if the patient had a prior convulsion (89%) or abnormal eye movements (85%). Most respondents would continue cEEG for 24 h. If NCS or NCSE is identified, the most common anticonvulsants administered were phenytoin/fosphenytoin, lorazepam, or levetiracetam, with slightly more use of levetiracetam for NCS than NCSE.
Continuous EEG monitoring (cEEG) is commonly employed in critically ill patients to detect NCS and NCSE. However, there is substantial variability in current practice related to cEEG indications and duration and to management of NCS and NCSE. The fact that such variability exists in the management of this common clinical problem suggests that further prospective study is needed. Multiple points of uncertainty are identified that require investigation.
对危重病患者进行连续脑电图监测（cEEG）常用于检测非惊厥性发作（NCS）和癫痫持续状态（NCSE）。cEEG 的适应证以及何时以及如何治疗 NCS 仍不清楚。我们旨在描述危重病患者中 cEEG 的当前实践，以确定可能有助于设计未来研究的不确定领域。
我们对专注于 cEEG 利用和 NCS 管理的神经病学家进行了国际调查。
330 名医生完成了调查。83%的人每月至少使用一次 cEEG，86%的人每年至少管理五次 NCS。在意识状态改变的患者中使用 cEEG 很常见（69%），如果患者有先前的抽搐（89%）或异常眼球运动（85%），则使用频率更高。大多数受访者会继续进行 24 小时 cEEG。如果发现 NCS 或 NCSE，最常使用的抗惊厥药是苯妥英/苯妥英钠、劳拉西泮或左乙拉西坦，用于 NCS 的左乙拉西坦略多于 NCSE。
连续脑电图监测（cEEG）常用于检测危重病患者的 NCS 和 NCSE。然而，与 cEEG 适应证、持续时间以及 NCS 和 NCSE 的管理相关的当前实践存在很大差异。这种常见临床问题的管理存在差异表明需要进一步进行前瞻性研究。确定了需要调查的多个不确定点。
