engleski

Does EEG monitoring in NICU have to be interpreted by epileptologist?

Continuous electroencephalography (CEEG) monitoring is one of the diagnostic procedures to investigate cerebral activity, easily recorded at bedside and sensitive to changes in brain function. This diagnostic tool provides dynamic real-time information on the brain function enabling immediate detection of changes in the neurofunctional status, even if clinical signs and symptoms of pathologic cerebral processes are subtle or unspecific. Critical care CEEG (CCEEG) is longer than routine EEG, but the time required varies depending on individual patient characteristics, indications for monitoring and EEG findings. For most indications, recording for a minimum of 24 hours is recommended. CCEEG should be started as soon as feasible in comatose intensive care unit (ICU) patients with or without known acute brain injuries who have unexplained and persistent altered consciousness. Several international guidelines recommend its use for detection of nonconvulsive seizures (NCS) and nonconvulsive status epilepticus (NSCE) in patients with altered consciousness or mental deterioration, also after convulsive SE, for assessment of the efficacy of antiepileptic drug treatment, monitoring of sedation, assessment of severity of encephalopathy and prognostication, especially in hypoxic-ischemic encephalopathy following cardiac arrest, and early detection of cerebral ischemia associated with subarachnoid hemorrhage. Interpretation of continuous EEG in ICU is challenged by EEG artifacts and frequent subtle differences between ictal and interictal patterns. Correct interpretation of EEG findings with emphasis on personnel and other logistic aspects, as well as standardized terminology, NCSE criteria and treatment protocols are essential for optimal use of CEEG in ICU.

EEG monitoring ; NICU

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