• Lara V Marcuse, David J Bronster, Madeline Fields, Antonio Polanco, Tsana Yu, and Joanna Chikwe.
• Mount Sinai School of Medicine, Department of Neurology, One Gustave Levy Place, Box 1028, New York, NY 10029, USA.
• J Crit Care. 2014 Apr 1;29(2):316.e1-5.

PurposeThis prospective study was designed to evaluate the role of continuous electroencephalography (EEG) in the management of adult patients with neurological dysfunction early after cardiac surgery.Materials And MethodsSeven hundred twenty-three patients undergoing cardiac surgery between December 2010 and June 2011 were divided into 2 groups based on the presence or absence of post-operative neurological dysfunction. All patients with neurological dysfunction underwent continuous EEG.ResultsNeurological dysfunction was diagnosed in 12 patients (1.7%), of whom 5 (42%) did not regain consciousness after surgery, 4 (33%) had a clinical event suspicious for seizure and 3 (25%) had neurological deficits. Continuous EEG showed that 2 of the 5 patients who failed to regain consciousness, without clinical signs of seizures, were in electrographic non-convulsive focal status epilepticus. Periodic discharges were present in the continuous EEGs of 3 patients. Three additional patients (25%) had abnormal movements that continuous EEG demonstrated was not due to seizure activity.ConclusionsNon-convulsive status epilepticus may be an under-recognized cause of obtundation early after cardiac surgery. Continuous EEG monitoring is a non-invasive test that can identify patients that may benefit from anti-epileptic medication. Larger comparative studies are required to establish whether this leads to significant improvements in patient outcomes.Copyright © 2014 Elsevier Inc. All rights reserved.

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