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J Clin Neurophysiol · Apr 2015
Practice GuidelineConsensus statement on continuous EEG in critically ill adults and children, part I: indications.
- Susan T Herman, Nicholas S Abend, Thomas P Bleck, Kevin E Chapman, Frank W Drislane, Ronald G Emerson, Elizabeth E Gerard, Cecil D Hahn, Aatif M Husain, Peter W Kaplan, Suzette M LaRoche, Marc R Nuwer, Mark Quigg, James J Riviello, Sarah E Schmitt, Liberty A Simmons, Tammy N Tsuchida, Lawrence J Hirsch, and Critical Care Continuous EEG Task Force of the American Clinical Neurophysiology Society.
- *Comprehensive Epilepsy Program, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, U.S.A.; †Departments of Neurology and Pediatrics, Perelman School of Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.; ‡Departments of Neurological Sciences, Neurosurgery, Medicine, and Anesthesiology, Rush Medical College, Chicago, Illinois, U.S.A.; §Department of Pediatrics and Neurology, University of Colorado, Boulder, Colorado, U.S.A.; ‖Department of Neurology, Hospital for Special Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medical College, New York, New York, U.S.A.; ¶Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, U.S.A. #Division of Neurology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada; **Department of Neurology, Duke University Medical Center, Durham, North Carolina, U.S.A.; ††Neurodiagnostic Center, Veterans Affairs Medical Center, Durham, North Carolina, U.S.A.; ‡‡Department of Neurology, Johns Hopkins Bayview Medical Center, Baltimore, Maryland, U.S.A.; §§Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, U.S.A.; ‖‖Department of Neurology, David Geffen School of Medicine and Clinical Neurophysiology, Ronald Reagan UCLA Medical Center, Los Angeles, California, U.S.A.; ¶¶FE Dreifuss Comprehensive Epilepsy Program, Department of Neurology, University of Virginia, Charlottesville, Virginia, U.S.A.; ##NYU Division of Child Neurology, Columbia University Medical Center, New York, New York, U.S.A.; ***Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.; †††School of Clinical Neurophysiology, Crozer-Chester Medical Center, Upland, Pennsylvania, U.S.A.; ‡‡‡Department of Neurology and Pediatrics, Children's National Med
- J Clin Neurophysiol. 2015 Apr 1; 32 (2): 87-95.
IntroductionCritical Care Continuous EEG (CCEEG) is a common procedure to monitor brain function in patients with altered mental status in intensive care units. There is significant variability in patient populations undergoing CCEEG and in technical specifications for CCEEG performance.MethodsThe Critical Care Continuous EEG Task Force of the American Clinical Neurophysiology Society developed expert consensus recommendations on the use of CCEEG in critically ill adults and children.RecommendationsThe consensus panel recommends CCEEG for diagnosis of nonconvulsive seizures, nonconvulsive status epilepticus, and other paroxysmal events, and for assessment of the efficacy of therapy for seizures and status epilepticus. The consensus panel suggests CCEEG for identification of ischemia in patients at high risk for cerebral ischemia; for assessment of level of consciousness in patients receiving intravenous sedation or pharmacologically induced coma; and for prognostication in patients after cardiac arrest. For each indication, the consensus panel describes the patient populations for which CCEEG is indicated, evidence supporting use of CCEEG, utility of video and quantitative EEG trends, suggested timing and duration of CCEEG, and suggested frequency of review and interpretation.ConclusionCCEEG has an important role in detection of secondary injuries such as seizures and ischemia in critically ill adults and children with altered mental status.
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