EEG Use and Interpretation in the Critical Care Unit

Presentation Description / Summary: EEG is recommended in seizure patients that have an alteration in mentation (confused, stupor, coma) and/or abnormal movement. Patients in this setting may have a normal EEG and thus no additional need for anti-epileptic drug (AED). Alternatively, the EEG may demonstrate electrographic status epilepticus or electrographic seizure, which is associated with high mortality and a requirement for additional AED. Lastly, patients may demonstrate periodic discharges, indicating that they are somewhere on the ictal-interictal continuum, and may require more AED. A focus of this lecture will be the identification and interpretation of periodic discharges in both veterinary and human medicine. Novel information will be presented regarding the incidence and importance of periodic discharges. This case based lecture will firstly discuss a simple approach to the EEG set-up (sedation, electrode type and placement, montage, filter settings) and artifact identification. We will then discuss the indication, exam, video, and routine and continuous EEG findings in patients suspected of having on-going seizure and how EEG assisted in patient management. Lastly, data will be presented from our EEG database that will help to define the incidence, risk factors and outcome of patients with electrographic status epilepticus, electrographic seizure and periodic complexes.

Learner Outcomes: 1. Attendees will learn how to set-up and record EEG in their clinic 2. Attendees will be able to identify and understand the sigificance of the improtant EEG patterns; electrographic status epilepticus, electrographic seizure, and periodic complexes 3. Attendees with learn how to combine EEG and clinical observation in treating patients suspected of having ongoing seizure in the critical care setting.