This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (13)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Neurology  • Pediatric Neurology  • Seizures, Nonepileptic  • Alert me on articles by topic  Social Bookmarking   What's this?

Nathalie Jette, MD, MSc; Jan Claassen, MD; Ronald G. Emerson, MD; Lawrence J. Hirsch, MD

Arch Neurol. 2006;63:1750-1755.

Objective  To determine the incidence, predictors, and timing of nonconvulsive seizures (NCSz) during continuous electroencephalographic monitoring (cEEG) in critically ill children.

Methods  We identified critically ill children who underwent cEEG during a 4-year period. Multivariate logistic regression analysis was performed to determine variables associated with NCSz.

Results  Among 117 monitored children, 44% had seizures on cEEG and 39% had NCSz. The majority of patients with seizures (75%) had purely NCSz, and 23% of patients had status epilepticus, which was purely nonconvulsive in 89% of cases. Seizures occurred immediately on cEEG initiation in 15%, within 1 hour in 50%, and within 24 hours in 80%. Those with clinical seizures prior to cEEG were more likely to have NCSz on cEEG (83%) than those without prior seizures (17%). On multivariate analysis, NCSz were associated with periodic lateralized epileptiform discharges and absence of background reactivity.

Conclusions  Seizures, the majority being NCSz, are common during cEEG in critically ill children (seen in 44% of patients). Half are detected in the first hour of recording, whereas 20% are not detected until after more than 24 hours of recording. Nonconvulsive seizures are associated with periodic lateralized epileptiform discharges and absence of reactivity on cEEG. This study confirms the importance of prolonged cEEG for critically ill children as a means to detect NCSz.

Author Affiliations: Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta (Dr Jette); and Department of Neurology, Columbia University, New York, NY (Drs Claassen, Emerson, and Hirsch).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Continuous Electroencephalogram Monitoring in the Intensive Care Unit
Friedman et al.
Anesth. Analg. 2009;109:506-523.
ABSTRACT | FULL TEXT  

Electroencephalographic monitoring during hypothermia after pediatric cardiac arrest
Abend et al.
Neurology 2009;72:1931-1940.
ABSTRACT | FULL TEXT  

Factors Affecting Recovery of Consciousness After Seizures
Millichap
AAP Grand Rounds 2007;17:40-40.
FULL TEXT