{"corpus_id":23235785,"paper_sha":"644970eb739dfa5da763fcbb77b38e355b4aa78b","doi":"10.1212/01.WNL.0000125184.88797.62","arxiv_id":null,"pmid":15159471,"pmcid":null,"mag_id":2082136405,"dblp_id":null,"acl_id":null,"title":"Detection of electrographic seizures with continuous EEG monitoring in critically ill patients","year":2004,"publication_date":"2004-05-25","venue":"Neurology","journal":{"name":"Neurology","pages":"1743 - 1748","volume":"62"},"journal_issn":null,"journal_title":null,"publication_types":["Review","JournalArticle"],"pubmed_pub_types":["Journal Article","Review"],"s2_fields_of_study":["Medicine"],"reference_count":15,"citation_count":1071,"influential_citation_count":79,"is_open_access":false,"arxiv_categories":null,"arxiv_license":null,"arxiv_journal_ref":null,"mesh_headings":[{"d":"Adult","mj":false,"ui":"D000328"},{"d":"Aged","mj":false,"ui":"D000368"},{"d":"Anticonvulsants","mj":false,"qs":[{"q":"administration & dosage","mj":false,"ui":"Q000008"},{"q":"therapeutic use","mj":false,"ui":"Q000627"}],"ui":"D000927"},{"d":"Brain Diseases","mj":false,"qs":[{"q":"complications","mj":false,"ui":"Q000150"}],"ui":"D001927"},{"d":"Child","mj":false,"ui":"D002648"},{"d":"Child, Preschool","mj":false,"ui":"D002675"},{"d":"Cohort Studies","mj":false,"ui":"D015331"},{"d":"Coma","mj":false,"qs":[{"q":"etiology","mj":false,"ui":"Q000209"},{"q":"physiopathology","mj":false,"ui":"Q000503"}],"ui":"D003128"},{"d":"Consciousness Disorders","mj":false,"qs":[{"q":"etiology","mj":false,"ui":"Q000209"},{"q":"physiopathology","mj":false,"ui":"Q000503"}],"ui":"D003244"},{"d":"Critical Care","mj":false,"qs":[{"q":"methods","mj":true,"ui":"Q000379"},{"q":"statistics & numerical data","mj":false,"ui":"Q000706"}],"ui":"D003422"},{"d":"Drug Monitoring","mj":false,"ui":"D016903"},{"d":"Electroencephalography","mj":true,"ui":"D004569"},{"d":"Epilepsy","mj":false,"qs":[{"q":"complications","mj":false,"ui":"Q000150"},{"q":"drug therapy","mj":false,"ui":"Q000188"}],"ui":"D004827"},{"d":"Female","mj":false,"ui":"D005260"},{"d":"Humans","mj":false,"ui":"D006801"},{"d":"Infant","mj":false,"ui":"D007223"},{"d":"Inpatients","mj":false,"ui":"D007297"},{"d":"Male","mj":false,"ui":"D008297"},{"d":"Middle Aged","mj":false,"ui":"D008875"},{"d":"Monitoring, Physiologic","mj":true,"ui":"D008991"},{"d":"Pentobarbital","mj":false,"qs":[{"q":"administration & dosage","mj":false,"ui":"Q000008"},{"q":"therapeutic use","mj":false,"ui":"Q000627"}],"ui":"D010424"},{"d":"Retrospective Studies","mj":false,"ui":"D012189"},{"d":"Seizures","mj":false,"qs":[{"q":"diagnosis","mj":true,"ui":"Q000175"},{"q":"epidemiology","mj":false,"ui":"Q000453"},{"q":"physiopathology","mj":false,"ui":"Q000503"}],"ui":"D012640"},{"d":"Subarachnoid Hemorrhage","mj":false,"qs":[{"q":"complications","mj":false,"ui":"Q000150"}],"ui":"D013345"},{"d":"Treatment Outcome","mj":false,"ui":"D016896"}],"chemicals":[{"n":"Anticonvulsants","ui":"D000927","reg":"0"},{"n":"Pentobarbital","ui":"D010424","reg":"I4744080IR"}],"comments_corrections":null,"source_flags":5,"s2_open_access_pdf_url":null,"s2_open_access_landing_url":null,"s2_open_access_license":null,"s2_open_access_status":null,"pmc_open_access_pdf_url":null,"pmc_open_access_landing_url":null,"pmc_open_access_license":null,"pmc_open_access_status":null,"unpaywall_open_access_pdf_url":null,"unpaywall_open_access_landing_url":null,"unpaywall_open_access_license":null,"unpaywall_open_access_status":null,"abstract":"OBJECTIVE: To identify patients most likely to have seizures documented on continuous EEG (cEEG) monitoring and patients who require more prolonged cEEG to record the first seizure. METHODS: Five hundred seventy consecutive patients who underwent cEEG monitoring over a 6.5-year period were reviewed for the detection of subclinical seizures or evaluation of unexplained decrease in level of consciousness. Baseline demographic, clinical, and EEG findings were recorded and a multivariate logistic regression analysis performed to identify factors associated with 1) any EEG seizure activity and 2) first seizure detected after >24 hours of monitoring. RESULTS: Seizures were detected in 19% (n = 110) of patients who underwent cEEG monitoring; the seizures were exclusively nonconvulsive in 92% (n = 101) of these patients. Among patients with seizures, 89% (n = 98) were in intensive care units at the time of monitoring. Electrographic seizures were associated with coma (odds ratio [OR] 7.7, 95% CI 4.2 to 14.2), age <18 years (OR 6.7, 95% CI 2.8 to 16.2), a history of epilepsy (OR 2.7, 95% CI 1.3 to 5.5), and convulsive seizures during the current illness prior to monitoring (OR 2.4, 95% CI 1.4 to 4.3). Seizures were detected within the first 24 hours of cEEG monitoring in 88% of all patients who would eventually have seizures detected by cEEG. In another 5% (n = 6), the first seizure was recorded on monitoring day 2, and in 7% (n = 8), the first seizure was detected after 48 hours of monitoring. Comatose patients were more likely to have their first seizure recorded after >24 hours of monitoring (20% vs 5% of noncomatose patients; OR 4.5, p = 0.018). CONCLUSIONS: CEEG monitoring detected seizure activity in 19% of patients, and the seizures were almost always nonconvulsive. Coma, age <18 years, a history of epilepsy, and convulsive seizures prior to monitoring were risk factors for electrographic seizures. Comatose patients frequently required >24 hours of monitoring to detect the first electrographic seizure.","claims":[{"public_id":"cl_d981f4082847a12ffb63cf5bf797b518","status":"active","text":"Coma, age under 18 years, a history of epilepsy, and convulsive seizures before monitoring were associated with electrographic seizures.","confidence":0.97,"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_d981f4082847a12ffb63cf5bf797b518"},{"public_id":"cl_0f0e65ec437a755dc8f06a9920e0010f","status":"active","text":"Comatose patients were more likely than noncomatose patients to have the first electrographic seizure recorded after more than 24 hours of monitoring.","confidence":0.95,"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous 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