How to carry out and interpret EEG recordings in COVID-19 patients in ICU?

Details

Serval ID
serval:BIB_6BFE8B9BE93B
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
How to carry out and interpret EEG recordings in COVID-19 patients in ICU?
Journal
Clinical neurophysiology
Author(s)
Gélisse P., Rossetti A.O., Genton P., Crespel A., Kaplan P.W.
ISSN
1872-8952 (Electronic)
ISSN-L
1388-2457
Publication state
Published
Issued date
08/2020
Peer-reviewed
Oui
Volume
131
Number
8
Pages
2023-2031
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
There are questions and challenges regarding neurologic complications in COVID-19 patients. EEG is a safe and efficient tool for the evaluation of brain function, even in the context of COVID-19. However, EEG technologists should not be put in danger if obtaining an EEG does not significantly advance diagnosis or change management in the patient. Not every neurologic problem stems from a primary brain injury: confusion, impaired consciousness that evolves to stupor and coma, and headaches are frequent in hypercapnic/hypoxic encephalopathies. In patients with chronic pulmonary disorders, acute symptomatic seizures have been reported in acute respiratory failure in 6%. The clinician should be aware of the various EEG patterns in hypercapnic/hypoxic and anoxic (post-cardiac arrest syndrome) encephalopathies as well as encephalitides. In this emerging pandemic of infectious disease, reduced EEG montages using single-use subdermal EEG needle electrodes may be used in comatose patients. A full 10-20 EEG complement of electrodes with an ECG derivation remains the standard. Under COVID-19 conditions, an expedited study that adequately screens for generalized status epilepticus, most types of regional status epilepticus, encephalopathy or sleep may serve for most clinical questions, using simplified montages may limit the risk of infection to EEG technologists. We recommend noting whether the patient is undergoing or has been placed prone, as well as noting the body and head position during the EEG recording (supine versus prone) to avoid overinterpretation of respiratory, head movement, electrode, muscle or other artifacts. There is slight elevation of intracranial pressure in the prone position. In non-comatose patients, the hyperventilation procedure should be avoided. At present, non-specific EEG findings and abnormalities should not be considered as being specific for COVID-19 related encephalopathy.
Keywords
Brain Diseases/diagnosis, Brain Diseases/etiology, Brain Diseases/physiopathology, Coronavirus Infections/complications, Coronavirus Infections/diagnosis, Coronavirus Infections/therapy, Critical Care/methods, Critical Care/standards, Electroencephalography/instrumentation, Electroencephalography/methods, Electroencephalography/standards, Humans, Pandemics, Patient Positioning/methods, Pneumonia, Viral/complications, Pneumonia, Viral/diagnosis, Pneumonia, Viral/therapy, Practice Guidelines as Topic, COVID-19, Coma, EEG, ICU, Prone position
Pubmed
Open Access
Yes
Create date
14/06/2020 20:43
Last modification date
12/08/2020 5:22
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