The neuro-ICU patient and electroencephalography paroxysms: if and when to treat.

Details

Serval ID
serval:BIB_D7989B7FAB2F
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
The neuro-ICU patient and electroencephalography paroxysms: if and when to treat.
Journal
Current opinion in critical care
Author(s)
Rossetti A.O., Oddo M.
ISSN
1531-7072 (Electronic)
ISSN-L
1070-5295
Publication state
Published
Issued date
04/2010
Peer-reviewed
Oui
Volume
16
Number
2
Pages
105-109
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
To review recent clinical data and summarize actual recommendations for the management of electrographic seizures and status epilepticus in neuro-ICU patients.
Electrographic, 'nonconvulsive', seizures are frequent in neuro-ICU patients including traumatic brain injury, subarachnoid hemorrhage, intracerebral hemorrhage and hypoxic-ischemic encephalopathy. Continuous electroencephalography monitoring is thus of great potential utility. The impact of electrographic seizures on outcome however is not entirely established and it is also unclear what type of electroencephalography paroxysms require treatment and when and how exactly to treat them. Evidence from randomized studies is lacking and will not be available in the near future. Given robust animal and human evidence showing the potential negative impact of seizures on secondary cerebral damage and outcome, treatment of seizures appears reasonable, particularly if related to status epilepticus. On the contrary, over-aggressive antiepileptic therapy entails risks. The management of seizures should therefore be guided individually, based on the underlying cause, the severity of illness and patient comorbidities.
We provide a pragmatic approach for the management of electrographic seizures in neuro-ICU patients. International consensus guidelines on continuous electroencephalography monitoring and seizure therapy are needed and would represent the rationale for a future multicenter randomized trial.

Keywords
Brain Diseases/diagnosis, Brain Diseases/drug therapy, Brain Diseases/pathology, Brain Injuries/diagnosis, Brain Injuries/pathology, Electroencephalography, Humans, Hypoxia-Ischemia, Brain, Intensive Care Units, Intracranial Hemorrhages/diagnosis, Intracranial Hemorrhages/pathology, Prognosis, Seizures/diagnosis, Seizures/drug therapy, Seizures/pathology, Status Epilepticus/diagnosis, Status Epilepticus/drug therapy, Status Epilepticus/pathology, Subarachnoid Hemorrhage/diagnosis, Subarachnoid Hemorrhage/pathology
Pubmed
Web of science
Create date
06/05/2010 14:46
Last modification date
20/08/2019 15:57
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