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The following is a summary of “Indications, results and consequences of electroencephalography in neurocritical care: A retrospective study,” published in the July 2024 issue of Critical care by Haksteen et al.

Electroencephalography (EEG) is an easy tool for assessing cerebral cortical activity in patients under neurocritical care with multifactorial causes of altered consciousness, including brain injury, sedative medication, and metabolic derangements,  thus providing valuable information on brain dysfunction.

Researchers conducted a retrospective study to investigate indications and results of EEG recordings in patients under neurocritical care and corresponding changes in anti-seizure medication (ASM).

They examined patients in the Intensive Care Unit (ICU) with severe acute brain injury who received EEG daily for 30–60 min; documentation on indications, background patterns, presence of rhythmic and periodic patterns, seizures, and adjustments in ASM were also taken. 

The results showed a total of 109 patients; EEGs were performed primarily to investigate the presence of non-convulsive (NC) and status epilepticus (SE) and seizures. A slow, continuous background pattern was present in 94% of the patients. Low voltage, burst-suppression, and suppressed background patterns were found in 6 patients (5.5%). Seizures were diagnosed in 2 patients, and (NC)SE was diagnosed in 5 patients (6.4%). ASM was changed in 47 patients (43%). This encompassed discontinuation of ASM in 27 patients, 24.8%, and initiation of ASM in 20 patients (18.3%).

They concluded EEGs revealed a slowed but continuous background pattern in nearly all patients, with (NC)SE and seizures rarely diagnosed. Adjustments in ASM were made in approximately half of the patients.

Source: sciencedirect.com/science/article/pii/S0883944124003484