Continuous EEG monitoring in comatose intensive care patients: epileptiform activity in etiologically distinct groups.

INTRODUCTION: It is unclear whether patients or subpopulations of patients might benefit from EEG monitoring.

METHODS: We conducted a prospective trial of continuous electroencephalogram monitoring (CEEG; 48 hours).

RESULTS: Eleven of 55 (20%) patients who underwent CEEG monitoring recorded seizures. Of patients with acute structural brain lesions (ASBLs), 10 of 31 (32%) patients experiences recorded seizures, whereas only 24 (4%) patients with metabolic encephalopathies experienced recorded seizures (p < 0.01). Six patients with ASBLs (11%) and one patient with metabolic encephalopathy (4%) had spikes/interictal epileptiform discharges (p = 0.087).

CONCLUSION: Our study suggests that CEEG monitoring may be more valuable for detection of seizures in patients with ASBLs than in patients with metabolic encephalopathies.