Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Does continuous electroencephalography influence therapeutic decisions in neurocritical care?

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Effect and efficacy of lifestyle interventions as secondary prevention

    Research output: Contribution to journalReviewResearchpeer-review

  2. Circulating nociceptin and CGRP in medication-overuse headache

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Neurostimulation for the treatment of chronic migraine and cluster headache

    Research output: Contribution to journalReviewResearchpeer-review

  4. Personality traits in migraine and medication-overuse headache: A comparative study

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Treatment of spatial neglect in clinical practice: A nationwide survey

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. After stroke, apraxia of eyelid opening is associated with high mortality and right hemispheric infarction

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Vacuoles, Often Containing Glycogen, Are a Consistent Finding in Hypokalemic Periodic Paralysis

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

OBJECTIVES: In the neurocritical care unit (neuro-ICU), the impact of continuous EEG (cEEG) on therapeutic decisions and prognostication, including outcome prediction using the Status Epilepticus Severity Score (STESS), is poorly investigated. We studied to what extent cEEG contributes to treatment decisions, and how this relates to clinical outcome and the use of STESS in neurocritical care.

METHODS: We included patients admitted to the neuro-ICU or neurological step-down unit of a tertiary referral hospital between 05/2013 and 06/2015. Inclusion criteria were ≥20 hours cEEG monitoring and age ≥15 years. Exclusion criteria were primary epileptic and post-cardiac arrest encephalopathies.

RESULTS: Ninety-eight patients met inclusion criteria, 80 of which had status epilepticus, including 14 with super-refractory status. Median length of cEEG monitoring was 50 hours (range 21-374h). Mean STESS was lower in patients with favorable outcome 1 year after discharge (modified Rankin Scale [mRS] 0-2) compared to patients with unfavorable outcome (mRS 3-6), albeit not statistically significant (mean STESS 2.3±2.1 vs. 3.6±1.7, p=0.09). STESS had a sensitivity of 80%, a specificity of 42% and a negative predictive value of 93% for outcome. cEEG results changed treatment decisions in 76 patients, including escalation of antiepileptic treatment in 65 and reduction in 11 patients.

CONCLUSION: STESS had a high negative predictive value but low sensitivity, suggesting that STESS should be used cautiously. Of note, cEEG results altered clinical decision making in 3 of 4 patients, irrespective of the presence or absence of status epilepticus, confirming the clinical value of cEEG in neurocritical care.

Original languageEnglish
JournalActa Neurologica Scandinavica
ISSN0001-6314
DOIs
Publication statusPublished - 22 Oct 2020

ID: 61137453