17 Jan Standardized EEG Reporting Helps Predict Risk of Seizures
MedicalResearch.com Interview with:
Dr. Andres Rodriguez Ruiz
Andres Rodriguez Ruiz, MD
Clinical Neurophysiology and Neurology
Emory School of Medicine
MedicalResearch.com: What is the background for this study?
Response: The Critical Care EEG monitoring research consortium (CCEMRC) was established with the goal of promoting collaboration and research among healthcare institutions highly involved in continuous EEG monitoring of critically ill patients. This group together with the American Clinical Neurophysiology Society (ACNS) established the standardized critical care EEG terminology that allowed uniform reporting of EEG findings in critically ill patients. As part of this effort, a database was developed for collection and clinical reporting of such EEG findings and was adopted for daily clinical use by Yale University, Emory University and Brigham and Women’s Hospital.
Prior retrospective reports have acknowledged an association between periodic discharges and seizures. However, many of these reports were small series and did not include specific characteristics of these patterns. Our goal was to ascertain whether features of periodic and rhythmic patterns such as location (generalized vs. lateralized), frequency and prevalence influenced seizure risk in a large cohort of critically ill adults.
MedicalResearch.com: What are the main findings?
Response: Upon reviewing EEG findings in 4772 patients, we report that lateralized periodic discharges (LPDs), lateralized rhythmic activity (LRDA) and generalized periodic discharges (GPDs) are highly associated with seizures but generalized rhythmic delta activity (GRDA) is not. Furthermore, having the additional characteristic of high frequency (rate of that finding per second) above 2 Hz and Plus (superimposed fast, rhythmic or sharp activity) provide additional risk for seizures in patients with these patterns.
Finally, increased prevalence (% of the whole record that includes a pattern) in patients with LPDs and GPDs confer increase risk for seizures.
MedicalResearch.com: What should readers take away from your report?
Response: A detail EEG interpretation using standardized nomenclature can be useful for the stratification of seizure risk in critically ill patients. At the very least careful attention should be paid to periodic and rhythmic patterns, their frequency, prevalence and if they have associated plus characteristics.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Due to the retrospective nature of the study, we can only describe the association of these patterns with seizures. Future prospective studies could help create predictive models to identify critically ill patients at highest risk for developing seizures and ensure appropriate diagnostic and therapeutic intervention.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Citation:
Rodriguez Ruiz A, Vlachy J, Lee JW, Gilmore EJ, Ayer T, Haider HA, Gaspard N, Ehrenberg JA, Tolchin B, Fantaneanu TA, Fernandez A, Hirsch LJ, LaRoche S, for the Critical Care EEG Monitoring Research Consortium. Association of Periodic and Rhythmic Electroencephalographic Patterns With Seizures in Critically Ill Patients. JAMA Neurol. Published online December 19, 2016. doi:10.1001/jamaneurol.2016.4990
http://jamanetwork.com/journals/jamaneurology/article-abstract/2593851
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Last Updated on January 17, 2017 by Marie Benz MD FAAD