PMID- 24456622
OWN - NLM
STAT- MEDLINE
DCOM- 20150123
LR  - 20161125
IS  - 1532-2688 (Electronic)
IS  - 1059-1311 (Linking)
VI  - 23
IP  - 4
DP  - 2014 Apr
TI  - Assessment of cerebral blood flow changes in nonconvulsive status epilepticus in 
      comatose patients: a pathophysiological transcranial Doppler study.
PG  - 284-9
LID - S1059-1311(14)00002-8 [pii]
LID - 10.1016/j.seizure.2014.01.001 [doi]
AB  - PURPOSE: We assessed the accuracy of transcranial Doppler (TCD) in helping to 
      diagnose nonconvulsive status epilepticus (NCSE) in comatose patients admitted to 
      the intensive care unit (ICU) for acute neurological disorders at high risk for 
      NCSE. METHODS: A 2-year prospective observational study in 38 consecutive 
      patients requiring continuous electroencephalography (EEG) monitoring and 
      intracranial pressure monitoring with TCD. RESULTS: Of the 38 patients, 10 
      (26.3%) had NCSE by continuous EEG monitoring. Bilateral mean and maximal 
      systolic and diastolic TCD velocities were significantly different between 
      patients with and those without NCSE. Areas under the receiver-operating 
      characteristic (ROC) curves of mean and maximal systolic velocities by TCD were 
      0.82 (95% CI, 0.64-1.00) and 0.79 (95% CI, 0.62-0.95) with cutoffs of 95 cm/s and 
      105 cm/s, respectively. Areas under the ROC curves of mean and maximal diastolic 
      velocities were 0.76 (95% CI, 0.56-0.95) and 0.78 (95% CI, 0.60-0.96) with 
      cutoffs of 31 cm/s and 40 cm/s, respectively. For none of the velocity parameters 
      did the areas under the ROC curves differ significantly between the left and 
      right sides. The best performance was obtained using mean systolic (SV) and a 
      cutoff of 95 cm/s, which yielded a positive likelihood ratio of 3.8 and a 
      negative likelihood ratio of 0.25. CONCLUSION: Our preliminary results showed a 
      significant association between increased TCD velocities and NCSE in comatose 
      patients. However, the likelihood ratios suggested a limited role for TCD in 
      helping to diagnose seizure activity. Further studies with larger samples of NCSE 
      patients are warranted to determine the exact contribution of TCD for NCSE 
      detection in comatose ICU patients.
CI  - Copyright (c) 2014 British Epilepsy Association. Published by Elsevier Ltd. All 
      rights reserved.
FAU - Merceron, Sybille
AU  - Merceron S
AD  - Service de reanimation medico-chirurgicale, Centre Hospitalier de Versailles - 
      Site Andre Mignot, Le Chesnay (78), France.
FAU - Geeraerts, Thomas
AU  - Geeraerts T
AD  - Pole Anesthesie Reanimation, Centre Hospitalier Universitaire de Toulouse, Equipe 
      d'accueil Modelisation de l'agression tissulaire et nociceptive, Universite Paul 
      Sabatier, 31059 Toulouse (31), France.
FAU - Montlahuc, Claire
AU  - Montlahuc C
AD  - Service de Biostatistique et Informatique Medicale (SBIM), CHU Saint Louis, Paris 
      (75), France.
FAU - Bedos, Jean-Pierre
AU  - Bedos JP
AD  - Service de reanimation medico-chirurgicale, Centre Hospitalier de Versailles - 
      Site Andre Mignot, Le Chesnay (78), France.
FAU - Resche-Rigon, Matthieu
AU  - Resche-Rigon M
AD  - Service de Biostatistique et Informatique Medicale (SBIM), CHU Saint Louis, Paris 
      (75), France.
FAU - Legriel, Stephane
AU  - Legriel S
AD  - Service de reanimation medico-chirurgicale, Centre Hospitalier de Versailles - 
      Site Andre Mignot, Le Chesnay (78), France. Electronic address: 
      slegriel@ch-versailles.fr.
LA  - eng
PT  - Journal Article
DEP - 20140108
PL  - England
TA  - Seizure
JT  - Seizure
JID - 9306979
SB  - IM
MH  - Adult
MH  - Aged
MH  - Coma/*complications
MH  - Electroencephalography
MH  - Epilepsy, Generalized/*diagnostic imaging/*etiology
MH  - Female
MH  - Glasgow Coma Scale
MH  - Humans
MH  - Intensive Care Units
MH  - Intracranial Pressure/physiology
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Observational Studies as Topic
MH  - Optic Nerve/pathology
MH  - ROC Curve
MH  - *Ultrasonography, Doppler, Transcranial
OTO - NOTNLM
OT  - Electroencephalography
OT  - Intensive care units
OT  - Neurological
OT  - Transcranial Doppler sonography
EDAT- 2014/01/25 06:00
MHDA- 2015/01/24 06:00
CRDT- 2014/01/25 06:00
PHST- 2013/07/21 00:00 [received]
PHST- 2013/12/09 00:00 [revised]
PHST- 2014/01/02 00:00 [accepted]
PHST- 2014/01/25 06:00 [entrez]
PHST- 2014/01/25 06:00 [pubmed]
PHST- 2015/01/24 06:00 [medline]
AID - S1059-1311(14)00002-8 [pii]
AID - 10.1016/j.seizure.2014.01.001 [doi]
PST - ppublish
SO  - Seizure. 2014 Apr;23(4):284-9. doi: 10.1016/j.seizure.2014.01.001. Epub 2014 Jan 
      8.