PMID- 26198216
OWN - NLM
STAT- MEDLINE
DCOM- 20160307
LR  - 20181202
IS  - 1525-5069 (Electronic)
IS  - 1525-5050 (Linking)
VI  - 49
DP  - 2015 Aug
TI  - Incidence of recurrent seizures following hospital discharge in patients with 
      LPDs (PLEDs) and nonconvulsive seizures recorded on continuous EEG in the 
      critical care setting.
PG  - 250-4
LID - S1525-5050(15)00357-1 [pii]
LID - 10.1016/j.yebeh.2015.06.026 [doi]
AB  - PURPOSE: Continuous EEG (cEEG) has helped to identify nonconvulsive seizures 
      (NCS) and nonconvulsive status epilepticus (NCSE) along with lateralized periodic 
      patterns (LPDs or PLEDs) in ICU patients with much higher frequency than 
      previously appreciated, but understanding their implications may be more complex. 
      The aim of this study was to investigate the incidence of recurrent seizures 
      after hospital discharge and their associated factors in patients with PLEDs and 
      NCS in the critical care setting. METHODS: After IRB approval, we used our EEG 
      reporting database to find 200 consecutive patients who had PLEDs and/or NCSs on 
      cEEG. Patients with less than 3 months of follow-up were excluded. Remaining 
      patients were divided into three groups: PLEDs+Seizure (NCS/NCSE), PLEDs only, 
      and Seizures (NCS/NCSE) only. Medical records were reviewed to gather 
      demographical and clinical details. Univariate data analysis was done using JMP 
      9.0 (Marlow, Buckinghamshire, UK). RESULTS: There were 51 patients in 
      'PLEDs+Seizure' group, 45 in 'PLEDs only' group, and 22 in 'Seizure only' group. 
      Ischemic stroke, hemorrhage, and tumors were the top three etiologies. Nearly 47% 
      of our study population had postdischarge seizures during a mean follow-up period 
      of 11.9 (+/-6) months. We found that 24.4% of patients in the PLEDs only group 
      had seizures after discharge, which increased to 60.7% if they had seizures as 
      well during their ICU stay. Slightly more than 52% of patients had a 
      postdischarge EEG, of which, 59% was in the form of inpatient cEEG during a 
      rehospitalization, accounting for 30.5% of the total study population. It was an 
      indicator of high readmission rates in this population. CONCLUSION: Almost every 
      other patient with PLEDs and/or NCS on cEEG had seizures after ICU discharge. A 
      quarter of patients on cEEG in the ICU with PLEDs alone had seizures after 
      discharge, and after excluding prior epilepsy, 17% of patients with PLEDs had 
      seizures on follow-up. This was dramatically increased with the recording of 
      PLEDs with NCS, with 60% of patients having seizures after discharge from the ICU 
      and 48% of patients after excluding prior epilepsy. Patients with NCS on cEEG 
      alone had 63% chance of seizure recurrence that dropped to 38% with exclusion of 
      prior epilepsy. Future studies are needed to define the postdischarge outcomes 
      including seizure recurrence in this patient population. This article is part of 
      a Special Issue entitled "Status Epilepticus".
CI  - Copyright (c) 2015 Elsevier Inc. All rights reserved.
FAU - Punia, Vineet
AU  - Punia V
AD  - Cleveland Clinic Epilepsy Center, 9500 Euclid Ave., S51, Cleveland, OH 44195, 
      USA.
FAU - Garcia, Camilo Gracia
AU  - Garcia CG
AD  - Cleveland Clinic Epilepsy Center, 9500 Euclid Ave., S51, Cleveland, OH 44195, 
      USA.
FAU - Hantus, Stephen
AU  - Hantus S
AD  - Cleveland Clinic Epilepsy Center, 9500 Euclid Ave., S51, Cleveland, OH 44195, 
      USA. Electronic address: hantuss@ccf.org.
LA  - eng
PT  - Journal Article
DEP - 20150718
PL  - United States
TA  - Epilepsy Behav
JT  - Epilepsy & behavior : E&B
JID - 100892858
RN  - 0 (Anticonvulsants)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anticonvulsants/therapeutic use
MH  - Brain Ischemia/complications
MH  - Brain Neoplasms/complications
MH  - *Critical Care
MH  - *Electroencephalography
MH  - Female
MH  - Follow-Up Studies
MH  - Functional Laterality
MH  - Humans
MH  - Intracranial Hemorrhages/complications
MH  - Male
MH  - Middle Aged
MH  - Patient Discharge
MH  - Patient Readmission/statistics & numerical data
MH  - Recurrence
MH  - Seizures/*epidemiology/etiology
MH  - Status Epilepticus/*epidemiology/etiology
MH  - Stroke/complications
MH  - Treatment Outcome
OTO - NOTNLM
OT  - LPDs
OT  - Nonconvulsive seizure
OT  - PLEDs
OT  - Recurrent seizure
OT  - cEEG
EDAT- 2015/07/23 06:00
MHDA- 2016/03/08 06:00
CRDT- 2015/07/23 06:00
PHST- 2015/04/08 00:00 [received]
PHST- 2015/06/09 00:00 [revised]
PHST- 2015/06/14 00:00 [accepted]
PHST- 2015/07/23 06:00 [entrez]
PHST- 2015/07/23 06:00 [pubmed]
PHST- 2016/03/08 06:00 [medline]
AID - S1525-5050(15)00357-1 [pii]
AID - 10.1016/j.yebeh.2015.06.026 [doi]
PST - ppublish
SO  - Epilepsy Behav. 2015 Aug;49:250-4. doi: 10.1016/j.yebeh.2015.06.026. Epub 2015 
      Jul 18.