PMID- 29262437
OWN - NLM
STAT- MEDLINE
DCOM- 20180726
LR  - 20220321
IS  - 1098-9048 (Electronic)
IS  - 1069-3424 (Linking)
VI  - 38
IP  - 6
DP  - 2017 Dec
TI  - Ictal-Interictal Continuum: When to Worry About the Continuous 
      Electroencephalography Pattern.
PG  - 793-806
LID - 10.1055/s-0037-1607987 [doi]
AB  - Continuous electroencephalography (cEEG) monitoring is an invaluable tool in the 
      evaluation of encephalopathy and coma in critically ill patients. Marked 
      increases in cEEG monitoring, coinciding with several societal guideline 
      statements in the last decade, have allowed earlier detection and treatment of 
      clearly harmful patterns, including nonconvulsive seizures (NCSz) and 
      nonconvulsive status epilepticus (NCSE). However, it has also unmasked a range of 
      EEG patterns of less clear clinical significance, with some more "malignant" than 
      others given their potential association with increased neuronal stress and 
      secondary brain injury. These patterns lay on a spectrum often referred to as the 
      ictal-interictal continuum (IIC). To date, no definitive guidelines exist for the 
      management of these potentially harmful EEG patterns, thus presenting a clinical 
      dilemma for critical care physicians. Here, we review the various IIC patterns, 
      their associated features, seizure risk, and outcomes and also propose a clinical 
      approach to management based on the available data and expert opinion.
CI  - Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
FAU - Cormier, Justine
AU  - Cormier J
AD  - Department of Neurology, Yale University School of Medicine, New Haven, 
      Connecticut.
FAU - Maciel, Carolina B
AU  - Maciel CB
AD  - Department of Neurology, Yale University School of Medicine, New Haven, 
      Connecticut.
AD  - Department of Neurology, UF Health Shands Hospital, University of Florida College 
      of Medicine, Gainesville, Florida.
FAU - Gilmore, Emily J
AU  - Gilmore EJ
AD  - Department of Neurology, Yale University School of Medicine, New Haven, 
      Connecticut.
AD  - Division of Neurocritical Care and Emergency Neurology, Department of Neurology, 
      Yale University School of Medicine, New Haven, Connecticut.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20171220
PL  - United States
TA  - Semin Respir Crit Care Med
JT  - Seminars in respiratory and critical care medicine
JID - 9431858
SB  - IM
MH  - Brain Diseases/diagnosis/physiopathology
MH  - Brain Injuries/diagnosis/etiology/physiopathology
MH  - Coma/diagnosis/physiopathology
MH  - Critical Care
MH  - Critical Illness
MH  - Electroencephalography/*methods
MH  - Humans
MH  - Seizures/*diagnosis/physiopathology
MH  - Status Epilepticus/*diagnosis/physiopathology
COIS- Disclosure: None.
EDAT- 2017/12/21 06:00
MHDA- 2018/07/27 06:00
CRDT- 2017/12/21 06:00
PHST- 2017/12/21 06:00 [entrez]
PHST- 2017/12/21 06:00 [pubmed]
PHST- 2018/07/27 06:00 [medline]
AID - 10.1055/s-0037-1607987 [doi]
PST - ppublish
SO  - Semin Respir Crit Care Med. 2017 Dec;38(6):793-806. doi: 10.1055/s-0037-1607987. 
      Epub 2017 Dec 20.