PMID- 29998425
OWN - NLM
STAT- MEDLINE
DCOM- 20191009
LR  - 20191010
IS  - 1556-0961 (Electronic)
IS  - 1541-6933 (Linking)
VI  - 29
IP  - 3
DP  - 2018 Dec
TI  - Early Epileptiform Discharges and Clinical Signs Predict Nonconvulsive Status 
      Epilepticus on Continuous EEG.
PG  - 388-395
LID - 10.1007/s12028-018-0563-3 [doi]
AB  - BACKGROUND: Critical care continuous electroencephalography (CCEEG) represents 
      the gold standard for detection of nonconvulsive status epilepticus (NCSE) in 
      neurological critical care patients. It is unclear which findings on short-term 
      routine EEG and which clinical parameters predict NCSE during subsequent CCEEG 
      reliably. The aim of the present study was to assess the prognostic significance 
      of changes within the first 30 min of EEG as well as of clinical parameters for 
      the occurrence of NCSE during subsequent CCEEG. METHODS: Systematic analysis of 
      the first 30 min and the remaining segments of prospective CCEEG recordings 
      according to the ACNS Standardized Critical Care EEG Terminology and according to 
      recently proposed NCSE criteria as well as review of clinical parameters of 85 
      consecutive neurological critical care patients. Logistic regression and binary 
      classification tests were used to determine the most useful parameters within the 
      first 30 min of EEG predicting subsequent NCSE. RESULTS: The presence of early 
      sporadic epileptiform discharges (SED) and early rhythmic or periodic EEG 
      patterns of "ictal-interictal uncertainty" (RPPIIIU) (OR 15.51, 95% CI 
      2.83-84.84, p = 0.002) and clinical signs of NCS (OR 18.43, 95% CI 2.06-164.62, 
      p = 0.009) predicted NCSE on subsequent CCEEG. Various combinations of early SED, 
      early RPPIIIU, and clinical signs of NCS showed sensitivities of 79-100%, 
      specificities of 49-89%, and negative predictive values of 95-100% regarding the 
      incidence of subsequent NCSE (p < 0.001). CONCLUSIONS: Early SED and early 
      RPPIIIU within the first 30 min of EEG as well as clinical signs of NCS predict 
      the occurrence of NCSE during subsequent CCEEG with high sensitivity and high 
      negative predictive value and may be useful to select patients who should undergo 
      CCEEG.
FAU - Koren, Johannes
AU  - Koren J
AUID- ORCID: 0000-0002-5290-2837
AD  - Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive 
      Neurology, Vienna, Austria.
AD  - Department of Neurology, General Hospital Hietzing with Neurological Center 
      Rosenhugel, Vienna, Austria.
FAU - Herta, Johannes
AU  - Herta J
AD  - Department of Neurosurgery, Medical University of Vienna, Vienna, Austria.
FAU - Draschtak, Simone
AU  - Draschtak S
AD  - Department of Neurology, General Hospital Hietzing with Neurological Center 
      Rosenhugel, Vienna, Austria.
FAU - Potzl, Georg
AU  - Potzl G
AD  - Department of Neurology, General Hospital Hietzing with Neurological Center 
      Rosenhugel, Vienna, Austria.
FAU - Furbass, Franz
AU  - Furbass F
AD  - Center for Health and Bioresources, AIT Austrian Institute of Technology GmbH, 
      Vienna, Austria.
FAU - Hartmann, Manfred
AU  - Hartmann M
AD  - Center for Health and Bioresources, AIT Austrian Institute of Technology GmbH, 
      Vienna, Austria.
FAU - Kluge, Tilmann
AU  - Kluge T
AD  - Center for Health and Bioresources, AIT Austrian Institute of Technology GmbH, 
      Vienna, Austria.
FAU - Gruber, Andreas
AU  - Gruber A
AD  - Department of Neurosurgery, Medical University of Vienna, Vienna, Austria.
AD  - Department of Neurosurgery, Kepler University Hospital, Linz, Austria.
FAU - Baumgartner, Christoph
AU  - Baumgartner C
AD  - Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive 
      Neurology, Vienna, Austria. christoph.baumgartner@wienkav.at.
AD  - Department of Neurology, General Hospital Hietzing with Neurological Center 
      Rosenhugel, Vienna, Austria. christoph.baumgartner@wienkav.at.
AD  - Medical Faculty, Sigmund Freud University, Vienna, Austria. 
      christoph.baumgartner@wienkav.at.
LA  - eng
GR  - 826816/Osterreichische Forschungsforderungsgesellschaft/International
GR  - 826816/Osterreichische Forschungsforderungsgesellschaft/International
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Neurocrit Care
JT  - Neurocritical care
JID - 101156086
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Critical Care/*methods/standards
MH  - Electroencephalography/*methods/standards
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Sensitivity and Specificity
MH  - Status Epilepticus/*diagnosis/*physiopathology
MH  - Young Adult
OTO - NOTNLM
OT  - EEG in critical care patients
OT  - Early epileptiform discharges
OT  - Ictal-interictal continuum
OT  - Nonconvulsive status epilepticus
OT  - Standardized Critical Care EEG Terminology
EDAT- 2018/07/13 06:00
MHDA- 2019/10/11 06:00
CRDT- 2018/07/13 06:00
PHST- 2018/07/13 06:00 [pubmed]
PHST- 2019/10/11 06:00 [medline]
PHST- 2018/07/13 06:00 [entrez]
AID - 10.1007/s12028-018-0563-3 [pii]
AID - 10.1007/s12028-018-0563-3 [doi]
PST - ppublish
SO  - Neurocrit Care. 2018 Dec;29(3):388-395. doi: 10.1007/s12028-018-0563-3.