Abstracts

Continuous EEG (cEEG) monitoring has been shown to be useful in management of seizures in critically ill patients. We sought to determine the outcome of patients with acute brain injury (ABI) undergoing cEEG who had status epilepticus at our institution., 44 patients were monitored with continuous EEG (CEEG) monitoring for more than 24 hours from 1999-2004. Patients[apos] diagnosis, EEG recordings, hospitalization course and imaging findings were reviewed. Morbiditiy and mortaliy in relation to etiology, type and duration of status epilepticus (SE), and effects of treatment were analyzed., 31 (70%) patients had SE of which eight (26%) patients had convulsive SE (CSE) and 19(61%) patients had non-convulsive SE (NCSE) with a combination in 4 (13%) patients.13 (56%) of 23 patients with acute brain injury developed SE in 13 (56%) of patients and 62% died. The first seizure occurred most commonly (54%) during intial 30 min EEG. Duration of EEG monitoring ranged from 1 to 8 days.7/13 (57%) had NCSE, 5/13(37%) had GCSEand 1/13 had mix SE. The most common EEG pattern was PLEDs seen in 9/13(69%) patients. Seizures were controlled in 24 hours in 11 of 13 patients with SE and acute brain injury (ABI). Treatment given varied significantly between patients. Mortality was 57% in NCSE group(4 patients), 60% in GCSE group (3 patients) and 100% in mixed SE(1 patient). In presence of ABI and NCSE, the overall mortality was 62 %. Four (37%) of 13 patients with SE had acute embolic stroke and mortality was 75 %., Status epilepticus occurs frequently in acute brain injury and is associated with a significant mortality both with CSE and NCSE. Seizure control in first 24 hours is not predictive of survival which may be related to underlying etiology. The prevalence of acute embolic stroke with NCSE and high mortality highlights the need for strong suspicion of SE occurrence in this group.,