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8-37%
48%
50%
Associated with increased mortality and poor outcomes
Delay in diagnosis of NCS increases mortality
We need more prospective outcome trials...
In 1st 24hrs:
- PED's
- Absence of sleep architecture
- Absences of reactivity
- GPEDs/BiPLEDs
- NCSE
- Absent EEG reactivity
- GPEDs
- BiPEDs
- NCSE
- Impaired % Alpha reactivity on qEEG
So...
- Think about seizures
- Snapshots aren't always the answer
- Watch this space
What's it good for?
What's new?
Why now?
cEEG
What does a seizure mean?
Detecting Seizures
We don't look for long enough....
We miss it...
NCS & NCSE common
56% in 1st hour
88% after 12-24 hours
93% after 12-48 hours
Triphasic waves
PLEDs
PLEDs Plus
Bilateral independent periodic lateralized epileptiform discharges
If not in a coma, 24 hours sufficient....
If PLEDs present,
monitor for > 24 hours
GPEDs
FIRDA
SIRPID's
In a coma, 48-72 hours recommended
Decreased LOC &
neurological injury
Who?
Monitoring response to treatment
Minimise the dose and adverse effects of AED's
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