Abstracts

Rationale: EEG electrode associated skin lesions are usually minor and rare, with few published cases. We came across forehead lesions corresponding to EEG electrodes, with differential diagnoses including contact dermatitis and burn injury. Although the lesions were not severe, given this unexpected adverse effect, we explored possible mechanisms for electrical burn injuries while having EEG electrodes on. Methods: Medical chart was reviewed. Patient was a 54-year-old man with recurrent ventricular tachycardia (VT) on continuous Propofol infusion, one month after myocardial infarct. Change in cranial nerve exam prompted head CT, which showed small subdural hematoma. Video EEG revealed no seizure. Twenty-one hours after EEG lead placement, patient underwent cardiac ablation at a catheterization lab. Patient was disconnected from the machine, but had EEG electrodes on with attached amplifier. Upon disconnection of EEG electrodes (total connection for 32 hours, unmonitored for 8.5 hours), forehead lesions were seen. Results: There were well-demarcated hyperpigmented circular lesions and swelling underneath on the forehead, corresponding to EEG electrode placement. Based on the appearance of the lesions, they could be contact dermatitis or burn injury. It is rare for contact dermatitis to develop in couple days after the exposure when it usually takes about one week for lesions to appear. It is also highly unlikely that cardiac ablation with proper grounding could have caused burn injury. It is important to review the danger of improper grounding in the intensive care units and operating room settings. Conclusions: The etiology of EEG electrode associated lesions in a patient undergoing cardiac ablation remains unclear, but potential burn injury with improper grounding is discussed. For safety measure, patients undergoing cardiac ablation and other operations will be disconnected from EEG electrodes at our institution. Funding: No funding