Abstracts

Rationale: Purpose: The use of continuous EEG (cEEG) to diagnose Non-Convulsive Status Epilepticus (NCSE) has grown exponentially in the last couple of years. This growth is in part due to large medical institution, being able to place a substantial amount of cEEGs ; however, in other institutions with limited resources, clinical suspicious for NCSE plays a major role in deciding which patients are placed on cEEGs . Prior studies, which placed patient on cEEG for changes in levels of consciousness yield approximately 19% NCSE/subclinical seizures .We decided to do an audit of the last 100 continuous EEG ordered to diagnose non convulsive status epilepticus in our institution, to measure the overall yield, and the yield by ordering service.Methods: Methods: An audit of the last 100 long-term continuous EEG ordered for NCSE at our institution, regardless of patient location (ICU vs general ward), for yield of NCSE. We divided our sample by the department (Neurosurgery, Neurology, Vascular neurology, and Pulmonary/Critical care) who ordered the continuous EEG. Then we further subdivided our sample by a diagnosis of NCSE vs NCSE plus convulsive seizure vs convulsive seizure vs ictal-intertical continuum vs otherResults: Results: Of 100 continuous EEG ordered, 17 % patients were on NCSE. The EEG’s ordered by the Neurology service yielded 16.7 %, Vascular Neurology yielded 17.5 %, Neurosurgery yielded 18.8 %, and Pulmonary/critical care was 0.0 % respectively for NCSE. Of the 17 patients found to be on NCSE, 4 of them had convulsive seizures. 17 patients had convulsive seizures and out of them, 4 patients were also in NCSE. 32 patients had ictal-interictal continuum pattern.Conclusions: Conclusion: Neurology and Neurosurgery trained physicians were correctly able to identified in NCSE with the use of cEEG monitoring in 17% of the patients of whom cEEGs were ordered for NCSE. If NCSE was not found, about 45% either showed convulsive seizures or ictal-interical abnormalities. Clinical suspicion plays an important role in the utility of a continuous EEG monitoring