Electrographic Predictors of Electrographic Seizures and Electrographic Status Epilepticus in Patients With Bilateral Independent Periodic Discharges: A Retrospective Multi-Center Study
Abstract number :
3.125
Submission category :
3. Neurophysiology / 3B. ICU EEG
Year :
2018
Submission ID :
503564
Source :
www.aesnet.org
Presentation date :
12/3/2018 1:55:12 PM
Published date :
Nov 5, 2018, 18:00 PM
Authors :
Gamaleldin Osman, Henry Ford Hospital; Rahul Rahangdale, Allegheny General Hospital; Adam Wallace, University of Wisconsin; Jeffrey W. Britton, Mayo Clinic; Emily J. Gilmore, Yale University School of Medicine; Hiba A. Haider, Emory University School of M
Rationale: To identify electrographic characteristics associated with increased seizure risk in patients with BIPDs on EEG. Methods: This is a retrospective review of 88 patients with BIPDs. EEGs were re-reviewed page-by page for this study. EEG modifiers for BIPDs were defined based on the ACNS Critical Care EEG Terminology. Electrographic seizures and Electrographic Status Epilepticus were defined based on Modified Salzburg Criteria. Results: 39 (44%) patients had seizures during monitoring. EEG characteristics associated with increased seizure risk included continuous prevalence (60% vs 35%, OR=2.83, 95%CI 1.17-6.87, p=0.02), whereas very brief duration was associated with decreased seizure risk (7% vs 51%, OR=0.08, 95%CI= 0.01-0.60, p=0.003). 20 (23%) patients had electrographic status epilepticus during monitoring. EEG characteristics associated with SE included frequency >1 Hz (41% vs 15%, OR=3.89, 95%CI 1.37-11.07, p=0.008), continuous prevalence (34% vs 15%, OR=2.87, 95%CI 1.03-8.01, p=0.04), spiky morphology (50% vs 18%, OR=4.62, 95%CI 1.38-15.43, p=0.015), and low absolute amplitude (50% vs 18%, OR=4.62, 95%CI 1.38-15.43, p=0.015). 33 (37.5 %) patients died during the hospital stay. EEG characteristics associated with increased mortality risk included very long duration (53% vs 26%, OR=3.17, 95%CI 1.25-8.01, p=0.013), low absolute amplitude (64% vs 32%, OR=3.75, 95%CI 1.13-12.41, p=0.024), and association with rhythmic discharges (63% vs 33%, OR=3.33, 95%CI 1.22-9.07, p=0.016). 72 (82%) patients had poor short-term outcome (GOS 1-3). No EEG characteristics were significantly associated with poor outcome. Conclusions: : EEG characteristics may help stratify seizure and SE risk in patients with BIPDs. Continuous prevalence was associated with increased seizure risk. Frequencies > 1 Hz, continuous prevalence, spiky morphology and low absolute amplitudes were associated with increased SE risk. Very long duration, low absolute amplitude and association with rhythmic discharges were associated with increased mortality risk. Funding: None
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