Lateralized periodic discharges are predictors of seizure recurrence and clinical outcome in critically ill neurological patients
Abstract number :
256
Submission category :
3. Neurophysiology / 3B. ICU EEG
Year :
2020
Submission ID :
2422602
Source :
www.aesnet.org
Presentation date :
12/6/2020 12:00:00 PM
Published date :
Nov 21, 2020, 02:24 AM
Authors :
Chetan Nayak, University of Missouri - Columbia; Susanta Bandyopadhyay - University of Missouri - Columbia;
Rationale:
Studies looking at outcome of patients who showed lateralized periodic discharges (LPDs) on EEG following acute brain insult are sparse. The aim of this study is to investigate the outcome of patients with LPDs on EEG in the neurocritical care setting.
Method:
This retrospective study included 62 critically ill neurological patients who were noted to have lateralized periodic discharges (LPDs) on continuous video-EEG (cvEEG) between the years 2013 and 2019. LPDs were defined based on American Clinical Neurophysiology Society (ACNS) criteria. Data on patient characteristics, neurological diagnosis, and cvEEG findings during hospitalization as well as post-discharge follow-up data were collected and analyzed. Pearson’s Chi-Squared test (p≤0.05) was used for statistical comparison.
Results:
Majority (66.1%) of the patients with LPDs on cvEEG had seizures during hospital stay (mean age: 66.29 ± 11.30 years; M:F = 22:19; N = 41); the remaining patients did not have seizures (mean age: 69.48 ± 14.22 years; M:F = 9:12; N = 21). In-hospital mortality was 45% (28 out of 62) and 27 of the remaining patients followed up in the clinic. At follow up, post-discharge seizure was reported in 15 patients (“LPDs + seizure” group) whereas 12 patients (“LPDs only” group) did not have seizure post-discharge. The mean follow-up period between these two groups (128.13±109.06 days for “LPDs only group” and 149.74±117.57 days for “LPDs + seizure” group) was similar (p=0.341). There was no significant difference (p = 0.398) in the number of patients reporting seizures at follow-up in “LPDs only” group (3 out of 8) and “LPDs + seizure” group (12 out of 19). Mortality in the two groups was similar (p=0.405) as well.
Conclusion:
Mortality and incidence of post-discharge seizures in patients who showed LPDs on cvEEG in neurocritical care setting were similar irrespective of the detection of seizures during the cvEEG recording. LPDs appear to be a risk factor for seizure and future seizure recurrence in critically ill neurological patients.
Funding:
:None
Neurophysiology