Abstracts

The use of continuous EEG monitoring (cEEG) is essential for the detection of subclinical/nonconvulsive seizures. However, how long to monitor patients in order to rule out nonconvulsive seizures is unclear. The Columbia Comprehensive Epilepsy Center cEEG database was reviewed to identify pediatric patients with nonconvulsive seizures and to determine time to first seizure on cEEG. 189 pediatric patients were monitored, the majority in the ICU, with ages ranging from day one of life to 18 years (mean 5). 56 patients (29.6%) had nonconvulsive seizures, while 24 patients (12.7%) had convulsive seizures on cEEG. Of the 56 patients with nonconvulsive seizures, seizures occurred immediately upon hookup in 9 patients (16.4%), in [le] 1 hour in 53%, [le] 12 hours in 83%, [le] 24 hours in 87%, [le] 48 hours in 93%, and [gt] 48 hours in the remaining 7%. Nonconvulsive seizures are common during cEEG monitoring in the pediatric population but only half are detected in the first hour of recording, and 13% are not recorded until [gt]24 hours of monitoring. This confirms the importance of prolonged EEG monitoring for critically ill pediatric patients in order to detect nonconvulsive seizures.