Following Severe Brain Injury: Need to Monitor For Seizure Activity

Two new studies published  in the Annals of Neurology and Critical Care Medicine  demonstrate a need for more vigilant monitoring for seizure activity among intensive care patients who may be experiencing subtle seizures that are typically unrecognized. These subtle seizures may be affecting patients' prognoses and causing long-term brain damage, death and severe disability.

It has previously been shown that unrecognized seizures are common in the critically ill, particularly in those with acute brain injury, and that these seizures are associated with unfavorable outcomes.
 
The two studies found that electroencephalography (EEG)  was effective in detecting subtle seizures that are often impossible to detect by visual observation.

The findings demonstrated the value of continuous EEG (where electrodes are placed on the scalp – a noninvasive procedure used in nonsurgical ICUs)  and intracranial EEG (ICE), an invasive technology where a probe is placed in the cortex of the patient's brain. ICE is mainly used in Neurological ICUs for serious acute brain injuries, such as subarachnoid hemorrhage, severe head trauma and very large strokes (hemorrhagic or ischemic), which require other invasive brain monitoring devices.

The papers, are entitled  "Intracortical Electroencephalography in Acute Brain Injury," and  "Continuous Electroencephalography in the Medical Intensive Care Unit".