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Introduction: Continuous EEG (cEEG) monitoring is being used with increasing frequency in critically ill patients, most often to detect non-convulsive seizures.

Purpose: To describe the indications, findings and impact on clinical management of continuous EEG  monitoring.

Methods: 50 cEEG were performed in the pediatric and neonatal intensive care units were reviewed. Age, gender, diagnosis, EEG background, epileptiform activity, ictal findings, time of onset, changes in treatment and survival were collected.

Results: Thirty two patients aged 1 day to 16 years (median 3 months) were monitored with cEEG for 3-24hs (median 4hs) from 2011 to 2013. Thirteen patients were monitored more than once during the study period which resulted in a total of 51 recordings. The indications were: seizures in 35 patients and suspected non-convulsive status epilepticus in 15.

We observed non convulsive seizures in 6 (12%) cEEG, electrical non convulsive status in 6 (12%), electro-clinical seizures in 15 (30%) and 2 (4%) paroxysmal non-epileptic events. In 12 cEEG we did not register events. Seizures were identified at the onset of cEEG in 6 (12%) and during the first hour in 17 (34%). EEG monitoring led to increase in AEDs in 28 (56%) patients and decrease in 3 (6%).

Conclusions:

In this study, we observed  non convulsive seizures in almost a quarter of the cEEG, half being non convulsive status.

The cEEG led to changes in AEDs in more than half of the patients.

We emphasize the importance of cEEG in pediatric  patients for detection of non convulsive seizures.

EEG monitoring, critically ill children