Continuous EEG monitoring for 24 hours in patients with non-traumatic coma in neurological intensive care unit

Background: Neurological status of comatose patients in ICU cannot be assessed clinically and certain factors affecting the management and prognosis can be missed on routine neurological examination like non-convulsive seizures, secondary brain insults and increased intracranial pressure. Structural derangements are usually evaluated by imaging techniques and functional status by EEG. Objectives: A 24-hour continuous EEG monitoring was done to detect non-convulsive status epilepticus (NCSE) and non-convulsive seizures (NCS) in non-traumatic comatose patients. Methods: This prospective study included 50 patients with non-traumatic coma who were divided into Group A (30 patients with seizures) and Group B (20 patients without seizures). A 24-hour continuous EEG monitoring was done to detect NCSE and NCS. The data was collected and the results statistically analyzed. Results: There was a statistically significant difference in the number of patients with altered sensorium (p < 0.05), neurological deficit (p < 0.01) and seizures (p < 0.01) in both the groups. A statistically significant difference was found on 24 hours EEG for the presence of NCS/NCSE (p < 0.05) and associated risk factors (p < 0.01). Conclusions: Continuous EEG is of great help in detecting NCS/NCSE which are not detected clinically. Certain risk factors are associated with the presence of NCS/NCSE. (C) 2016 Published by Elsevier, a division of Reed Elsevier India, Pvt. Ltd on behalf of Indian Journal of Medical Specialities.