Abstract
Trends of electroencephalogram (EEG) over 24 to 48 hours can help in prognostication
in patients. Continuous electroencephalography (cEEG) allows for “real-time” bedside
evaluation of cerebral function and can help to monitor patients in intensive care
units. Lack of expertise in interpretation of the long-term EEG patterns and controversies
in treatment implications have restricted the widespread use of this modality. This
review summarizes the indications, techniques, duration, and pitfalls in cEEG monitoring.
Compared with routine planned EEG, use of cEEG monitoring increases the sensitivity
to detect nonconvulsive seizures (NCS) or nonconvulsive status epilepticus (NCSE)
in unresponsive patients with no or subtle clinical signs of seizures. cEEG helps
in reducing the overall intensive care unit (ICU) stay by timely detection of possible
ischemic or ictal insults, alleviating the need for costlier imaging tests, and by
precise drug adjustment in case of SE. However, standardization of the technical terms
for wider applicability is needed. Analysis of automated computerized assays in seizure
detection and their clinical role and addressing the technical aspects in long-term
recordings should be evaluated; cEEG is gaining an important role in the multiparametric
neuro-critical care units. Development of defined guidelines for the indications and
application of cEEG, technological advances, and ongoing refinements are expected
to enhance its utility in clinical practice.
Keywords
continuous EEG - nonconvulsive status epilepticus - nonconvulsive seizures - neurocritical
care unit - encephalopathy
