Introduction: Clinical seizures and status epilepticus are frequent complications of encephalitis, can lead to depressed level of consciousness, and are associated with poor outcome. We sought to determine the frequency, risk factors, and clinical impact of electrographic seizures detected with continuing electroencephalography (cEEG) in patients with encephalitis and altered level of consciousness.
Methods: We retrospectively identified all patients with presumed or definite viral or autoimmune encephalitis who underwent cEEG monitoring at Henry Ford Hospital from January 2012 to October 2017. Clinical data and cEEG monitoring reports were abstracted and recorded. The primary outcome was electrographic seizures detected by cEEG.
Results: Of 1,735 patients who underwent a minimum of 12 h of cEEG monitoring, we identified 54 with a verified discharge diagnosis of encephalitis. Twenty-two of these patients (41%) had electrographic seizures on cEEG. Compared with encephalitis patients without seizures, electrographic seizures were associated with lower serum sodium levels (137 ± 5 vs 141 ± 7, P = 0.027) and more often were on antiepileptic therapy (100% vs 78%, P = 0.033) on the first day of monitoring. Seizures were also associated with a higher frequency of cortical imaging abnormalities (68% vs 28%, P = 0.005), lateralized periodic discharges (LPDs; 50% vs 16%, P = 0.014), delta background frequency (81% vs 45%, P = 0.010), low or suppressed voltage (96% vs 62%, P = 0.005), and focal slowing (86% vs 47%, P = 0.004). There was no association between electrographic seizures and clinical outcome at discharge.
Conclusion: Electrographic seizures occur in approximately 40% of patients with acute encephalitis. Low serum sodium, cortical imaging abnormalities, and on cEEG LPDs and background abnormalities are associated factors. The lack of association with short-term outcome suggests that with aggressive treatment, the clinical impact of electrographic seizures in encephalitis can be minimized.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s12028-018-0599-4 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Adherence to Recommendations and Yield of Critical Care EEG Monitoring: A Prospective Multicentric Study.
J Clin Neurophysiol
January 2025
Service de Neurologie, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Bruxelles, Belgique; and.
Purpose: The American Clinical Neurophysiology Society has provided a set of recommendations on the use of critical care EEG monitoring (CEEG). However, these recommendations have not been prospectively validated. We aimed to assess the adherence to the American Clinical Neurophysiology Society recommendations for obtaining CEEG for different indications and the yield of obtained CEEG according to these different indications.
View Article and Find Full Text PDFA novel computational method for rodent electrographic recording and analysis using off-the-shelf intracerebral depth electrodes.
MethodsX
June 2025
Medical College of Wisconsin, Department of Neurosurgery, 8701 Watertown Plank Road, Milwaukee, WI, 53226.
Electrographic recording of brain activity through either surface electrodes (electroencephalography, EEG) or implanted electrodes (electrocorticography, ECOG) are valuable research tools in neuroscience across many disciplines, including epilepsy, sleep science and more. Research techniques to perform recordings in rodents are wide-ranging and often require custom parts that may not be readily available. Moreover, the information required to connect individual components is often limited and can therefore be challenging to implement.
View Article and Find Full Text PDFSeizures and status epilepticus in anti-NMDA receptor encephalitis.
J Neurol
January 2025
Department of Neurology, Mayo Clinic, Rochester, MN, 55905, USA.
Background: Seizures, including status epilepticus (SE), are common in anti-NMDA receptor encephalitis (NMDARE). We aimed to describe clinical and electrographic features of patients with seizures with NMDARE, determine factors associated with SE, and describe long-term seizure outcomes.
Methods: We retrospectively identified patients with seizures in the setting of NMDARE treated at inpatient Mayo Clinic sites during the acute phase of encephalitis between October 2008 and March 2023.
Infantile Spasms in Pediatric Down Syndrome: Potential Mechanisms Driving Therapeutic Considerations.
Children (Basel)
December 2024
Division of Pediatric Neurology, Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Infantile spasms are common in Down Syndrome (DS), but the mechanisms by which DS predisposes to this devastating epilepsy syndrome are unclear. In general, neuronal excitability and therefore seizure predisposition results from an imbalance of excitation over inhibition in neurons and neural networks of the brain. Animal models provide clues to mechanisms and thereby provide potential therapeutic approaches.
View Article and Find Full Text PDFIndications for continuous electroencephalography and frequency of electrographic seizure detection in a pediatric and neonatal cardiovascular intensive care unit.
Epilepsia
January 2025
Division of Child Neurology, Stanford Medicine Children's Health, California, USA.
Article Synopsis
- The study evaluated the use of continuous video-electroencephalography (cEEG) to detect seizures in infants and children in a cardiovascular intensive care unit (CVICU), emphasizing symptoms and risk factors that led to cEEG evaluations.
- Among 605 cEEGs performed over 38 months, seizures were found in 9% of cases, with a significantly higher detection rate (30%) when both vital sign and non-vital sign symptoms were present, while isolated vital sign changes did not yield any seizures.
- The results indicated that certain symptoms (like gaze deviation and abnormal limb movements) and risk factors (like preexisting epilepsy and recent neuroscience surgeries) were linked to a higher likelihood of seizure detection, highlighting
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!