Electroencephalographic monitoring in the intensive care unit

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Abstract

EEG in the intensive care unit in critically ill patients can be provisionally allocated to a special type of research — EEG of critical states. The article deals with the methodological features of EEG performance in the intensive care, as well as general patterns of EEG changes in patients in coma. The analysis of the patterns of the EEG in intensive care unit is described. Parameters of responsiveness of the central nervous system are given. An algorithm for describing epileptiform changes is presented. The criteria for the diagnosis of nonconvulsive status epilepticus in unconscious patients are discussed, as well as a prognosis of the outcome of a long unconscious state in the presence of epileptiform changes in the EEG. Data on the parameters of periodic patterns are collected, their description and diagnostic criteria are given. The role and possibilities of EEG in the diagnosis of brain death are considered.

About the authors

Mikhail V. Aleksandrov

Polenov Russian Research Institute of Neurosurgery (the branch of Almazov National Medical Research Centre)

Author for correspondence.
Email: mdoktor@yandex.ru
ORCID iD: 0000-0002-9935-3249

доктор медицинских наук, профессор, руководитель НИО клинической нейрофизиологии и эпилептологии

Russian Federation, Saint-Petersburg

Tatiana V. Aleksandrova

Saint Petersburg I.I. Dzhanelidze Research Institute of Emergency Medicine

Email: tata-al@yandex.ru

кандидат медицинских наук, заведующая отделением клинической нейрофизиологии

3, Budapeshtskaya street, Saint-Petersburg, 192242

Ekaterina S. Povaliukhina

Polenov Russian Research Institute of Neurosurgery (the branch of Almazov National Medical Research Centre)

Email: katrinkassiopeya@gmail.com

врач функциональной диагностики, отделение клинической нейрофизиологии

Saint-Petersburg

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Supplementary files

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2. Fig. 1. Changes in spontaneous bioelectric activity of the brain at various depths of coma (scheme)

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3. Fig. 2. Non-convulsive status epilepticus: generalized frequent (index 60–70%) “peak-slow wave” complexes with episodes of post-ictal depression; the evolution of the discharge activity by the frequency in the succession of complexes

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4. Fig. 3. Classification of periodic patterns of brain bioelectric activity (scheme)

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5. Fig. 4. The pattern of “burst-suppression”: the alternation of episodes of activity with a duration of 0.5–1 s and epochs of depression to a level of 10 μV. Terminal coma

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6. Fig. 5. Pattern of periodic discharges: stereotyped alternation of generalized high-amplitude “polypic-slow wave” complexes and epochs of signal depression (amplitude less than 10 μV) duration 2–3 seconds. Terminal coma

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Copyright (c) 2018 Aleksandrov M.V., Aleksandrova T.V., Povaliukhina E.S.

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This work is licensed under a Creative Commons Attribution 4.0 International License.

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