AUTHOR=Sang Tian , Wang Ying , Wu Ye , Guan Qiao , Yang ZhiXian 

TITLE=VEEG monitoring and electrographic seizures in 232 pediatric patients in ICU at a tertiary hospital in China

JOURNAL=Frontiers in Neurology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.957465

DOI=10.3389/fneur.2022.957465

ISSN=1664-2295

ABSTRACT=Objectives: To investigate the electroencephalography (EEG) background and electrographic seizures in patients in the pediatric intensive care unit (PICU) who underwent bedside video-electroencephalography (vEEG) monitoring.
Methods: A total of 232 pediatric patients admitted or transferred to PICU who underwent vEEG monitoring were retrospectively enrolled in this study, and electrographic status epilepticus was observed after vEEG monitoring.
Results: The median age was 1.56 years [95% confidence internal (CI)=1.12 to 2.44]. Electrographic seizures occurred in 88 patients (37.9%), of which 36 cases (40.9%) had electrographic status epilepticus. Prior epileptic encephalopathy diagnosis [odd ratio (OR)= 6.57, 95% CI=1.91-22.59, p=0.003], interictal epileptiform discharges (OR=46.82, 95%CI= 5.31-412.86, p=0.0005), slow disorganized EEG background (OR=11.92, 95%CI=1.31-108.71, p= 0.028), and burst-suppression EEG background (OR= 23.64, 95%CI= 1.71-327.57, p=0.018) were the risk factors for electrographic seizures occurrence. Of the 232 patients, 179 (77.2%) were improved and discharged, 34 cases (14.7%) were withdrawn, and 18 cases (7.8%) died. The in-hospital death rate was 47.6% (10 in 21 cases) in patients with attenuated/featureless, compared to 0/23 with normal EEG background. 
Conclusions: Electrographic status epilepticus occurs in more than one-third of patients with electrographic seizures. VEEG is an efficient method to determine electrographic seizures in children. Abnormal EEG background activity is associated with both electrographic seizures occurrence and unfavorable in-hospital outcome.