Application Of Continuous Electroencephalogram Monitoring In Critical Cerebrovascular Disease

Objectives: We use CEEG to observe the CEEG patterns and incidence of nonconvulsive seizures in critical cerebrovascular disease. It is our aim to investigate the predictive value of CEEG classification, and to assess accuracy of prognosis to relate CEEG classification and GCS.Methods: 42 patients with coma, including 16 patients with cerebral infarction and 26 patients with intracerebral hemorrhage, were collected from March 2004 to March 2005 in neurological intensive care unit in our hospital. All of the cases underwent CEEG monitoring after performed GCS. The CEEG patterns will be analyzed according to patterns of comatose patients. We are going to relate outcome with CEEG classification.Results: The CEEG of 42 patients in critical cerebrovascular disease is nearly always markedly abnormal. Of 13 diffuse slowing activity, 3 died; of 3 intermittent Delta rhythms, all survived; of 5 focal abnormalities in coma, all survived; of 2 triphasic waves, 1 died; of 9 epileptiform activities, 4 died; 1 burst-suppression pattern is died; of 3 monorhythmical activities and 6 low voltage output EEG, all died. There were 8 for nonconvulsive seizures that were 19% in all patients, and the mortality rate was 50%. There was amarkedly difference between the two groups of CEEG classification and outcome by chi-square test. We found no significant difference in age% sex^ etiology and history of hypertension with different prognosis by crosstabalation table test. The prognostic accuracy of CEEG classification and GCS were 78.6% and 73.8% by logistic regression.Conclusions: The CEEG in critical cerebrovascular disease is following patterns: diffuse slowing activity; intermittent Delta rhythms; focal abnormalities in coma; triphasic waves; epileptiform activities; burst-suppression pattern; monorhythmical activities (alpha coma, theta coma) and low voltage output EEG. Nonconvulsive seizures are more common than previously recognized and are associated with worse outcome. There was a markedly difference between the CEEG classification and outcome, and no difference between the age> sex> etiology and history of hypertension and outcome. The prognostic accuracy of CEEG classification is better than GCS. CEEG classification in critical cerebrovascular disease is an important tool to calculate outcome.