Prognostic Significance Of Continuous EEG Monitoring In Stroke Patients With Alteration Of Consciousness

Research purpose: Continuous Electroencephalography is an important bedside examination tool for monitoring the brain function of patients.Currently,there are few studies on the application of continuous Electroencephalography in evaluating the prognosis of stroke patients.In this prospective study,continuous EEG monitoring was conducted on patients with acute ischemic stroke and intracerebral hemorrhage combined with disturbance of consciousness,to investigate the relationship between EEG characteristics and clinical characteristics as well as prognosis of patients,so as to provide some beneficial help for early prognosis management and determination medication of patients.Research methods: 1.This study enrolled acute stroke patients with consciousness disorder within 7 days after the onset of in neurology intensive care unit from February 2018 through August 2018 in the Shanghai Sixth People's Hospital for 24-hour continuous EEG monitoring.2.The clinical data of all the patients in the group,such as age,sex,types of stroke(ischemic stroke,intracerebral hemorrhage),medical comorbidities(atrial fibrillation,hypertension,diabetes),EEG examination national institute of health stroke scale(NIHSS)and changes of consciousness(lethargy?coma),stroke location(cortex or subcortex),the scope of lesions(on one side of the brain hemispheres or bilateral cerebral hemisphere)and hospital days,were collected.Non-convulsive status epilepticus(NCSE),abnormal EEG background,sleep cycle were are read by board certified electrophysiologists.Then explore the potential predictive clinical features of non-convulsive status epilepticus(NCSE),abnormal EEG background,lack of sleep cycle in stroke patients with alteration of consciousness.3.Functional outcome was assessed using the discharge modified Rankin Scale(m Rs)and 90-day modified Rankin Scale(m Rs).A good outcome was defined as m Rs=0–4,and poor outcome was defined as m RS =5-6.The investigate the relationship between various EEG characteristics and prognosis of stroke patients.Research results: A total of 26 cases(ischemic stroke(IS)occurred in 21 patients while 5 patients had intracerebral hemorrhage(ICH))were enrolled in this study.Mean age was 80.2(SD 6.8),and 53.8% of patients were female.There are 4 cases(15.4%)of NCSE,17 cases(65.4%)of mind abnormal EEG background,9 cases(34.6%)of moderate and severe abnormal EEG background,and 14 cases(53.8%)of absence of sleep cycle.Nonconvulsive status epilepticus and abnormal EEG background were not related to clinical features.Sleep cycle deficiency was related with age(p=0.017),NIHSS score(p=0.006),coma(p=0.036)and lesion range(p=0.036).There was no statistically significant difference between the EEG characteristics and poor prognosis of the patients upon discharge.Being followed up for a period of 90 days after the end of CEEG monitoring,the patients with abnormal EEG background(p=0.003)and absence of sleep cycle(p=0.008)had relatively poorer functional outcomes(severe disability or death).Research conclusion: In patients with ischemic stroke and intracerebral hemorrhage complicated with alteration of consciousness,moderate and severe abnormal EEG background and absence of sleep cycle predict 90-day poor functional outcome.NCSE is not associated with the prognosis of patients.