S02. The diagnostic and prognostic yield of long term EEG in a developing country

Abstract

Continuous Electroencephalography Monitoring (c EEG) is routinely used in the intensive care units (ICU) to detect, evaluate and prognosticate. cEEG monitoring has only recently been adopted in Saudi Arabia and data with regards to its diagnostic and prognostic yields are still lacking. This study aims to report such data in a single tertiary care center in Saudi Arabia during the initial year after establishment of the cEEG program. The authors retrospectively identified all patients who underwent cEEG recording in adult surgical and medical ICUs at a tertiary care center in the 12-month time period from June 2016 to June 2017. These EEGs were retrieved from the records of the clinical neurophysiology laboratory. Continues EEG duration from 6 h to several days. Shorter EEGs were excluded. The medical records were reviewed to obtain data with regards to the diagnosis, duration of hospitalization, duration of ICU stay, neuroimaging findings and mortality. Descriptive and correlational statistics were then used to describe the yield of cEEGs. 101 cEEGs were performed during the study period. The most frequent diagnosis was ischemic stroke, followed by epilepsy, and sepsis. All cEEGs were abnormal. Forty-six percent showed epileptiform abnormalities. Electrographic seizures were seen in 10%. Periodic patterns were seen in 20% of cases. Rhythmic patterns were seen in 17%. There was a significant association between having an epileptifrom EEG and mortality at 3 and 6 months, as well as longer hospital stay (p < 0.05). In this first study of cEEG in Saudi Arabia using the ACNS nomenclature of EEG reporting, ICU EEG evidence of epileptiform abnormalities and seizures was helpful in guiding management and predicting mortality. Limitations and difficulties associated with this early phase of establishing cEEG in the ICU as well as patient selection may contribute to the relatively low incidence of seizures.