Status epilepticus on the paediatric intensive care unit—the role of EEG monitoring

Abstract

A pilot study was undertaken of the feasibility of continuous EEG monitoring of patients admitted to a Paediatric Intensive Care Unit (PICU) for management of status epilepticus or its immediate sequelae. Eight children were studied and seizure activity was recorded in four patients. Additional information influencing management was obtained: the bedside nurse considered decerebrate posturing in one patient to be a seizure: there were no epileptiform EEG changes. Another patient was considered to have seizures (clonic movements of both upper limbs) following cardiac arrest; the EEG showed electrocerebral silence, and thiopentone treatment was discontinued. In another patient, continuing epileptiform activity on EEG gave intensivists the confidence to use higher than usual doses of thiopentone. The problems encountered were delays in monitoring, once for a CT scan and once because of two admissions within hours of each other. We conclude that EEG monitoring on a PICU is feasible and provides clinically useful information.