The Clinical Use of Neuromuscular Blocking Agents as an Interpretive Aid to the EEG in Suspected Status Epilepticus

Abstract

ABSTRACT.Generalized convulsive status epilepticus can evolve into a condition of coma with subtle clinical signs. These subtle signs are often indistinguishable from those of a different etiology. The EEG must be used to assess the ongoing electrical activity of the brain and how that is related to the observed clinical features. Determination of status epilepticus must be done as swiftly as possible since abnormal cerebral potentials can permanently damage the cortex. Movement and electromyogenic artifacts from the patient can obscure interpretation of the recording. Temporary pharmaceutical paralysis with non-depolarizing neuromuscular blocking agents can effectively help distinguish artifact from cerebral potentials and guide patient care. Examples are given of cases in which pharmaceutical paralysis helped in the evaluation of the state of the brain in patients with suspected status epilepticus.