Withdrawn: Prevalence and Etiology of Non-Convulsive Status Epilepticus: Significance of Background Activity of the cEEG in Patients Under Hypnosedative Drugs Treatment.

Abstract

To determine the rate of convulsive/nonconvulsive/ status epilepticus (CSE /NCSE) and predictive value of electroclinical findings of long-term electroencephalography (cEEG) monitoring of these patients and its association with the most commonly used drugs in intensive care units (ICU). We retrospectively collected data of 218 patients whose cEEG was performed in ICU between 2016 and 2017. The cEEG for NCSE diagnosis was evaluated according to Salzburg Consensus Criteria (SCC). EEG background activity, amplitude, minimal-maximal frequencies evaluated and patients' clinical properties, medication use, and glasgow coma scores (GCS) were gathered during EEG recording. The mean age of patients was 57.09 ± 18.9 (16-95) years and 49.1% (107) were female. Of 218 patients, 32 (14.7%) had CSE/NCSE; 38.9% (n = 85) had a seizure/convulsion before EEG recording with 27% (23/85) diagnosed with CSE/NCSE based on cEEG. According to SCC, 20.6% (27/131) were on antiepileptic drugs (AED) and/or hypnosedative drugs (HSD); 5.7% (5/87) who were not taking any drugs had CSE/NCSE findings. For NCSE diagnosis, the cutoff amplitude of the background activity was 37.5 μV with 65.6% sensitivity and 76.2% specificity (AUC = 0.690; p < 0.05) in patients receiving drugs in ICU. Electrophysiological findings frequently appeared in EEGs with a minimum background activity frequency of ≥2.5 Hz (p < 0.001). NCSz/NCSE findings are mostly found in patients who were comatose and had seizure/convulsion history on follow-up. In most cases, NCSz/NCSE diagnosis is missed due to the frequently used drugs in ICU. Electrophysiological findings of NCSE can be determined less frequently in ICU patients under hypnosedative drug treatment with a background activity of cEEG <37 μV.