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Continuous EEG Monitoring for the Detection of Seizures in Traumatic Brain Injury, Infarction, and Intracerebral Hemorrhage: “To Detect and Protect”

Vespa, Paul

Journal of Clinical Neurophysiology: April 2005 - Volume 22 - Issue 2 - p 99-106
doi: 10.1097/01.WNP.0000154919.54202.E0
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Brain injury results in a primary pathophysiologic response that enables the brain to have seizures. Seizures occur frequently after traumatic and nontraumatic intracerebral bleeding. These seizures can be nonconvulsive, and if one does not monitor for seizures, one will not know they are occurring. The use of continuous EEG monitoring (cEEG) to detect brain arrhythmias after a primary insult, much in way that cardiac arrhythmias are detected after myocardial infarction, can influence treatment decisions and mitigate some of the pathophysiologic natural history of brain injuries. Seizures after brain injury worsen clinical outcome and need to be treated. In summary, cEEG is a valuable clinical instrument “to detect and protect,” i.e., to detect seizures and protect the brain from seizure-related injury in critically ill patients, whose brains are often in a particularly vulnerable state.

Division of Neurosurgery, Department of Neurology, University of California, Los Angeles, School of Medicine, Los Angeles, California, U.S.A.

Address correspondence and reprint requests to Dr. Paul M. Vespa, UCLA School of Medicine, Division of Neurosurgery, 10833 Le Conte Ave, CHS 18–218; Los Angeles, CA 90095, U.S.A.; e-mail: Pvespa@mednet.ucla.edu.

Copyright © 2005 American Clinical Neurophysiology Society