Critical Care Continuous EEG (CCEEG) is a common procedure to monitor brain function in patients with altered mental status in intensive care units. There is significant variability in patient populations undergoing CCEEG and in technical specifications for CCEEG performance.
The Critical Care Continuous EEG Task Force of the American Clinical Neurophysiology Society developed expert consensus recommendations on the use of CCEEG in critically ill adults and children.
The consensus panel describes the qualifications and responsibilities of CCEEG personnel including neurodiagnostic technologists and interpreting physicians. The panel outlines required equipment for CCEEG, including electrodes, EEG machine and amplifier specifications, equipment for polygraphic data acquisition, EEG and video review machines, central monitoring equipment, and network, remote access, and data storage equipment. The consensus panel also describes how CCEEG should be acquired, reviewed and interpreted. The panel suggests methods for patient selection and triage; initiation of CCEEG; daily maintenance of CCEEG; electrode removal and infection control; quantitative EEG techniques; EEG and behavioral monitoring by non-physician personnel; review, interpretation, and reports; and data storage protocols.
Recommended qualifications for CCEEG personnel and CCEEG technical specifications will facilitate standardization of this emerging technology.
*Comprehensive Epilepsy Program, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, U.S.A.;
†Departments of Neurology and Pediatrics, Perelman School of Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.;
‡Departments of Neurological Sciences, Neurosurgery, Medicine, and Anesthesiology, Rush Medical College, Chicago, Illinois, U.S.A.;
§Department of Pediatrics and Neurology, University of Colorado, Boulder, Colorado, U.S.A.;
‖Department of Neurology, Hospital for Special Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medical College, New York, New York, U.S.A.;
¶Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, U.S.A.;
#Division of Neurology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada;
**Department of Neurology, Duke University Medical Center, Durham, North Carolina, U.S.A.;
††Neurodiagnostic Center, Veterans Affairs Medical Center, Durham, North Carolina, U.S.A.;
‡‡Department of Neurology, Johns Hopkins Bayview Medical Center, Baltimore, Maryland, U.S.A.;
§§Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, U.S.A.;
‖‖Department of Neurology, David Geffen School of Medicine and Clinical Neurophysiology, Ronald Reagan UCLA Medical Center, Los Angeles, California, U.S.A.;
¶¶FE Dreifuss Comprehensive Epilepsy Program, Department of Neurology, University of Virginia, Charlottesville, Virginia, U.S.A.;
##NYU Division of Child Neurology, Columbia University Medical Center, New York, New York, U.S.A.;
***Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.;
†††School of Clinical Neurophysiology, Crozer-Chester Medical Center, Upland, Pennsylvania, U.S.A.;
‡‡‡Department of Neurology and Pediatrics, Children's National Medical Center, George Washington University School of Medicine, Washington, District of Columbia, U.S.A.; and
§§§Department of Neurology, Yale Comprehensive Epilepsy Center, Yale School of Medicine, New Haven, Connecticut, U.S.A.
Address correspondence and reprint requests to Susan T. Herman, MD, Beth Israel Deaconess Medical Center, Baker 5, 330 Brookline Avenue, Boston, MA 02215, U.S.A.; e-mail: firstname.lastname@example.org.