Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-03T16:57:18.036Z Has data issue: false hasContentIssue false

Chapter 16 - Ictal Patterns (Electrographic Seizures)

from Part II - Interpretation

Published online by Cambridge University Press:  24 June 2021

Neville M. Jadeja
Affiliation:
University of Massachusetts Medical School
Get access

Summary

Ictal patterns represent ongoing electrographic seizures. They are recognized by their clinical accompaniments (may be subtle) and electrographic features. Evolution is the electrographic hallmark of an ictal pattern, plus features (such as overriding fast activity) also render a pattern more ictal in appearance. Electrographic seizures will typically have a clear onset, evolution and offset. Conventionally, they should last for greater than 10 seconds. Electrographic seizures are common in after convulsive seizures, acute brain injury and in critically ill patients with altered mentation. Continuous EEG monitoring is the preferred method of diagnosing electrographic seizures. Typically, a duration of 24 hours is sufficient, but this should be extended in certain high-risk populations.

Type
Chapter
Information
How to Read an EEG , pp. 149 - 159
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Cole, AJ. Status epilepticus and periictal imaging. Epilepsia. 2004 Jul;45:7277.CrossRefGoogle ScholarPubMed
Jirsch, J, Hirsch, LJ. Nonconvulsive seizures: developing a rational approach to the diagnosis and management in the critically ill population. Clinical Neurophysiology. 2007 Aug;118(8):1660–70.CrossRefGoogle Scholar
Hirsch, LJ, Fong, MWK, Leitinger, M, et al. American Clinical Neurophysiology Society’s Standardized Critical Care EEG terminology: 2021 version. Journal of Clinical Neurophysiology. 2021 Jan;38(1):129.CrossRefGoogle ScholarPubMed
Reiher, J, Rivest, J, Maison, FG, Leduc, CP. Periodic lateralized epileptiform discharges with transitional rhythmic discharges: association with seizures. Electroencephalography and Clinical Neurophysiology. 1991 Jan 1;78(1):1217.CrossRefGoogle ScholarPubMed
Beniczky, S, Hirsch, LJ, Kaplan, PW, et al. Unified EEG terminology and criteria for nonconvulsive status epilepticus. Epilepsia. 2013 Sep;54:2829.CrossRefGoogle ScholarPubMed
Leitinger, M, Trinka, E, Gardella, E, et al. Diagnostic accuracy of the Salzburg EEG criteria for non-convulsive status epilepticus: a retrospective study. The Lancet Neurology. 2016 Sep 1;15(10):1054–62.CrossRefGoogle ScholarPubMed
Laccheo, I, Sonmezturk, H, Bhatt, AB, et al. Non-convulsive status epilepticus and non-convulsive seizures in neurological ICU patients. Neurocritical Care. 2015 Apr 1;22(2):202–11.CrossRefGoogle ScholarPubMed
DeLorenzo, RJ, Waterhouse, EJ, Towne, AR, et al. Persistent nonconvulsive status epilepticus after the control of convulsive status epilepticus. Epilepsia. 1998 Aug;39(8):833–40.CrossRefGoogle ScholarPubMed
Claassen, J, Mayer, SA, Kowalski, RG, Emerson, RG, Hirsch, LJ. Detection of electrographic seizures with continuous EEG monitoring in critically ill patients. Neurology. 2004 May 25;62(10):1743–48.CrossRefGoogle ScholarPubMed
Herman, ST, Abend, NS, Bleck, TP, et al. Consensus statement on continuous EEG in critically ill adults and children, part I: indications. Journal of Clinical Neurophysiology. 2015 Apr;32(2):87.CrossRefGoogle ScholarPubMed
Struck, AF, Osman, G, Rampal, N, et al. Time‐dependent risk of seizures in critically ill patients on continuous electroencephalogram. Annals of Neurology. 2017 Aug;82(2):177–85.CrossRefGoogle ScholarPubMed
De Marchis, GM, Pugin, D, Meyers, E, et al. Seizure burden in subarachnoid hemorrhage associated with functional and cognitive outcome. Neurology. 2016 Jan 19;86(3):253–60.CrossRefGoogle ScholarPubMed
Foreman, B, Claassen, J, Khaled, KA, et al. Generalized periodic discharges in the critically ill: a case-control study of 200 patients. Neurology. 2012 Nov 6;79(19):1951–60.CrossRefGoogle Scholar
Kaplan, PW. Prognosis in nonconvulsive status epilepticus. In Prognosis of epilepsies (pp. 311–25). John Libbey Eurotext, Paris; 2003.Google Scholar
Yoo, JY, Rampal, N, Petroff, OA, Hirsch, LJ, Gaspard, N. Brief potentially ictal rhythmic discharges in critically ill adults. JAMA Neurology. 2014 Apr 1;71(4):454–62.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×