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Epidemiology of Seizures in Critically Ill Adults

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Continuous EEG Monitoring

Abstract

Seizures and status epilepticus (SE) are relatively common in critically ill adults, and manifestations may include convulsive status epilepticus (CSE), nonconvulsive status epilepticus (NCSE), and nonconvulsive seizures (NCS). Convulsive seizures that do not meet criteria for status are also seen in this patient population. SE is associated with significant morbidity and mortality and should be diagnosed and treated appropriately. Some challenges in diagnosis and treatment center on the entity of NCSE. This group is now thought to be a heterogeneous patient population including different conditions and associated etiologies. In fact, the underlying etiology of seizures and status is felt to be a very important determinant of overall prognosis and outcome in this group of critically ill adult patients. In this chapter, the epidemiology, clinical features, and etiologies of the various SE types will be presented.

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References

  1. Shorvon S. The outcome of tonic-clonic status epilepticus. Curr Opin Neurol. 1994;7:93–5.

    Article  CAS  PubMed  Google Scholar 

  2. Krumholz A. Epidemiology and evidence for morbidity of nonconvulsive status epilepticus. J Clin Neurophysiol. 1999;16:314–22; discussion 353.

    Article  CAS  PubMed  Google Scholar 

  3. Guidelines for epidemiologic studies on epilepsy. commission on epidemiology and prognosis, international league against epilepsy. Epilepsia. 1993;34(4):592.

    Google Scholar 

  4. Lowenstein DH. Status epilepticus: an overview of the clinical problem. Epilepsia. 1999;40:s3–8.

    Article  PubMed  Google Scholar 

  5. Chin RFM, Neville BGR, Scott RC. A systematic review of the epidemiology of status epilepticus. Eur J Neurol. 2004;11:800–10.

    Article  CAS  PubMed  Google Scholar 

  6. Hesdorffer D, Logroscino G, Cascino G, Annegers J, Hauser W. Incidence of status epilepticus in Rochester, Minnesota, 1965–1984. Neurology. 1998;50:735–41.

    Article  CAS  PubMed  Google Scholar 

  7. DeLorenzo RJ, Hauser WA, Towne AR, et al. A prospective, population-based epidemiologic study of status epilepticus in Richmond, Virginia. Neurology. 1996;46:1029–35.

    Article  CAS  PubMed  Google Scholar 

  8. Dham B, Hunter K, Rincon F. The epidemiology of status epilepticus in the United States. Neurocrit Care. 2014;20:476.

    Article  PubMed  Google Scholar 

  9. Knake S, Rosenow F, Vescovi M, et al. Incidence of status epilepticus in adults in Germany: a prospective, population-based study. Epilepsia. 2001;42:714–8.

    Article  CAS  PubMed  Google Scholar 

  10. Dham B, Hunter K, Rincon F. The epidemiology of status epilepticus in the United States. Neurocrit Care. 2014;20:476.

    Article  PubMed  Google Scholar 

  11. Gastaut H. Classification of status epilepticus. Adv Neurol. 1983;34:15–35.

    CAS  PubMed  Google Scholar 

  12. Towne AR, Waterhouse EJ, Boggs JG, et al. Prevalence of nonconvulsive status epilepticus in comatose patients. Neurology. 2000;54(2):340–5.

    Article  CAS  PubMed  Google Scholar 

  13. Shorvon S. Status epilepticus: its clinical features and treatment in children and adults. Cambridge: Cambridge University Press; 1994.

    Book  Google Scholar 

  14. Kaplan PW. History of status epilepticus. In: Drislane FW, editor. Status epilepticus: a clinical perspective. Totowa: Humana Press; 2005. p. 3–10.

    Chapter  Google Scholar 

  15. Drislane FW. Types of status epilepticus: definitions and classification. In: Drislane FW, editor. Status epilepticus: a clinical perspective. Totowa: Humana Press; 2005. p. 3–10.

    Chapter  Google Scholar 

  16. Gastaut H. Classification of status epilepticus. In: Delgado-Escueta AV, Wasterlain CG, Treiman DM, Porter RJ, editors. Status epilepticus. Vol 34, Advances in neurology. New York: Raven Press; 1983. p. 15–35.

    Google Scholar 

  17. Treiman DM, Walker MC. Treatment of seizure emergencies: convulsive and non-convulsive status epilepticus. Epilepsy Res. 2006;68 Suppl 1:S77–82.

    Article  CAS  PubMed  Google Scholar 

  18. Alroughani R, Javidan M, Qasem A, Alotaibi N. Non-convulsive status epilepticus; the rate of occurrence in a general hospital. Seizure. 2009;18:38–42.

    Article  CAS  PubMed  Google Scholar 

  19. Young GB, Jordan KG, Diog GS. An assessment of nonconvulsive seizures in the intensive care unit using continuous EEG monitoring; an investigation of variables associated with mortality. Neurology. 1996;47:83–9.

    Article  CAS  PubMed  Google Scholar 

  20. Hopp JL, Sanchez A, Krumholz A, et al. Nonconvulsive SE: value of a benzodiazepine trial for predicting outcomes. Neurologist. 2011;17(6):325–9.

    Google Scholar 

  21. Hopp J, Krumholz A. Parietal lobe nonconvulsive status epilepticus. In: Kaplan PW, Drislane FW, editors. Nonconvulsive status epilepticus. New York: Demos Medical; 2009. p. 109–18.

    Google Scholar 

  22. Drislane FW, Lopez MR, Blum AS, Schomer DL. Detection and treatment of refractory status epilepticus in the intensive care unit. J Clin Neurophysiol. 2008;25:181–6.

    Article  PubMed  Google Scholar 

  23. Bauer G, Trinka E. Nonconvulsive status epilepticus and coma. Epilepsia. 2010;51:177–90.

    Article  PubMed  Google Scholar 

  24. Trinka E, Hofler J, Zerbs A. Causes of status epilepticus. Epilepsia. 2012;53 Suppl 4:127–38.

    Article  PubMed  Google Scholar 

  25. Pro S, Vicenzini E, Rocco M, Spadetta G, Randi F, Pulitano P, Mecarelli O. An observational electro-clinical study of status epilepticus: from management to outcome. Seizure. 2012;21:98–103.

    Article  PubMed  Google Scholar 

  26. Varelas PN, Corry J, Rehman M, Abdelhak T, Schultz L, Spanaki M, Bartscher J. Management of status epilepticus in neurological versus medical intensive care unit: does it matter? Neurocrit Care. 2013;19:4–9.

    Article  PubMed  Google Scholar 

  27. Thomas P, Zifkin B. Frontal lobe non convulsive status epilepticus. In: Kaplan PWA, Drislane F, editors. Non convulsive status epilepticus. New York: Demos Biomedical; 2008. p. 91–101.

    Google Scholar 

  28. DeLorenzo RJ, Pellock JM, Towne AR, Boggs JG. Epidemiology of status epilepticus. J Clin Neurophysiol. 1995;12(4):316–25.

    Article  CAS  PubMed  Google Scholar 

  29. Fields M, Labovitz D, French J. Hospital onset seizures: an inpatient study. JAMA Neurol. 2013;70(3):360–4.

    Article  PubMed  Google Scholar 

  30. Claassen J, Jette N, Chum F, et al. Electrographic seizures and periodic discharges after intracerebral hemorrhage. Neurology. 2007;69(13):1356–65.

    Article  CAS  PubMed  Google Scholar 

  31. Lindgren C, Nordh E, Naredi S, Olivecrona M. Frequency of non-convulsive seizures and non-convulsive status epilepticus in subarachnoid hemorrhage patients in need of controlled ventilation and sedation. Neurocrit Care. 2012;17(3):367–73.

    Article  CAS  PubMed  Google Scholar 

  32. Claassen J, Mayer SA, Kowalski RG, Emerson RG, Hirsch LJ. Detection of electrographic seizures with continuous EEG monitoring in critically ill patients. Neurology. 2004;62(10):1743–8.

    Article  CAS  PubMed  Google Scholar 

  33. Little AS, Kerrigan JF, McDougall CG, et al. Nonconvulsive status epilepticus in patients suffering spontaneous subarachnoid hemorrhage. J Neurosurg. 2007;106(5):805–11.

    Article  PubMed  Google Scholar 

  34. Vespa PM, Miller C, McArthur D, et al. Nonconvulsive electrographic seizures after traumatic brain injury result in a delayed, prolonged increase in intracranial pressure and metabolic crisis. Crit Care Med. 2007;35(12):2830–6.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Whitley RJ, Soong SJ, Linneman Jr C, Liu C, Pazin G, Alford CA. Herpes simplex encephalitis: clinical assessment. JAMA. 1982;247(3):317–20.

    Article  CAS  PubMed  Google Scholar 

  36. Carrera E, Claassen J, Oddo M, Emerson RG, Mayer SA, Hirsch LJ. Continuous electroencephalographic monitoring in critically ill patients with central nervous system infections. Arch Neurol. 2008;65(12):1612–8.

    Article  PubMed  Google Scholar 

  37. Tan R, Neligan A, Shorvon SD. Uncommon causes of status epilepticus. Eplepsy Res. 2010;91:11–2.

    Google Scholar 

  38. Beghi E, Carpio A, Forsgren L, et al. Recommendation for a definition of acute symptomatic seizure. Epilepsia. 2010;51(4):671–5.

    Article  PubMed  Google Scholar 

  39. Singh B, Strobos R. Epilepsia partialis continua associated with nonketotic hyperglycemia: clinical and biochemical profile of 21 patients. Ann Neurol. 1980;8(2):155–60.

    Article  CAS  PubMed  Google Scholar 

  40. Thabet F, Al Maghrabi M, Al Barraq A, Tabarki B. Cefepime-induced nonconvulsive status epilepticus: case report and review. Neurocrit Care. 2009;10(3):347–51.

    Article  PubMed  Google Scholar 

  41. Oddo M, Carrera E, Claassen J, Mayer SA, Hirsch LJ. Continuous electroencephalography in the medical intensive care unit. Crit Care Med. 2009;37:2051–6.

    Article  PubMed  Google Scholar 

  42. Gall CR, Jumma O, Mohanraj R. Five cases of new onset refractory status epilepticus (NORSE) syndrome: outcomes with early immunotherapy. Seizure. 2013;22:217–20.

    Article  PubMed  Google Scholar 

  43. Irani SR, Michell AW, Lang B, et al. Faciobrachial dystonic seizures precede Lgi1 antibody limbic encephalitis. Ann Neurol. 2011;69:892–900.

    Article  PubMed  Google Scholar 

  44. Chaigne B, Mercier E, Garot D, Legras A, Dequin PF, Perrotin D. Hashimoto’s encephalopathy in the intensive care unit. Neurocrit Care. 2013;18(3):386–90.

    Article  CAS  PubMed  Google Scholar 

  45. Knight WA, Hart KW, Adeoye OM, et al. The incidence of seizures in patients undergoing therapeutic hypothermia after resuscitation from cardiac arrest. Epilepsy Res. 2013;106:396–402.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Mani R, Schmitt SE, Mazer M, Putt ME, Gaieski DF. The frequency and timing of epileptiform activity on continuous electroencephalogram in comatose post-cardiac arrest syndrome patients treated with therapeutic hypothermia. Resuscitation. 2012;83:840–7.

    Article  PubMed  Google Scholar 

  47. Foreman B, Claassen J, Abou Khaled K, et al. Generalized periodic discharges in the critically ill: a case-control study of 200 patients. Neurology. 2012;79:1951–60.

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to Jennifer M. Pritchard MD .

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Pritchard, J.M., Hopp, J.L. (2017). Epidemiology of Seizures in Critically Ill Adults. In: Husain, A., Sinha, S. (eds) Continuous EEG Monitoring. Springer, Cham. https://doi.org/10.1007/978-3-319-31230-9_2

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  • DOI: https://doi.org/10.1007/978-3-319-31230-9_2

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