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Intensive care unit monitoring program (for uncontrolled seizures)

Intensive care unit monitoring program (for uncontrolled seizures)

Jeffrey Politsky, MD, FRCP(C)

Program description:
Patients in the Intensive Care Unit often suffer from significant neurologic injury. In many cases, patients also suffer from seizures that are only visible with continuous EEG monitoring (sub-clinical seizures and/or non-convulsive status epilepticus). Because seizure activity can compound the neurologic injury and potentially worsen prognosis, the critical care monitoring program was developed to assist the physicians who look after ICU patients (intensivists, neuro-surgeons, trauma surgeons) optimize patient care. In essence, ICU patients with changes in mental status, with or without a known brain injury will typically undergo at least 24 hours of continuous EEG monitoring. If seizure activity is detected, the patient will be treated with anti-seizure medication.  Continuous seizure activity may necessitate more aggressive treatment. Monitoring may need to be prolonged (several days or more). In other cases, repeat monitoring may be indicated at various times in the ICU stay.

Research activities:
Prevalence of status epilepticus in cerebral hemorrhage
Relationship of seizure activity to risk of vasospasm in Sub-Arachnoid Hemorrhage (SAH)
Impact of status epilepticus on ICU patient outcome

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