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EEG efficiency of detecting sub-clinical seizures in critical ill patients: Retrospective study
Abstracts / Journal of the Neurological Sciences 405S (2019) 116542
Methods In this study, 148 women aged 15–45 were included. The importance of an accurate description of simptoms was considered. Paraclinical examination was performed by electroencephalography (EEG) simple, EEG sleep deprivation, long-time computerized EEG on the Nicoletone cEEG system using the “10–20 system” method. Cerebral Computerized tomography was performed on Tomato Spiral Somatom Emotion 16 Slices tomograph (“Siemens”). Cerebral Magnetic Resonance (MRI) imaging was applied using IR Magnetom-Open (“Siemens”) and T1, T2, T1C, FLAIR recording techniques. Data was processed using Excel methods. Results Initially, 99 patients were diagnosed with focal epileptic seizures. According to repeated EEG monitoring, for 48 h, 15 of patients were without a certain focal origin, although it has clinical focal seizures. These subjects were transferred to the unknown seizures group for further investigation. Subsequently, patients with generalized seizures initially constituted 49, of whom 7 had a diagnosis difficult to differentiate between the absence and the focal seizure with the disturbance of consciousness, thus falling into the group with unknown seizures. As a result, we obtained 84 patients-focal seizures, 42-generalized seizures, 22-unknown. Conclusion Focal seizures were prevalent in women with epilepsy monitored in the study. The fact that suggests in depth examination by cerebral neuroimaging to determine etiology and optimal treatment. doi:10.1016/j.jns.2019.10.853
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consciousness. Descriptive analysis was used to study the factors involved in the patient findings. Findings/prognosis Only 1 of the 4 patients with subclinical seizures had periodic lateralizing epileptogenic discharges. Only one of the patients with the subclinical seizures was known to have seizure. Last 2 patients were post cardiac arrest & one had brain metastasis. 2 of the patients with the subclinical seizure died few days later because of the seizure or drug side effects. Conclusion Patient with decrease level of consciousness after clinical seizure increase suspicion of subclinical seizure, therefore, early diagnosis of the subclinical seizure allows early management and most likely better outcome. However, there was an over utilization of EEG found in through the study. Keywords: cEEG, NCSE
doi:10.1016/j.jns.2019.10.854
WCN19-0627 Journal of the Neurological Sciences 405S (2019) 104517 Poster Session 2 Role of dementia support groups in countries like India
WCN19-0617 Journal of the Neurological Sciences 405S (2019) 104516 Poster Session 2 EEG efficiency of detecting sub-clinical seizures in critical ill patients: Retrospective study R. Alharbia, A. Baarmahb a King Faisal University, Biomedical Science, Hofuf, Saudi Arabia b King Fahad Specialist Hospital, Department of Neuroscience, Dammam, Saudi Arabia Introduction Continuous electroencephalography (cEEG) monitoring in the critical care setting demonstrates a linear increase in seizure incidence with declining mental status. Delayed diagnosis and treatment of non-convulsive status epilepticus (NCSE) may lead to increased mortality. No clinical or paraclinical parameter can reliably distinguish elderly patients with delirium with or without patterns compatible with NCSE in the absence of cEEG monitoring. EEG may be over-utilized in our hospital ICUs & usually ordered for most of the patient with altered mental status. We aimed to evaluate the efficiency of EEG to detect subclinical seizures in patients with altered level of consciousness. Methods Single-center retrospective study comprised 24 patients who were hospitalized in King Fahad Specialist Hospital in Dammam between January2017-December2018 due to change of their level of
B. Rajendran Kauvery Hospital, Chennai, India Dementia isn't a specific disease. Instead, dementia describes a group of symptoms affecting memory, thinking and social abilities severely enough to interfere with daily functioning. Alzheimer's disease accounts for 60 to 80% of cases. Vascular dementia, which occurs after a stroke or small vessel disease, is the second most common dementia type. But there are many other conditions that can cause symptoms of dementia, including some that are reversible, such as thyroid problems and vitamin deficiencies. Medical treatment is useful to reduce some of the symptoms, mainly in the early stages of dementia but there is no complete cure. Support is vital for people with dementia. The help of families, friends and carers can make a positive difference to managing the condition. Caring for patients with dementia is huge responsibility especially in countries like India where we do not have many residential or nursing homes. The family has to take up care and it is a huge burden financially and physically leading to a lot familial disharmony. We wanted to see if this integrated care for dementia which includes creating awareness about dementia, evaluation, treatment of dementia and establishing support care for the patients who are in the later stages of dementia helps with better management. India is a country where many disease have a stigma attached and we were not sure if we could bring people together to talk freely about the problems they face. The caretakers'support group has become very popular and helped beat so much taboo and alleviate fear. doi:10.1016/j.jns.2019.10.855
Methods In this study, 148 women aged 15–45 were included. The importance of an accurate description of simptoms was considered. Paraclinical examination was performed by electroencephalography (EEG) simple, EEG sleep deprivation, long-time computerized EEG on the Nicoletone cEEG system using the “10–20 system” method. Cerebral Computerized tomography was performed on Tomato Spiral Somatom Emotion 16 Slices tomograph (“Siemens”). Cerebral Magnetic Resonance (MRI) imaging was applied using IR Magnetom-Open (“Siemens”) and T1, T2, T1C, FLAIR recording techniques. Data was processed using Excel methods. Results Initially, 99 patients were diagnosed with focal epileptic seizures. According to repeated EEG monitoring, for 48 h, 15 of patients were without a certain focal origin, although it has clinical focal seizures. These subjects were transferred to the unknown seizures group for further investigation. Subsequently, patients with generalized seizures initially constituted 49, of whom 7 had a diagnosis difficult to differentiate between the absence and the focal seizure with the disturbance of consciousness, thus falling into the group with unknown seizures. As a result, we obtained 84 patients-focal seizures, 42-generalized seizures, 22-unknown. Conclusion Focal seizures were prevalent in women with epilepsy monitored in the study. The fact that suggests in depth examination by cerebral neuroimaging to determine etiology and optimal treatment. doi:10.1016/j.jns.2019.10.853
47
consciousness. Descriptive analysis was used to study the factors involved in the patient findings. Findings/prognosis Only 1 of the 4 patients with subclinical seizures had periodic lateralizing epileptogenic discharges. Only one of the patients with the subclinical seizures was known to have seizure. Last 2 patients were post cardiac arrest & one had brain metastasis. 2 of the patients with the subclinical seizure died few days later because of the seizure or drug side effects. Conclusion Patient with decrease level of consciousness after clinical seizure increase suspicion of subclinical seizure, therefore, early diagnosis of the subclinical seizure allows early management and most likely better outcome. However, there was an over utilization of EEG found in through the study. Keywords: cEEG, NCSE
doi:10.1016/j.jns.2019.10.854
WCN19-0627 Journal of the Neurological Sciences 405S (2019) 104517 Poster Session 2 Role of dementia support groups in countries like India
WCN19-0617 Journal of the Neurological Sciences 405S (2019) 104516 Poster Session 2 EEG efficiency of detecting sub-clinical seizures in critical ill patients: Retrospective study R. Alharbia, A. Baarmahb a King Faisal University, Biomedical Science, Hofuf, Saudi Arabia b King Fahad Specialist Hospital, Department of Neuroscience, Dammam, Saudi Arabia Introduction Continuous electroencephalography (cEEG) monitoring in the critical care setting demonstrates a linear increase in seizure incidence with declining mental status. Delayed diagnosis and treatment of non-convulsive status epilepticus (NCSE) may lead to increased mortality. No clinical or paraclinical parameter can reliably distinguish elderly patients with delirium with or without patterns compatible with NCSE in the absence of cEEG monitoring. EEG may be over-utilized in our hospital ICUs & usually ordered for most of the patient with altered mental status. We aimed to evaluate the efficiency of EEG to detect subclinical seizures in patients with altered level of consciousness. Methods Single-center retrospective study comprised 24 patients who were hospitalized in King Fahad Specialist Hospital in Dammam between January2017-December2018 due to change of their level of
B. Rajendran Kauvery Hospital, Chennai, India Dementia isn't a specific disease. Instead, dementia describes a group of symptoms affecting memory, thinking and social abilities severely enough to interfere with daily functioning. Alzheimer's disease accounts for 60 to 80% of cases. Vascular dementia, which occurs after a stroke or small vessel disease, is the second most common dementia type. But there are many other conditions that can cause symptoms of dementia, including some that are reversible, such as thyroid problems and vitamin deficiencies. Medical treatment is useful to reduce some of the symptoms, mainly in the early stages of dementia but there is no complete cure. Support is vital for people with dementia. The help of families, friends and carers can make a positive difference to managing the condition. Caring for patients with dementia is huge responsibility especially in countries like India where we do not have many residential or nursing homes. The family has to take up care and it is a huge burden financially and physically leading to a lot familial disharmony. We wanted to see if this integrated care for dementia which includes creating awareness about dementia, evaluation, treatment of dementia and establishing support care for the patients who are in the later stages of dementia helps with better management. India is a country where many disease have a stigma attached and we were not sure if we could bring people together to talk freely about the problems they face. The caretakers'support group has become very popular and helped beat so much taboo and alleviate fear. doi:10.1016/j.jns.2019.10.855