Impact of seizures on outcome

Abstract

Clinical seizures occur frequently in the critically ill patient. In addition, the increasing application and recent widespread use of continuous electroencephalogram monitoring have revealed that electrographic seizures are even more frequent than clinical seizures in the critically ill patient. There are limited data on how electrographic seizures affect outcome and whether and how aggressively to treat electrographic seizures in the critically ill patient. This review aims to address this gap in knowledge by summarizing the impact of electrographic seizures on outcome and providing a general guide to treat electrographic seizures in the critically ill patient. Current literature suggests that electrographic seizures likely worsen outcome independent of the underlying etiology. This association is stronger in subarachnoid hemorrhage and in traumatic brain injury and warrants a proactive treatment. In contrast, the presence of electrographic seizures in stroke or tumors is unlikely to modify outcomes.