Continuous EEG Monitoring: Systems of Care

Abstract

This chapter reviews the indications and practical aspects of continuous electroencephalogram (cEEG) monitoring in the intensive care unit (ICU). cEEG monitoring can be performed for diagnostic, prognostic, and therapeutic indications. For example, it can be used to detect and monitor for nonconvulsive seizures, ischemia, electrocerebral silence, and depth of sedation as well as characterize paroxysmal events that are not clearly epileptogenic. In addition, cEEG can be used to help predict outcomes, particularly in patients who have suffered anoxic brain injury. Successful implementation of cEEG monitoring in a Neurosciences ICU (NCCU) necessitates both daytime and off-hours support. Different models may be used with regard to EEG technologist staffing, but temporary EEG systems are available that can be placed on a short-term, emergent basis if necessary. Duration of cEEG monitoring depends upon each patient’s clinical scenario. The American Clinical Neurophysiology Society has published guidelines in order to standardize EEG reporting. Finally, every successful cEEG monitoring service requires a multidisciplinary collaborative approach in order to optimize patient care.