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Chapter 3 - Real-Time Bedside EEG Reading

from Part I - Introduction

Published online by Cambridge University Press:  22 February 2024

Neville M. Jadeja
Affiliation:
University of Massachusetts Medical School
Kyle C. Rossi
Affiliation:
University of Massachusetts Medical School
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Summary

When evaluating a patient on continuous EEG monitoring at the bedside, the two fundamental questions a reader must ask themselves are: a) is the patient encephalopathic? and b) if so, is this due to epileptiform activity or seizures? This chapter describes a simple method of rapid bedside EEG interpretation using three easy steps. The first step is to analyze the background for continuity, symmetry, voltage, and the presence of a posterior dominant rhythm. The second step involves searching for abnormal waveforms, such as slow or sharp waves, and the third step involves recognizing artifacts. Sharp waves are associated with seizure activity. Finally, the chapter also describes the significance and method for testing reactivity and grading the severity of encephalopathy.

Type
Chapter
Information
Critical Care EEG Basics
Rapid Bedside EEG Reading for Acute Care Providers
, pp. 24 - 40
Publisher: Cambridge University Press
Print publication year: 2024

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References

Hirsch, LJ, Fong, MW, Leitinger, M, et al. American Clinical Neurophysiology Society’s Standardized Critical Care EEG Terminology: 2021 version. Journal of Clinical Neurophysiology. 2021 Jan 1;38(1):129.Google Scholar
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Azabou, E, Navarro, V, Kubis, N, et al. Value and mechanisms of EEG reactivity in the prognosis of patients with impaired consciousness: A systematic review. Critical Care. 2018 Dec;22(1):15.Google Scholar
Benghanem, S, Paul, M, Charpentier, J, et al. Value of EEG reactivity for prediction of neurologic outcome after cardiac arrest: Insights from the Parisian registry. Resuscitation. 2019 Sep 1;142:168–74.Google Scholar
Admiraal, MM, van Rootselaar, AF, Hofmeijer, J, et al. Electroencephalographic reactivity as predictor of neurological outcome in postanoxic coma: A multicenter prospective cohort study. Annals of Neurology. 2019 Jul;86(1):1727.Google Scholar
Zafar, S, Doria, J, Karceski, S. Should we standardize the EEG classification of mild, moderate, and severe cerebral dysfunction? Epilepsy & Behavior: E&B. 2020 Nov 1;112:107332.Google Scholar

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