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Chapter 5 - Epileptiform Discharges, Seizures, and Status Epilepticus

from Part I - Introduction

Published online by Cambridge University Press:  22 February 2024

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

This chapter focuses on several of the most common actionable EEG abnormalities. This includes defining and describing epileptiform discharges, which are abnormal EEG waves that serve as markers of increased seizure risk. This also includes seizures themselves, and their characteristics and electrographic criteria. Prolonged and repetitive seizures known as status epilepticus are described, including their specific electrographic characteristics and criteria. The treatment resistant form of status epilepticus known as refractory status epilepticus is also described. Finally, the chapter describes a high risk electrographic phenomenon known as brief potentially ictal rhythmic discharges (BIRDs).

Keywords

epileptiform dischargesharp wavespike-waveseizureelectrographicelectroclinicalstatus epilepticusrefractory status epilepticusbrief potentially ictal rhythmic discharge
Type
Chapter
Information
Critical Care EEG Basics
Rapid Bedside EEG Reading for Acute Care Providers
 , pp. 71 - 82
Publisher: Cambridge University Press
Print publication year: 2024

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References

Fisher, RS, van Emde Boas, W, Blume, W, et al. Epileptic seizures and epilepsy: Definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). Epilepsia. 2005 Apr;46(4):470–2.Google Scholar
Trinka, E, Kälviäinen, R. 25 years of advances in the definition, classification and treatment of status epilepticus. Seizure. 2017 Jan;44:65–73.Google Scholar
Hirsch, LJ, Fong, MWK, 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):1–29.Google Scholar
Casale, MJ, Marcuse, LV, Young, JJ, et al. The sensitivity of scalp EEG at detecting seizures – a simultaneous scalp and stereo EEG study. Journal of Clinical Neurophysiology. 2022 Jan 1;39(1):78–84.Google Scholar
Yoo, JY. BIRDs (brief potentially ictal rhythmic discharges) watching during EEG monitoring. Frontiers in Neurology. 2022 Aug 23;13:966480.Google Scholar
Yoo, JY, Jetté, N, Kwon, CS, et al. Brief potentially ictal rhythmic discharges and paroxysmal fast activity as scalp electroencephalographic biomarkers of seizure activity and seizure onset zone. Epilepsia. 2021 Mar;62(3):742–51.Google Scholar
Yoo, JY, Marcuse, LV, Fields, MC, et al. Brief potentially ictal rhythmic discharges [B(I)RDs] in noncritically ill adults. Journal of Clinical Neurophysiology. 2017 May;34(3):222–9.Google Scholar
Yoo, JY, Rampal, N, Petroff, OA, et al. Brief potentially ictal rhythmic discharges in critically ill adults. JAMA Neurology. 2014 Apr;71(4):454–62.Google Scholar

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