Seizures In Critical Care

A panel of international ICU and epilepsy physicians and researchers detail the epileptic phenomena that occur in the complex environment of the ICU. Focusing on the central nervous system, the authors systematically examine the most up-to-date evidenced-based data regarding ICU seizures, including their most frequent causes, their pathophysiology, their clinical presentation, and the diagnostic evaluation needed to confirm their presence. They also discuss the challenges and specifics of the management of ICU seizures, reviewing the new antiepileptics and their interaction with other ICU medications, drugs with epileptogenic properties used in the ICU, and the role of the new enterally available antiepileptics in treating seizures. Numerous tables summarize drug interactions, neuroimages reveal common ICU seizure etiologies, and multiple electroencephalographic recordings demonstrate clinical or subclinical seizures in ICU patients.

As the population ages, technology improves, intensive care medicine expands and neurocritical care advances, the use of EEG monitoring in the critically ill is becoming increasingly important. This atlas is a comprehensive yet accessible introduction to the uses of EEG monitoring in the critical care setting. It includes basic EEG patterns seen in encephalopathy, both specific and non-specific, nonconvulsive seizures, periodic EEG patterns, and controversial patterns on the ictal–interictal continuum. Confusing artefacts, including ones that mimic seizures, are shown and explained, and the new standardized nomenclature for these patterns is included. The Atlas of EEG in Critical Care explains the principles of technique and interpretation of recordings and discusses the techniques of data management, and 'trending' central to long-term monitoring. It demonstrates applications in multi-modal monitoring, correlating with new techniques such as microdialysis, and features superb illustrations of commonly observed neurologic events, including seizures, hemorrhagic stroke and ischaemia. This atlas is written for practitioners, fellows and residents in critical care medicine, neurology, epilepsy and clinical neurophysiology, and is essential reading for anyone getting involved in EEG monitoring in the intensive care unit.

Now in paperback, the second edition of the Oxford Textbook of Critical Care is a comprehensive multi-disciplinary text covering all aspects of adult intensive care management. Uniquely this text takes a problem-orientated approach providing a key resource for daily clinical issues in the intensive care unit. The text is organized into short topics allowing readers to rapidly access authoritative information on specific clinical problems. Each topic refers to basic physiological principles and provides up-to-date treatment advice supported by references to the most vital literature. Where international differences exist in clinical practice, authors cover alternative views. Key messages summarise each topic in order to aid quick review and decision making. Edited and written by an international group of recognized experts from many disciplines, the second edition of the Oxford Textbook of Critical Careprovides an up-to-date reference that is relevant for intensive care units and emergency departments globally. This volume is the definitive text for all health care providers, including physicians, nurses, respiratory therapists, and other allied health professionals who take care of critically ill patients.

This book is designed to meet the need for a practically oriented textbook on the rapidly growing field of continuous EEG (cEEG) monitoring. A wide range of key clinical aspects are addressed, with explanation of status epilepticus classification, criteria for institution of monitoring, seizure patterns and their recognition, quantitative EEG analysis, and neuroimaging in patients undergoing cEEG monitoring. The value of cEEG and the nature of cEEG findings in various special situations are then reviewed, covering particular pathologies, critical care considerations, and prognostication. Treatments of nonconvulsive status epilepticus (NCSE) and nonconvulsive seizures (NCS) are discussed. The concluding section is devoted to important administrative issues including billing, staffing issues, comparison of EEG machines, and information technology (IT) issues.Continuous EEG monitoring offers the only reliable means of detecting seizures that are not clinically obvious in critically ill patients. Such seizures are common: approximately 20% of patients undergoing cEEG monitoring in hospital have NCSE or NCS. Against this background, many hospitals have started to offer cEEG monitoring as a basis for delivery of appropriate treatment. By presenting the state of the art in cEEG monitoring, this book will be invaluable to practitioners including neurophysiologists, neurologists, neurointensivists, intensivists, neurophysiology and epilepsy fellows, and neurology residents.

Atlas of EEG in CRITICAL CARE An essential resource enabling the rapid detection of clinically relevant EEG patterns in the ICU setting In the newly revised Second Edition of Atlas of EEG in Critical Care, a team of distinguished medical professionals deliver a highly illustrated, accessible, and authoritative guide to EEGs in critically ill patients. The book highlights key diagnostic patterns, enabling clinicians to make rapid, accurate diagnoses of all major critical conditions, including seizures, stroke, and coma. The authors offer up-to-date coverage of continuous and quantitative EEG methods, including explanations of the American Clinical Neurophysiology Society’s 2021 Terminology for Critical Care EEG. The new edition provides readers with a wide range of presentations seen in typical intensive care units and utilizes extensive color arrows and boxes to highlight the patterns in EEG traces. It explores methods of data management and trending that are central to long-term monitoring and covers invasive recordings, including multi-modal monitoring. Readers will also find: Thorough introductions to the basics of EEG and EEG in encephalopathy In-depth explorations of seizures and status epilepticus, as well as rhythmic and periodic patterns, the ictal-interictal continuum, the extreme delta brush pattern, and other controversial and recently defined EEG patterns Comprehensive discussions of EEG in encephalopathy, coma, and cerebrovascular disease, as well as artifacts that can mimic seizures and other physiologic patterns Numerous examples of prolonged EEG monitoring and an in-depth section on quantitative EEG techniques for detection of seizures and ischemia Perfect for neurologists, EEG’ers and neurointensivists, the latest edition of Atlas of EEG in Critical Care will also earn a place in the libraries of neurology trainees seeking a practical and accessible collection of EEG traces from intensive care patients.

Brain dysfunction is a major clinical problem in intensive care, with potentially debilitating long-term consequences for post-ICU patients of any age. The resulting extended length of stay in the ICU and post-discharge cognitive dysfunction are now recognized as major healthcare burdens. This comprehensive clinical text provides intensivists and neurologists with a practical review of the pathophysiology of brain dysfunction and a thorough account of the diagnostic and therapeutic options available. Initial sections review the epidemiology, outcomes, relevant behavioral neurology and biological mechanisms of brain dysfunction. Subsequent sections evaluate the available diagnostic options and preventative and therapeutic interventions, with a final section on clinical encephalopathy syndromes encountered in the ICU. Each chapter is rich in illustrations, with an executive summary and a helpful glossary of terms. Brain Disorders in Critical Illness is a seminal reference for all physicians and neuroscientists interested in the care and outcome of severely ill patients.

Handbook of Continuous EEG Monitoring in the ICU addresses a wide range of technical and clinical issues involved in successfully monitoring critically ill patients to detect seizure activity and prevent serious nervous system impairment. Divided into five sections, the handbook covers image acquisition and other technical considerations, clinical indications, EEG interpretation, treatment, and practical and administrative concerns such as billing and coding and report generation. Written by leading international experts the chapters are brief and formatted for maximum utility with bulleted text, pearls, and take-home points to reinforce key information. Full-page examples of routine and quantitative EEG findings hone interpretive understanding and build skills for detecting clinically significant EEG changes in the ICU.

The only comprehensive source of information on this frequently misdiagnosed problem, with information critical for physicians, ER and ICU doctors, and psychiatrists. An under-recognized condition that can potentially cause brain damage and even death, nonconvulsive status epilepticus (NCSE) is an important clinical problem, occurring in about 25% of status epilepsy cases. Despite this prevalence, Nonconvulsive Status Epilepticus is the first comprehensive clinical text to cover its diagnosis and management. The book progresses logically, beginning with chapters discussing the history and classification of NCSE, reflecting a contemporary understanding of developmental, syndromic, and clinical aspects. Following chapters discuss relevant epidemiology, electrophysiology, imaging and pathophysiology of NCSE, with supplementary sections devoted to psychiatric and behavioral aspects of NCSE and to the different diagnostic considerations of its frequently unusual behavioral presentations. Highlights include: An emphasis on diagnosis, management, and all pertinent clinical issues A heavily illustrated section on EEG interpretation in NCSE Contributions by the foremost international experts on NCSE Throughout, the book maintains a practical focus on recognizing the key signs and symptoms of this subtly presented and clinically challenging condition. This multidisciplinary volume will provide physicians, ER and ICU doctors, and psychiatrists with a comprehensive source of information and opinion on nonconvulsive status epilepticus.