Indications, results and consequences of electroencephalography in neurocritical care: A retrospective study

Electrocencephalography (EEG) is a tool to assess cerebral cortical activity. We investigated the indications and results of routine EEG recordings in neurocritical care patients and corresponding changes in anti-seizure medication (ASM). This was a single-center, retrospective cohort study. We included all adult Intensive Care Unit (ICU) patients with severe acute brain injury who received a routine EEG (30–60 min). Indications, background patterns, presence of rhythmic and periodic patterns, seizures, and adjustments in ASM were documented. A total of 109 patients were included. The EEGs were performed primarily to investigate the presence of (non-convulsive) status epilepticus ((NC)SE) and/or seizures. A (slowed) continuous background pattern was present in 94%. Low voltage, burst-suppression and suppressed background patterns were found in six patients (5.5%). Seizures were diagnosed in two patients and (NC)SE was diagnosed in five patients (6.4%). Based on the EEG results, ASM was changed in 47 patients (43%). This encompassed discontinuation of ASM in 27 patients (24.8%) and initiation of ASM in 20 patients (18.3%). All EEGs were performed to investigate the presence of (NC)SE or seizures. A slowed, but continuous background pattern was found in nearly all patients and (NC)SE and seizures were rarely diagnosed. Adjustments in ASM were made in approximately half of the patients. •Routine EEG is primarily used to investigate the presence of (NC)SE and seizures.•A continuous, but slowed background pattern is most commonly found.•ASM adjustments occur in nearly half of the patients following routine EEG.