Fluctuating mental status or unexplained alteration of mental status.Patients at risk for seizures which may be masked by the requirement for pharmacologic paralysis.Paroxysmal clinical events suspected to be possible seizures.A screening (“spot”) EEG has revealed patterns along the ictal-interictal continuum, which increase the likelihood of subsequent seizures.Assessment of treatment efficacy in patients with known status epilepticus (e.g., titration of antiepileptic infusions to target absence of seizures or burst-suppression).However, nonconvulsive status epilepticus can occur following only a single convulsive seizure. Nonconvulsive status epilepticus is commonly encountered following convulsive status epilepticus.(LaRoche 2018) Persistent alteration of mental status suggests the possibility of ongoing seizure activity. A postictal period is expected following seizure(s), but this should usually clear within an hour.Persistently abnormal mental status after generalized convulsive status epilepticus or clinically evident seizure(s).
General indications for prolonged EEG monitoring ( 34618762) However, by facilitating more rapid recovery and extubation, EEG monitoring may be cost-neutral or cost-saving.
Below are some rough guidelines (which are not intended to replace expert judgement). Thus, the decision to pursue EEG monitoring is a complex one, which will often involve neurology consultation. There is a broad variety of indications for EEG monitoring in the ICU (e.g., for any patient in whom there is a concern for nonconvulsive status epilepticus – as discussed further here). Indications for EEG monitoring in the ICU
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