PROGNOSTIC VALUE OF EEG MONITORING AFTER STATUS EPILEPTICUS - A PROSPECTIVE ADULT STUDY

Despite the significant morbidity and mortality associated with status epileptics (SE), little is known about changes in cortical function t hat occur after SE. We evaluated cortical function after clinical SE u sing continuous EEG monitoring lasting at least 24 h in 180 patients a dmitted to the Medical College of Virginia Hospitals (MCVH). The major EEG patterns observed after SE were a normal record, burst suppressio n, after SE ictal discharge (ASIDs), periodic lateralizing epileptifor m discharges (PLEDs), attenuation, focal and generalized slowing, and epileptiform discharges, Normalization of the EEG after SE was highly correlated with good outcome. The presence of burst suppression and AS IDs was highly statistically significantly associated with mortality, PLEDs were also highly correlated with mortality, but not Co the same degree as burst suppression and ASIDs. In addition, these EEG patterns were still significantly correlated with morbidity and mortality when we controlled for etiology using multivariate logistic statistical an alysis. Persistent Ictal activity was observed in many patients despit e control of clinical seizure activity, indicating the importance of E EG monitoring to determine treatment patterns after clinical seizure a ctivity in SE is controlled. The results indicate that certain EEG pat terns (normalization of the EEG, ASIDs, burst suppression and PLEDs) a re useful predictors of outcome in SE in addition to etiology. EEG mon itoring after control of clinical SE is important to guide treatment o f SE and is a useful technique for evaluating prognosis.