ELECTROPHYSIOLOGIC MONITORING IN THE INTENSIVE-CARE UNIT

Electroencephalography (EEG) and evoked potential studies are establis hed monitoring tools in the neurological intensive care unit (ICU). Th ese neurophysiologic techniques provide information on physiological s tate and response to therapy, and may aid diagnosis and prognosis. Ser ial studies or continuous monitoring may enable changes to be detected prior to irreversible deterioration in the patient's condition. Curre nt computer technology allows simultaneous display and correlation of electrophysiologic parameters, cardiovascular state and intracranial p ressure (ICP). Continuous EEG monitoring in the ICU has been shown to have a decisive or contributing impact on medical decision making in m ore than three-quarters of patients. In addition, continuous EEG monit oring has revealed previously unsuspected non-convulsive seizures in o ne-third of patients. SEPs and BAEPs can provide useful prognostic inf ormation in coma - however, these tests are etiologically nonspecific and must be carefully integrated into the clinical situation. Motor ev oked potentials offer a potentially useful tool for evaluating motor s ystem abnormalities in the ICU.