EMERGENCY EEG IN CONVULSIVE STATUS EPILEP TICUS

EEG is a major fool in convulsive status epilepticus. Several techniqu es may be used, including conventional or digitized EEG using 4, 8, 10 or 16 channels continuous monitoring with or without simultaneous vid eo recording, and cerebral function monitor. During the first phase, i n the emergency ward, EEG may be useful in severe convulsive status ep ilepticus to assess further evolution and/or prognosis. However, rapid control of seizure at this phase is the primary goal, and optimizatio n of EEG availabilities may lead to more systematic indications. After adequate control of seizures, EEG is mandatory in the following situa tions : i) a difficult-to-control convulsive status epilepticus, with a high risk of subsequent evolution towards subtle status epilepticus; ii) a resistant status epilepticus which needed high dose of sedative s drugs and/or curarization, to evaluate the level of anaesthesia and to watch for recurrence of epileptiform abnormalities; iii) a permanen t, unexplained impairment of consciousness which followed an apparentl y successful treatment, to detect non convulsive status epilepticus; 4 . a doubtful clinical diagnosis, to confirm pseudo-status epilepticus.