Status epilepticus on the paediatric intensive care unit - the role of EEGmonitoring

A pilot study was undertaken of the feasibility of continuous EEG monitorin g of patients admitted to a Paediatric Intensive Care Unit (PICU) for manag ement of status epilepticus or its immediate sequelae. Eight children were studied and seizure activity was recorded in four patients. Additional info rmation influencing management was obtained: the bedside nurse considered d ecerebrate posturing in one patient to be a seizure: there were no epilepti form EEG changes. Another patient was considered to have seizures (clonic m ovements of both upper limbs) following cardiac arrest; the EEG showed elec trocerebral silence, and thiopentone treatment was discontinued. In another patient, continuing epileptiform activity on EEG gave intensivists the con fidence to use higher than usual doses of thiopentone. The problems encount ered were delays in monitoring, once for a CT scan and once because of two admissions within hours of each other. We conclude that EEG monitoring on a PICU is feasible and provides clinically useful information. (C) 1999 BEA Trading Ltd.