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NEUROLOGY 1996;47:83-89
© 1996 American Academy of Neurology

An assessment of nonconvulsive seizures in the intensive care unit using continuous EEG monitoring

An investigation of variables associated with mortality Bryan G. Young, MD, Kenneth G. Jordan, MD and Gordon S. Doig, MSc, DVM

From Victoria Hospital (Drs. Young and Doig), London, Ontario, Canada; and the Neurodiagnostic Laboratory and Neuroscience ICU (Dr. Jordan), St. Bernardine Medical Center, San Bernardino, CA.
Received August 4, 1995. Accepted in final form December 8, 1995.
Address correspondence and reprint requests to Dr. G. Bryan Young, Dept, of Clinical Neurological Sciences, Victoria Hospital, 375 South Street, London, Ontario, Canada N6A 4G5.

Of 49 patients with nonconvulsive seizures studied with continuous EEG monitoring, the overall mortality was 33% (16/49).Of the 23 patients with nonconvulsive status epilepticus (NCSE), 13 died (mortality 57%). Individual variables significantly associated with mortality were age, presence of NCSE, seizure duration, hospital and NICU length of stay, and delay to diagnosis and etiology (acute illness versus remote symptomatic). With multivariate logistic regression, only seizure duration (p = 0.0057, OR = 1.131/hour) and delay to diagnosis (p = 0.0351, OR = 1.039/hour) were associated with increased mortality. Acute symptomatic cases could not be adequately classified as either absence, simple, or complex partial status epilepticus when the impairment of consciousness arose from the initial illness. Current classifications of status epilepticus are inadequate for such cases.

NEUROLOGY 1996;47: 83-89




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