Combined depth and scalp electroencephalographic monitoring in acute brain injury: Yield and prognostic value

Author:

Yuan Fang123ORCID,Damien Charlotte2ORCID,Schuind Sophie4,Salvagno Michele5,Taccone Fabio Silvio5,Legros Benjamin2,Gaspard Nicolas26

Affiliation:

1. Neurology Department Second Affiliated Hospital of Guangzhou University of Chinese Medicine Guangzhou China

2. Service de Neurologie, Hôpital Universitaire de Bruxelles, Hôpital Erasme Université Libre de Bruxelles Brussels Belgium

3. State Key Laboratory of Traditional Chinese Medicine Syndrome Guangzhou China

4. Service de Neurochirurgie, Hôpital Universitaire de Bruxelles, Hôpital Erasme Université Libre de Bruxelles Brussels Belgium

5. Service des Soins Intensifs, Hôpital Universitaire de Bruxelles, Hôpital Erasme Université Libre de Bruxelles Brussels Belgium

6. Neurology Department Yale University School of Medicine New Haven Connecticut USA

Abstract

AbstractBackground and purposeDepth electroencephalography (dEEG) is an emerging neuromonitoring technology in acute brain injury (ABI). We aimed to explore the concordances between electrophysiological activities on dEEG and on scalp EEG (scEEG) in ABI patients.MethodsConsecutive ABI patients who received dEEG monitoring between 2018 and 2022 were included. Background, sporadic epileptiform discharges, rhythmic and periodic patterns (RPPs), electrographic seizures, brief potentially ictal rhythmic discharges, ictal–interictal continuum (IIC) patterns, and hourly RPP burden on dEEG and scEEG were compared.ResultsSixty‐one ABI patients with a median dEEG monitoring duration of 114 h were included. dEEG significantly showed less continuous background (75% vs. 90%, p = 0.03), higher background amplitude (p < 0.001), more frequent rhythmic spike‐and‐waves (16% vs. 3%, p = 0.03), more IIC patterns (39% vs. 21%, p = 0.03), and greater hourly RPP burden (2430 vs. 1090 s/h, p = 0.01), when compared to scEEG. Among five patients with seizures on scEEG, one patient had concomitant seizures on dEEG, one had periodic discharges (not concomitant) on dEEG, and three had no RPPs on dEEG. Features and temporal occurrence of electrophysiological activities observed on dEEG and scEEG are not strongly associated. Patients with seizures and IIC patterns on dEEG seemed to have a higher rate of poor outcomes at discharge than patients without these patterns on dEEG (42% vs. 25%, p = 0.37).ConclusionsdEEG can detect abnormal electrophysiological activities that may not be seen on scEEG and can be used as a complement in the neuromonitoring of ABI patients.

Funder

Guangzhou Municipal Science and Technology Bureau

Publisher

Wiley

Subject

Neurology (clinical),Neurology

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