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High Incidence of Epileptiform Activity in Adults Undergoing Extracorporeal Membrane Oxygenation

By Currents Editor posted 08-12-2022 09:29


Clinical Neurophysiology (05/06/22) DOI: 10.1016/j.clinph.2022.04.018
Amorim, Edilberto; Firme, Marcos S.; Zheng, Wei-Long; et al. 

A recent study sought to estimate the prevalence of seizures and ictal-interictal continuum patterns in patients undergoing electroencephalography (EEG) during extracorporeal membrane oxygenation (ECMO). The retrospective review of a prospective ECMO registry from 2011-2018 included adult patients who had reduced level of consciousness and underwent EEG monitoring for seizure screening. Among 395 patients who had ECMO, 113 (28.6%) had EEG monitoring; 92 patients (23.3%) who had EEG performed during ECMO were included in the study. The most common cannulation method was veno-arterial ECMO, and 26 patients had extracorporeal cardiopulmonary resuscitation. The EEGs showed that nearly two-thirds of the patients (63%) had epileptiform activity or ictal-interictal continuum patterns. Nonconvulsive status epilepticus was uncommon, affecting 3%, while 36% had generalized periodic discharges and 5% had lateralized periodic discharges. In-hospital mortality and poor neurological outcome were comparable among patients with and without epileptiform activity. One-third of the patients had acute neuroimaging abnormalities. The findings show that epileptiform and ictal-interictal continuum abnormalities are often seen patients supported by ECMO and undergoing EEG monitoring, the study authors conclude.


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