Blog Viewer

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.


Ita Muharram Sari, MD National Brain Center Prof. Dr. Mahar Mardjono Hospital (NBC) is the main referral hospital specializing in brain and nervous systems under the Ministry of Health Republic of Indonesia. As a center of excellence, NBC gives advanced clinical practice on neurological diseases, education, ...
Jiping Zhou, MD, MPH PGY-3 resident in Neurology Wayne State University/Detroit Medical Center Wazim Mohamed, MD Associate Professor of Neurology and Neurosurgery Wayne State University R oberg, Lars Egil, et al. "Prediction of Long-term Survival After Status Epilepticus Using the ACD ...
Renad Abu-Sawwa, PharmD, BCPPS University of Florida, College of Pharmacy “When you adjust for hypoalbuminemia, his phenytoin level was therapeutic at 17.5 mcg/mL following his fosphenytoin load. In addition to starting maintenance phenytoin, I would recommend initiating ketamine rather than pentobarbital ...