Critical Care EEG: Möglichkeiten und Limitationen

Zusammenfassung

Unklare quantitative und qualitative Bewusstseinsstörungen, nicht-konvulsive Anfälle und Status epileptici sowie Sedierungs- und Therapiemanagement sind Indikationen für die Anwendung von kontinuierlichem EEG Monitoring auf der Intensivstation. Durch technologische und wissenschaftliche Fortschritte gewinnt das Neuromonitoring mittels EEG bei intensivpflichtigen Patienten in den letzten Jahren immer mehr an Bedeutung und kommt immer häufiger zur Anwendung. Aufgrund des hohen personellen und technischen Aufwandes, in Zeiten begrenzter Ressourcen, ist ein pragmatisches Vorgehen bei der Indikationsstellung notwendig. Dies gilt v. a. auf neurologischen Intensivstationen, wo metabolische, ischämische, entzündliche, traumatische und strukturelle Hirnschädigungen besonders oft eine differenzialdiagnostische Abklärung mittels EEG verlangen. Im Rahmen dieses Artikels soll die aktuelle Literatur, wie auch wichtige pathologische EEG Muster anhand von Beispielen übersichtlich dargestellt werden.

Abstract

Continuous EEG in the intensive care unit should be used for diagnosis of unclear deterioration in consciousness, nonconvulsive seizures and epileptic status as well as management of therapeutic sedation. Due to recent technologic and scientific advances, continuous EEG is more frequently used. However, because of the need for high personnel and technologic resources, a pragmatic approach regarding the use of continuous EEG is necessary. This is especially true in neurological intensive care units, because many patients with metabolic, ischemic, inflammatory, traumatic and structural brain damage/lesions require evaluation with EEG. We focus in this review on the recent literature regarding EEG evaluation in critical care patients. We illustrate important pathologic EEG patterns with examples.

Schlüsselwörter

EEG - kontinuierliches EEG - Intensivstation - nicht-konvulsive Anfälle - Status epilepticus

Key words

Critical care EEG - ICU - nonconvulsive seizures - status epilepticus - ictal-interictal continuum

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