Prevalence of Electrographic Seizures in Hospitalized Patients With Altered Mental Status With No Significant Seizure Risk Factors Who Underwent Continuous EEG Monitoring: A Retrospective Study

Elena Garrido; Amir Adeli; Marco Echeverria-Villalobos; Juan Fiorda; Yousef Hannawi

doi:10.7759/cureus.55903

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Prevalence of Electrographic Seizures in Hospitalized Patients With Altered Mental Status With No Significant Seizure Risk Factors Who Underwent Continuous EEG Monitoring: A Retrospective Study

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Prevalence of Electrographic Seizures in Hospitalized Patients With Altered Mental Status With No Significant Seizure Risk Factors Who Underwent Continuous EEG Monitoring: A Retrospective Study

Elena Garrido, Amir Adeli, Marco Echeverria-Villalobos, Juan Fiorda and Yousef Hannawi

Curēus (Palo Alto, CA), Vol.16(3), e55903

03/2024

DOI: 10.7759/cureus.55903

PMCID: PMC11003702

PMID: 38595868

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Abstract

Objectives: The objective of this study is to evaluate the prevalence of electrographic seizures in hospitalized patients with altered mental status and no significant risk factors for seizures. Methods: We retrospectively reviewed over a six-year period (2013-2019) the medical records of all adults admitted at Ohio State University Wexner Medical Center (OSUWMC), who underwent continuous electroencephalography (cEEG) monitoring for > 48 hours. Our primary objective was to identify the prevalence of electrographic seizures in patients with altered mental status and no significant acute or remote risk factors for seizures. Results: A total of 1966 patients were screened for the study, 1892 were excluded (96.2%) and 74 patients met inclusion criteria. Electrographic seizures were identified in seven of 74 patients (9.45%). We found a significant correlation between electrographic seizures and a history of hepatic cirrhosis, n= 4 (57%), (p=0.035), acute chronic hepatic failure during admission, 71% (n=5), (p=0.027), and hyperammonemia (p =0.009). Conclusion: In this retrospective study of patients with altered mental status and no significant acute or remote risk factors for seizures who underwent cEEG monitoring for > 48 hours, electrographic seizures were identified in 9.45%. Electrographic seizures were associated with hepatic dysfunction and hyperammonemia. Based on our results, cEEG monitoring should be considered in patients with altered mental status and hepatic dysfunction even in the absence of other seizure risk factors.

Anesthesiology

Neurology

Details

Title: Subtitle: Prevalence of Electrographic Seizures in Hospitalized Patients With Altered Mental Status With No Significant Seizure Risk Factors Who Underwent Continuous EEG Monitoring: A Retrospective Study
Creators: Elena Garrido - University of Iowa
Amir Adeli - The Ohio State University Wexner Medical Center
Marco Echeverria-Villalobos - Department of Anesthesiology, The University of Iowa Carver College of Medicine, Iowa City, USA Department of Neurology, Division of Epilepsy, The Ohio State University Wexner Medical Center, Columbus, USA Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, USA Department of Neurology, Division of Cerebrovascular Diseases and Neurocritical Care, The Ohio State University Wexner Medical Center, Columbus, USA
Juan Fiorda - The Ohio State University Wexner Medical Center
Yousef Hannawi - The Ohio State University Wexner Medical Center
Resource Type: Journal article
Publication Details: Curēus (Palo Alto, CA), Vol.16(3), e55903
DOI: 10.7759/cureus.55903
PMID: 38595868
PMCID: PMC11003702
NLM abbreviation: Cureus
ISSN: 2168-8184
eISSN: 2168-8184
Publisher: Cureus
Language: English
Date published: 03/2024
Academic Unit: Anesthesia
Record Identifier: 9984584906202771

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