654 Prolonged Video-Eeg Necessary to Identify Non-Convulsive Status Epilepticus in Infants Admitted to Icus

Abstract

Electrographic seizures are electrical events that can be detected by EEG but do not have clear clinical correlation Despite the fact that these are found in over 40% of unconscious patients in intensive care units, many physicians are not aware of it In the recent years it became clear that children and infants also suffer from it Moreover, non-convulsive status epilepticus as a cause of decreased mental status is prevalent in children more than in adults. We present 2 cases of infants who were admitted to the NICU and PICU, were unconcsious and their routine EEG did not show epileptic activity Only prolonged Video EEG demonstrated non-convulsive status epilepticus and the treatment was changed accordingly.

Electrographic seizures in unconscious infants are prevalent Though the long term consequences of these events are yet to be determined, in adults the delay in diagnosis and treatment is associated with poor prognosis The closest entity in pediatrics that maybe used as a model is electrical status epilepticus in sleep This is a pediatric disorder associated with cognitive and behavioral regression and carries a poor prognosis It is unclear weather the seizures themselves are the offending cause but early diagnosis and treatment increase the probability of recovery.

A prolonged Video-EEG monitoring is a safe, available and reliable test to diagnose this The literature and these two patients demonstrate the benefit of early use of the test and the immediate implications on the treatment.

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