Continuous EEG in Neuro Critical Care

Brandon loves wavy lines. He will draw the curtain on the use of continuous EEG in neuro critical care. Brandon will first take you back to medical school with some neuroanatomy and physiology to underpin you understanding of the EEG. He then steps you through what an EEG is telling you. Bumps, lines, amplitudes and hertz are all demystified. With this knowledge, there is a lot you can do with continuous EEG. A few examples: EEG can be reflective of external stimulus – be it a shock, a sound, or a pinch. This is used to test for reactivity and is useful at the bedside. Reactivity demonstrates whether a signal is getting from the body to the brainstem, to the thalamus and to the cortex. Reactivity is one of the most conserved, independent prognostic indicators in coma – making it important to capture using EEG. EEG is fantastically active when you are asleep. In the ICU, an EEG can show atypical sleep – indicating they are very unwell. Due to sleep being a network heavy, very complicated phenomenon. If sleep is generated on Day 3 post TBI – you have the capacity to recover. With this in mind, Brandon wants you to interact with your patient’s EEG and remember that EEGs are not just for seizures.

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