July 23, 2013; 81 (4) Article
Electrographic seizures in pediatric ICU patients
Cohort study of risk factors and mortality
Nicholas S. Abend, Daniel H. Arndt, Jessica L. Carpenter, Kevin E. Chapman, Karen M. Cornett, William B. Gallentine, Christopher C. Giza, Joshua L. Goldstein, Cecil D. Hahn, Jason T. Lerner, Tobias Loddenkemper, Joyce H. Matsumoto, Kristin McBain, Kendall B. Nash, Eric Payne, Sarah M. Sánchez, Iván Sánchez Fernández, Justine Shults, Korwyn Williams, Amy Yang, Dennis J. Dlugos
First published June 21, 2013, DOI: https://doi.org/10.1212/WNL.0b013e31829c5cfe
Nicholas S. Abend
From the Departments of Neurology and Pediatrics (N.S.A., S.M.S., D.J.D.), The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia; the Departments of Pediatrics and Neurology (D.H.A.), Oakland University William Beaumont School of Medicine, Royal Oak, MI; Department of Neurology (J.L.C.), Children's National Medical Center, Washington, DC; Division of Neurology (K.E.C.), Children's Hospital Colorado and University of Colorado School of Medicine, Aurora; Division of Neurology (K.M.C., W.B.G.), Duke Children's Hospital and Duke University School of Medicine, Durham, NC; Division of Neurology (C.C.G., J.L.T., J.H.M.), Department of Pediatrics, Mattel Children's Hospital and UCLA Brain Injury Research Center, Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA; Division of Neurology (J.L.G.), Children's Memorial Hospital and Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Neurology (C.D.H., K.M., E.P.), The Hospital for Sick Children and University of Toronto, Toronto, Canada; Division of Epilepsy and Clinical Neurophysiology (T.L., I.S.F.), Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA; the Department of Neurology (K.B.N.), University of California San Francisco, San Francisco; the Department of Biostatistics and Epidemiology (J.S., A.Y.), Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; The Department of Pediatrics (K.W.), University of Arizona College of Medicine and Barrow's Neurological Institute at Phoenix Children's Hospital, Phoenix;
MDDaniel H. Arndt
From the Departments of Neurology and Pediatrics (N.S.A., S.M.S., D.J.D.), The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia; the Departments of Pediatrics and Neurology (D.H.A.), Oakland University William Beaumont School of Medicine, Royal Oak, MI; Department of Neurology (J.L.C.), Children's National Medical Center, Washington, DC; Division of Neurology (K.E.C.), Children's Hospital Colorado and University of Colorado School of Medicine, Aurora; Division of Neurology (K.M.C., W.B.G.), Duke Children's Hospital and Duke University School of Medicine, Durham, NC; Division of Neurology (C.C.G., J.L.T., J.H.M.), Department of Pediatrics, Mattel Children's Hospital and UCLA Brain Injury Research Center, Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA; Division of Neurology (J.L.G.), Children's Memorial Hospital and Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Neurology (C.D.H., K.M., E.P.), The Hospital for Sick Children and University of Toronto, Toronto, Canada; Division of Epilepsy and Clinical Neurophysiology (T.L., I.S.F.), Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA; the Department of Neurology (K.B.N.), University of California San Francisco, San Francisco; the Department of Biostatistics and Epidemiology (J.S., A.Y.), Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; The Department of Pediatrics (K.W.), University of Arizona College of Medicine and Barrow's Neurological Institute at Phoenix Children's Hospital, Phoenix;
MDJessica L. Carpenter
From the Departments of Neurology and Pediatrics (N.S.A., S.M.S., D.J.D.), The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia; the Departments of Pediatrics and Neurology (D.H.A.), Oakland University William Beaumont School of Medicine, Royal Oak, MI; Department of Neurology (J.L.C.), Children's National Medical Center, Washington, DC; Division of Neurology (K.E.C.), Children's Hospital Colorado and University of Colorado School of Medicine, Aurora; Division of Neurology (K.M.C., W.B.G.), Duke Children's Hospital and Duke University School of Medicine, Durham, NC; Division of Neurology (C.C.G., J.L.T., J.H.M.), Department of Pediatrics, Mattel Children's Hospital and UCLA Brain Injury Research Center, Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA; Division of Neurology (J.L.G.), Children's Memorial Hospital and Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Neurology (C.D.H., K.M., E.P.), The Hospital for Sick Children and University of Toronto, Toronto, Canada; Division of Epilepsy and Clinical Neurophysiology (T.L., I.S.F.), Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA; the Department of Neurology (K.B.N.), University of California San Francisco, San Francisco; the Department of Biostatistics and Epidemiology (J.S., A.Y.), Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; The Department of Pediatrics (K.W.), University of Arizona College of Medicine and Barrow's Neurological Institute at Phoenix Children's Hospital, Phoenix;
MDKevin E. Chapman
From the Departments of Neurology and Pediatrics (N.S.A., S.M.S., D.J.D.), The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia; the Departments of Pediatrics and Neurology (D.H.A.), Oakland University William Beaumont School of Medicine, Royal Oak, MI; Department of Neurology (J.L.C.), Children's National Medical Center, Washington, DC; Division of Neurology (K.E.C.), Children's Hospital Colorado and University of Colorado School of Medicine, Aurora; Division of Neurology (K.M.C., W.B.G.), Duke Children's Hospital and Duke University School of Medicine, Durham, NC; Division of Neurology (C.C.G., J.L.T., J.H.M.), Department of Pediatrics, Mattel Children's Hospital and UCLA Brain Injury Research Center, Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA; Division of Neurology (J.L.G.), Children's Memorial Hospital and Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Neurology (C.D.H., K.M., E.P.), The Hospital for Sick Children and University of Toronto, Toronto, Canada; Division of Epilepsy and Clinical Neurophysiology (T.L., I.S.F.), Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA; the Department of Neurology (K.B.N.), University of California San Francisco, San Francisco; the Department of Biostatistics and Epidemiology (J.S., A.Y.), Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; The Department of Pediatrics (K.W.), University of Arizona College of Medicine and Barrow's Neurological Institute at Phoenix Children's Hospital, Phoenix;
MDKaren M. Cornett
From the Departments of Neurology and Pediatrics (N.S.A., S.M.S., D.J.D.), The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia; the Departments of Pediatrics and Neurology (D.H.A.), Oakland University William Beaumont School of Medicine, Royal Oak, MI; Department of Neurology (J.L.C.), Children's National Medical Center, Washington, DC; Division of Neurology (K.E.C.), Children's Hospital Colorado and University of Colorado School of Medicine, Aurora; Division of Neurology (K.M.C., W.B.G.), Duke Children's Hospital and Duke University School of Medicine, Durham, NC; Division of Neurology (C.C.G., J.L.T., J.H.M.), Department of Pediatrics, Mattel Children's Hospital and UCLA Brain Injury Research Center, Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA; Division of Neurology (J.L.G.), Children's Memorial Hospital and Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Neurology (C.D.H., K.M., E.P.), The Hospital for Sick Children and University of Toronto, Toronto, Canada; Division of Epilepsy and Clinical Neurophysiology (T.L., I.S.F.), Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA; the Department of Neurology (K.B.N.), University of California San Francisco, San Francisco; the Department of Biostatistics and Epidemiology (J.S., A.Y.), Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; The Department of Pediatrics (K.W.), University of Arizona College of Medicine and Barrow's Neurological Institute at Phoenix Children's Hospital, Phoenix;
MTWilliam B. Gallentine
From the Departments of Neurology and Pediatrics (N.S.A., S.M.S., D.J.D.), The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia; the Departments of Pediatrics and Neurology (D.H.A.), Oakland University William Beaumont School of Medicine, Royal Oak, MI; Department of Neurology (J.L.C.), Children's National Medical Center, Washington, DC; Division of Neurology (K.E.C.), Children's Hospital Colorado and University of Colorado School of Medicine, Aurora; Division of Neurology (K.M.C., W.B.G.), Duke Children's Hospital and Duke University School of Medicine, Durham, NC; Division of Neurology (C.C.G., J.L.T., J.H.M.), Department of Pediatrics, Mattel Children's Hospital and UCLA Brain Injury Research Center, Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA; Division of Neurology (J.L.G.), Children's Memorial Hospital and Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Neurology (C.D.H., K.M., E.P.), The Hospital for Sick Children and University of Toronto, Toronto, Canada; Division of Epilepsy and Clinical Neurophysiology (T.L., I.S.F.), Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA; the Department of Neurology (K.B.N.), University of California San Francisco, San Francisco; the Department of Biostatistics and Epidemiology (J.S., A.Y.), Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; The Department of Pediatrics (K.W.), University of Arizona College of Medicine and Barrow's Neurological Institute at Phoenix Children's Hospital, Phoenix;
DOChristopher C. Giza
From the Departments of Neurology and Pediatrics (N.S.A., S.M.S., D.J.D.), The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia; the Departments of Pediatrics and Neurology (D.H.A.), Oakland University William Beaumont School of Medicine, Royal Oak, MI; Department of Neurology (J.L.C.), Children's National Medical Center, Washington, DC; Division of Neurology (K.E.C.), Children's Hospital Colorado and University of Colorado School of Medicine, Aurora; Division of Neurology (K.M.C., W.B.G.), Duke Children's Hospital and Duke University School of Medicine, Durham, NC; Division of Neurology (C.C.G., J.L.T., J.H.M.), Department of Pediatrics, Mattel Children's Hospital and UCLA Brain Injury Research Center, Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA; Division of Neurology (J.L.G.), Children's Memorial Hospital and Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Neurology (C.D.H., K.M., E.P.), The Hospital for Sick Children and University of Toronto, Toronto, Canada; Division of Epilepsy and Clinical Neurophysiology (T.L., I.S.F.), Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA; the Department of Neurology (K.B.N.), University of California San Francisco, San Francisco; the Department of Biostatistics and Epidemiology (J.S., A.Y.), Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; The Department of Pediatrics (K.W.), University of Arizona College of Medicine and Barrow's Neurological Institute at Phoenix Children's Hospital, Phoenix;
MDJoshua L. Goldstein
From the Departments of Neurology and Pediatrics (N.S.A., S.M.S., D.J.D.), The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia; the Departments of Pediatrics and Neurology (D.H.A.), Oakland University William Beaumont School of Medicine, Royal Oak, MI; Department of Neurology (J.L.C.), Children's National Medical Center, Washington, DC; Division of Neurology (K.E.C.), Children's Hospital Colorado and University of Colorado School of Medicine, Aurora; Division of Neurology (K.M.C., W.B.G.), Duke Children's Hospital and Duke University School of Medicine, Durham, NC; Division of Neurology (C.C.G., J.L.T., J.H.M.), Department of Pediatrics, Mattel Children's Hospital and UCLA Brain Injury Research Center, Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA; Division of Neurology (J.L.G.), Children's Memorial Hospital and Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Neurology (C.D.H., K.M., E.P.), The Hospital for Sick Children and University of Toronto, Toronto, Canada; Division of Epilepsy and Clinical Neurophysiology (T.L., I.S.F.), Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA; the Department of Neurology (K.B.N.), University of California San Francisco, San Francisco; the Department of Biostatistics and Epidemiology (J.S., A.Y.), Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; The Department of Pediatrics (K.W.), University of Arizona College of Medicine and Barrow's Neurological Institute at Phoenix Children's Hospital, Phoenix;
MDCecil D. Hahn
From the Departments of Neurology and Pediatrics (N.S.A., S.M.S., D.J.D.), The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia; the Departments of Pediatrics and Neurology (D.H.A.), Oakland University William Beaumont School of Medicine, Royal Oak, MI; Department of Neurology (J.L.C.), Children's National Medical Center, Washington, DC; Division of Neurology (K.E.C.), Children's Hospital Colorado and University of Colorado School of Medicine, Aurora; Division of Neurology (K.M.C., W.B.G.), Duke Children's Hospital and Duke University School of Medicine, Durham, NC; Division of Neurology (C.C.G., J.L.T., J.H.M.), Department of Pediatrics, Mattel Children's Hospital and UCLA Brain Injury Research Center, Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA; Division of Neurology (J.L.G.), Children's Memorial Hospital and Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Neurology (C.D.H., K.M., E.P.), The Hospital for Sick Children and University of Toronto, Toronto, Canada; Division of Epilepsy and Clinical Neurophysiology (T.L., I.S.F.), Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA; the Department of Neurology (K.B.N.), University of California San Francisco, San Francisco; the Department of Biostatistics and Epidemiology (J.S., A.Y.), Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; The Department of Pediatrics (K.W.), University of Arizona College of Medicine and Barrow's Neurological Institute at Phoenix Children's Hospital, Phoenix;
MD, MPHJason T. Lerner
From the Departments of Neurology and Pediatrics (N.S.A., S.M.S., D.J.D.), The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia; the Departments of Pediatrics and Neurology (D.H.A.), Oakland University William Beaumont School of Medicine, Royal Oak, MI; Department of Neurology (J.L.C.), Children's National Medical Center, Washington, DC; Division of Neurology (K.E.C.), Children's Hospital Colorado and University of Colorado School of Medicine, Aurora; Division of Neurology (K.M.C., W.B.G.), Duke Children's Hospital and Duke University School of Medicine, Durham, NC; Division of Neurology (C.C.G., J.L.T., J.H.M.), Department of Pediatrics, Mattel Children's Hospital and UCLA Brain Injury Research Center, Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA; Division of Neurology (J.L.G.), Children's Memorial Hospital and Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Neurology (C.D.H., K.M., E.P.), The Hospital for Sick Children and University of Toronto, Toronto, Canada; Division of Epilepsy and Clinical Neurophysiology (T.L., I.S.F.), Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA; the Department of Neurology (K.B.N.), University of California San Francisco, San Francisco; the Department of Biostatistics and Epidemiology (J.S., A.Y.), Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; The Department of Pediatrics (K.W.), University of Arizona College of Medicine and Barrow's Neurological Institute at Phoenix Children's Hospital, Phoenix;
MDTobias Loddenkemper
From the Departments of Neurology and Pediatrics (N.S.A., S.M.S., D.J.D.), The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia; the Departments of Pediatrics and Neurology (D.H.A.), Oakland University William Beaumont School of Medicine, Royal Oak, MI; Department of Neurology (J.L.C.), Children's National Medical Center, Washington, DC; Division of Neurology (K.E.C.), Children's Hospital Colorado and University of Colorado School of Medicine, Aurora; Division of Neurology (K.M.C., W.B.G.), Duke Children's Hospital and Duke University School of Medicine, Durham, NC; Division of Neurology (C.C.G., J.L.T., J.H.M.), Department of Pediatrics, Mattel Children's Hospital and UCLA Brain Injury Research Center, Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA; Division of Neurology (J.L.G.), Children's Memorial Hospital and Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Neurology (C.D.H., K.M., E.P.), The Hospital for Sick Children and University of Toronto, Toronto, Canada; Division of Epilepsy and Clinical Neurophysiology (T.L., I.S.F.), Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA; the Department of Neurology (K.B.N.), University of California San Francisco, San Francisco; the Department of Biostatistics and Epidemiology (J.S., A.Y.), Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; The Department of Pediatrics (K.W.), University of Arizona College of Medicine and Barrow's Neurological Institute at Phoenix Children's Hospital, Phoenix;
MDJoyce H. Matsumoto
From the Departments of Neurology and Pediatrics (N.S.A., S.M.S., D.J.D.), The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia; the Departments of Pediatrics and Neurology (D.H.A.), Oakland University William Beaumont School of Medicine, Royal Oak, MI; Department of Neurology (J.L.C.), Children's National Medical Center, Washington, DC; Division of Neurology (K.E.C.), Children's Hospital Colorado and University of Colorado School of Medicine, Aurora; Division of Neurology (K.M.C., W.B.G.), Duke Children's Hospital and Duke University School of Medicine, Durham, NC; Division of Neurology (C.C.G., J.L.T., J.H.M.), Department of Pediatrics, Mattel Children's Hospital and UCLA Brain Injury Research Center, Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA; Division of Neurology (J.L.G.), Children's Memorial Hospital and Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Neurology (C.D.H., K.M., E.P.), The Hospital for Sick Children and University of Toronto, Toronto, Canada; Division of Epilepsy and Clinical Neurophysiology (T.L., I.S.F.), Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA; the Department of Neurology (K.B.N.), University of California San Francisco, San Francisco; the Department of Biostatistics and Epidemiology (J.S., A.Y.), Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; The Department of Pediatrics (K.W.), University of Arizona College of Medicine and Barrow's Neurological Institute at Phoenix Children's Hospital, Phoenix;
MDKristin McBain
From the Departments of Neurology and Pediatrics (N.S.A., S.M.S., D.J.D.), The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia; the Departments of Pediatrics and Neurology (D.H.A.), Oakland University William Beaumont School of Medicine, Royal Oak, MI; Department of Neurology (J.L.C.), Children's National Medical Center, Washington, DC; Division of Neurology (K.E.C.), Children's Hospital Colorado and University of Colorado School of Medicine, Aurora; Division of Neurology (K.M.C., W.B.G.), Duke Children's Hospital and Duke University School of Medicine, Durham, NC; Division of Neurology (C.C.G., J.L.T., J.H.M.), Department of Pediatrics, Mattel Children's Hospital and UCLA Brain Injury Research Center, Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA; Division of Neurology (J.L.G.), Children's Memorial Hospital and Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Neurology (C.D.H., K.M., E.P.), The Hospital for Sick Children and University of Toronto, Toronto, Canada; Division of Epilepsy and Clinical Neurophysiology (T.L., I.S.F.), Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA; the Department of Neurology (K.B.N.), University of California San Francisco, San Francisco; the Department of Biostatistics and Epidemiology (J.S., A.Y.), Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; The Department of Pediatrics (K.W.), University of Arizona College of Medicine and Barrow's Neurological Institute at Phoenix Children's Hospital, Phoenix;
MSKendall B. Nash
From the Departments of Neurology and Pediatrics (N.S.A., S.M.S., D.J.D.), The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia; the Departments of Pediatrics and Neurology (D.H.A.), Oakland University William Beaumont School of Medicine, Royal Oak, MI; Department of Neurology (J.L.C.), Children's National Medical Center, Washington, DC; Division of Neurology (K.E.C.), Children's Hospital Colorado and University of Colorado School of Medicine, Aurora; Division of Neurology (K.M.C., W.B.G.), Duke Children's Hospital and Duke University School of Medicine, Durham, NC; Division of Neurology (C.C.G., J.L.T., J.H.M.), Department of Pediatrics, Mattel Children's Hospital and UCLA Brain Injury Research Center, Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA; Division of Neurology (J.L.G.), Children's Memorial Hospital and Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Neurology (C.D.H., K.M., E.P.), The Hospital for Sick Children and University of Toronto, Toronto, Canada; Division of Epilepsy and Clinical Neurophysiology (T.L., I.S.F.), Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA; the Department of Neurology (K.B.N.), University of California San Francisco, San Francisco; the Department of Biostatistics and Epidemiology (J.S., A.Y.), Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; The Department of Pediatrics (K.W.), University of Arizona College of Medicine and Barrow's Neurological Institute at Phoenix Children's Hospital, Phoenix;
MDEric Payne
From the Departments of Neurology and Pediatrics (N.S.A., S.M.S., D.J.D.), The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia; the Departments of Pediatrics and Neurology (D.H.A.), Oakland University William Beaumont School of Medicine, Royal Oak, MI; Department of Neurology (J.L.C.), Children's National Medical Center, Washington, DC; Division of Neurology (K.E.C.), Children's Hospital Colorado and University of Colorado School of Medicine, Aurora; Division of Neurology (K.M.C., W.B.G.), Duke Children's Hospital and Duke University School of Medicine, Durham, NC; Division of Neurology (C.C.G., J.L.T., J.H.M.), Department of Pediatrics, Mattel Children's Hospital and UCLA Brain Injury Research Center, Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA; Division of Neurology (J.L.G.), Children's Memorial Hospital and Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Neurology (C.D.H., K.M., E.P.), The Hospital for Sick Children and University of Toronto, Toronto, Canada; Division of Epilepsy and Clinical Neurophysiology (T.L., I.S.F.), Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA; the Department of Neurology (K.B.N.), University of California San Francisco, San Francisco; the Department of Biostatistics and Epidemiology (J.S., A.Y.), Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; The Department of Pediatrics (K.W.), University of Arizona College of Medicine and Barrow's Neurological Institute at Phoenix Children's Hospital, Phoenix;
MDSarah M. Sánchez
From the Departments of Neurology and Pediatrics (N.S.A., S.M.S., D.J.D.), The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia; the Departments of Pediatrics and Neurology (D.H.A.), Oakland University William Beaumont School of Medicine, Royal Oak, MI; Department of Neurology (J.L.C.), Children's National Medical Center, Washington, DC; Division of Neurology (K.E.C.), Children's Hospital Colorado and University of Colorado School of Medicine, Aurora; Division of Neurology (K.M.C., W.B.G.), Duke Children's Hospital and Duke University School of Medicine, Durham, NC; Division of Neurology (C.C.G., J.L.T., J.H.M.), Department of Pediatrics, Mattel Children's Hospital and UCLA Brain Injury Research Center, Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA; Division of Neurology (J.L.G.), Children's Memorial Hospital and Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Neurology (C.D.H., K.M., E.P.), The Hospital for Sick Children and University of Toronto, Toronto, Canada; Division of Epilepsy and Clinical Neurophysiology (T.L., I.S.F.), Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA; the Department of Neurology (K.B.N.), University of California San Francisco, San Francisco; the Department of Biostatistics and Epidemiology (J.S., A.Y.), Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; The Department of Pediatrics (K.W.), University of Arizona College of Medicine and Barrow's Neurological Institute at Phoenix Children's Hospital, Phoenix;
BAIván Sánchez Fernández
From the Departments of Neurology and Pediatrics (N.S.A., S.M.S., D.J.D.), The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia; the Departments of Pediatrics and Neurology (D.H.A.), Oakland University William Beaumont School of Medicine, Royal Oak, MI; Department of Neurology (J.L.C.), Children's National Medical Center, Washington, DC; Division of Neurology (K.E.C.), Children's Hospital Colorado and University of Colorado School of Medicine, Aurora; Division of Neurology (K.M.C., W.B.G.), Duke Children's Hospital and Duke University School of Medicine, Durham, NC; Division of Neurology (C.C.G., J.L.T., J.H.M.), Department of Pediatrics, Mattel Children's Hospital and UCLA Brain Injury Research Center, Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA; Division of Neurology (J.L.G.), Children's Memorial Hospital and Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Neurology (C.D.H., K.M., E.P.), The Hospital for Sick Children and University of Toronto, Toronto, Canada; Division of Epilepsy and Clinical Neurophysiology (T.L., I.S.F.), Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA; the Department of Neurology (K.B.N.), University of California San Francisco, San Francisco; the Department of Biostatistics and Epidemiology (J.S., A.Y.), Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; The Department of Pediatrics (K.W.), University of Arizona College of Medicine and Barrow's Neurological Institute at Phoenix Children's Hospital, Phoenix;
MDJustine Shults
From the Departments of Neurology and Pediatrics (N.S.A., S.M.S., D.J.D.), The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia; the Departments of Pediatrics and Neurology (D.H.A.), Oakland University William Beaumont School of Medicine, Royal Oak, MI; Department of Neurology (J.L.C.), Children's National Medical Center, Washington, DC; Division of Neurology (K.E.C.), Children's Hospital Colorado and University of Colorado School of Medicine, Aurora; Division of Neurology (K.M.C., W.B.G.), Duke Children's Hospital and Duke University School of Medicine, Durham, NC; Division of Neurology (C.C.G., J.L.T., J.H.M.), Department of Pediatrics, Mattel Children's Hospital and UCLA Brain Injury Research Center, Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA; Division of Neurology (J.L.G.), Children's Memorial Hospital and Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Neurology (C.D.H., K.M., E.P.), The Hospital for Sick Children and University of Toronto, Toronto, Canada; Division of Epilepsy and Clinical Neurophysiology (T.L., I.S.F.), Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA; the Department of Neurology (K.B.N.), University of California San Francisco, San Francisco; the Department of Biostatistics and Epidemiology (J.S., A.Y.), Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; The Department of Pediatrics (K.W.), University of Arizona College of Medicine and Barrow's Neurological Institute at Phoenix Children's Hospital, Phoenix;
PhDKorwyn Williams
From the Departments of Neurology and Pediatrics (N.S.A., S.M.S., D.J.D.), The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia; the Departments of Pediatrics and Neurology (D.H.A.), Oakland University William Beaumont School of Medicine, Royal Oak, MI; Department of Neurology (J.L.C.), Children's National Medical Center, Washington, DC; Division of Neurology (K.E.C.), Children's Hospital Colorado and University of Colorado School of Medicine, Aurora; Division of Neurology (K.M.C., W.B.G.), Duke Children's Hospital and Duke University School of Medicine, Durham, NC; Division of Neurology (C.C.G., J.L.T., J.H.M.), Department of Pediatrics, Mattel Children's Hospital and UCLA Brain Injury Research Center, Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA; Division of Neurology (J.L.G.), Children's Memorial Hospital and Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Neurology (C.D.H., K.M., E.P.), The Hospital for Sick Children and University of Toronto, Toronto, Canada; Division of Epilepsy and Clinical Neurophysiology (T.L., I.S.F.), Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA; the Department of Neurology (K.B.N.), University of California San Francisco, San Francisco; the Department of Biostatistics and Epidemiology (J.S., A.Y.), Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; The Department of Pediatrics (K.W.), University of Arizona College of Medicine and Barrow's Neurological Institute at Phoenix Children's Hospital, Phoenix;
MD, PhDAmy Yang
From the Departments of Neurology and Pediatrics (N.S.A., S.M.S., D.J.D.), The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia; the Departments of Pediatrics and Neurology (D.H.A.), Oakland University William Beaumont School of Medicine, Royal Oak, MI; Department of Neurology (J.L.C.), Children's National Medical Center, Washington, DC; Division of Neurology (K.E.C.), Children's Hospital Colorado and University of Colorado School of Medicine, Aurora; Division of Neurology (K.M.C., W.B.G.), Duke Children's Hospital and Duke University School of Medicine, Durham, NC; Division of Neurology (C.C.G., J.L.T., J.H.M.), Department of Pediatrics, Mattel Children's Hospital and UCLA Brain Injury Research Center, Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA; Division of Neurology (J.L.G.), Children's Memorial Hospital and Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Neurology (C.D.H., K.M., E.P.), The Hospital for Sick Children and University of Toronto, Toronto, Canada; Division of Epilepsy and Clinical Neurophysiology (T.L., I.S.F.), Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA; the Department of Neurology (K.B.N.), University of California San Francisco, San Francisco; the Department of Biostatistics and Epidemiology (J.S., A.Y.), Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; The Department of Pediatrics (K.W.), University of Arizona College of Medicine and Barrow's Neurological Institute at Phoenix Children's Hospital, Phoenix;
BSDennis J. Dlugos
From the Departments of Neurology and Pediatrics (N.S.A., S.M.S., D.J.D.), The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia; the Departments of Pediatrics and Neurology (D.H.A.), Oakland University William Beaumont School of Medicine, Royal Oak, MI; Department of Neurology (J.L.C.), Children's National Medical Center, Washington, DC; Division of Neurology (K.E.C.), Children's Hospital Colorado and University of Colorado School of Medicine, Aurora; Division of Neurology (K.M.C., W.B.G.), Duke Children's Hospital and Duke University School of Medicine, Durham, NC; Division of Neurology (C.C.G., J.L.T., J.H.M.), Department of Pediatrics, Mattel Children's Hospital and UCLA Brain Injury Research Center, Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA; Division of Neurology (J.L.G.), Children's Memorial Hospital and Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Neurology (C.D.H., K.M., E.P.), The Hospital for Sick Children and University of Toronto, Toronto, Canada; Division of Epilepsy and Clinical Neurophysiology (T.L., I.S.F.), Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA; the Department of Neurology (K.B.N.), University of California San Francisco, San Francisco; the Department of Biostatistics and Epidemiology (J.S., A.Y.), Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; The Department of Pediatrics (K.W.), University of Arizona College of Medicine and Barrow's Neurological Institute at Phoenix Children's Hospital, Phoenix;
MDElectrographic seizures in pediatric ICU patients
Cohort study of risk factors and mortality
Nicholas S. Abend, Daniel H. Arndt, Jessica L. Carpenter, Kevin E. Chapman, Karen M. Cornett, William B. Gallentine, Christopher C. Giza, Joshua L. Goldstein, Cecil D. Hahn, Jason T. Lerner, Tobias Loddenkemper, Joyce H. Matsumoto, Kristin McBain, Kendall B. Nash, Eric Payne, Sarah M. Sánchez, Iván Sánchez Fernández, Justine Shults, Korwyn Williams, Amy Yang, Dennis J. Dlugos
Neurology Jul 2013, 81 (4) 383-391; DOI: 10.1212/WNL.0b013e31829c5cfe
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Abstract
Objectives: We aimed to determine the incidence of electrographic seizures in children in the pediatric intensive care unit who underwent EEG monitoring, risk factors for electrographic seizures, and whether electrographic seizures were associated with increased odds of mortality.
Methods: Eleven sites in North America retrospectively reviewed a total of 550 consecutive children in pediatric intensive care units who underwent EEG monitoring. We collected data on demographics, diagnoses, clinical seizures, mental status at EEG onset, EEG background, interictal epileptiform discharges, electrographic seizures, intensive care unit length of stay, and in-hospital mortality.
Results: Electrographic seizures occurred in 162 of 550 subjects (30%), of which 61 subjects (38%) had electrographic status epilepticus. Electrographic seizures were exclusively subclinical in 59 of 162 subjects (36%). A multivariable logistic regression model showed that independent risk factors for electrographic seizures included younger age, clinical seizures prior to EEG monitoring, an abnormal initial EEG background, interictal epileptiform discharges, and a diagnosis of epilepsy. Subjects with electrographic status epilepticus had greater odds of in-hospital death, even after adjusting for EEG background and neurologic diagnosis category.
Conclusions: Electrographic seizures are common among children in the pediatric intensive care unit, particularly those with specific risk factors. Electrographic status epilepticus occurs in more than one-third of children with electrographic seizures and is associated with higher in-hospital mortality.
GLOSSARY
- CEEG=
- continuous EEG;
- CI=
- confidence interval;
- IQR=
- interquartile range;
- OR=
- odds ratio;
- PICU=
- pediatric intensive care unit
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
- Received January 4, 2013.
- Accepted in final form March 13, 2013.
- © 2013 American Academy of Neurology
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