Efficacy of Continuous video EEG monitoring in the neurocritical care

Abstract

Recent advance of digital EEG system enables to monitor long term continuous EEG (CEEG) and find non convulsive status epilepticus (NCSE) which has just EEG seizure pattern with no evident clinical manifestation. NCSE should be treated with adequate amount of antiepileptic drugs as soon as possible after diagnosis. The problems of induction of CEEG in nerocritial care are EEG reading, EEG tech and medical remuneration. Firstly most of emergency physician feels weak in reading EEG. Emergent EEG should be read quickly and contribute treatment therefore three points are noted, temporal distribution, spatial distribution and EEG evolution. Second issue is EEG techs resources problem and EEG machine. EEG Technicians and EEG machines are often the rate limiting step to developing a successful program. To avoid this situation, EEG electrodes are fixed the last time of the daytime and taken next morning. Finally, in Japan, this neurocritical CEEG is not economically covered. This is the one of the fence that CEEG does not spread in our country. These situations should be improved by pertinent scientific societies and Japanese Ministry of Health, Labor and Welfare.