Neurocritical Care

, Volume 29, Issue 1, pp 3–8 | Cite as

The Ictal–Interictal Continuum: To Treat or Not to Treat (and How)?

  • Clio Rubinos
  • Alexandra S. Reynolds
  • Jan Claassen
Current Concepts


Continuous electroencephalography (cEEG) monitoring is becoming increasingly used in neurologic and non-neurologic intensive care units (ICUs). Non-convulsive seizures (NCSz) and periodic discharges (PDs) are commonly seen in critically ill patients. Some of these PD patterns, also known as the ictal–interictal continuum (IIC), are associated with an increased risk of seizures and poor outcome. However, we do not fully understand the significance of these periodic patterns and the decision of how aggressively to treat remains controversial. IIC patterns are associated with pathophysiologic changes that closely resemble those of seizures. Here we make the argument that, rather than feature description on EEG, associated changes in brain physiology should dictate management choices.


Seizures Continuous electroencephalography Periodic discharges Ictal–interictal continuum 


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Clio Rubinos
    • 1
  • Alexandra S. Reynolds
    • 1
  • Jan Claassen
    • 1
  1. 1.Columbia UniversityNew YorkUSA

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