Skip to main content
SpringerLink
Log in

Apport de l’EEG en médecine d’urgence: principales indications et contribution au diagnostic et à la prise en charge

The role of EEG in emergency department: major indications and contribution to diagnosis and care

  • Mise au Point / Update
  • Published:
Annales françaises de médecine d'urgence

Résumé

L’électroencéphalographie (EEG) occupe une place particulière au sein des investigations complémentaires disponibles dans le cadre de la médecine d’urgence: aisément disponible, mobilisable au lit du patient, non invasif, il fournit des informations importantes sur le fonctionnement cérébral et permet certains diagnostics de façon formelle, conduisant à la mise en place de thérapeutiques appropriées. Cet article fait le point sur les principales indications de l’EEG demandé « en urgence » ou « dès que possible », à partir des données recueillies dans la littérature concernant des situations spécifiques, rencontrées dans les services d’urgence.

Abstract

The role of EEG in the critical care and emergency department remains debatable. EEG represents a noninvasive, readily available functional exploration, providing valuable information regarding the diagnosis of nonconvulsive-status epilepticus, brain death in comatose patients and, in some cases, confirmatory data for an etiological diagnosis of encephalopathy (herpes encephalitis, metabolic). In patients presenting with epileptic seizure, EEG contributes to a whole situation analysis, including clinical findings (type of seizure, past medical history and neurological examination and neuroimaging). In this case, investigations are carried out in outpatient neurologic clinics. This review explores the current contribution of EEG in the specific setting of emergency department and critical care unit, by addressing each clinical presentation where EEG should be considered a valuable technique to examine patients. Either “true” emergent EEG or “as soon as possible” EEG are evaluated in this paper.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Références

  1. Perret J (1998) Conférence de consensus sur les indications de l’EEG en urgence. Rapport après les présentations des experts, Tours, mai, 1996. Neurophysiol Clin 28:103–110

    Article  Google Scholar 

  2. Benbadis SR (2008) Use and abuse of stat EEG. Expert Rev Neurother 8:865–868

    Article  PubMed  Google Scholar 

  3. Varelas PN, Spanki MV, Hacein-Bey L, et al (2003) Emergent EEG: indications and diagnostic yield. Neurology 61:702–704

    PubMed  CAS  Google Scholar 

  4. Quigg M, Shneker B, Domer P (2001) Current practice in administration and clinical criteria of emergent EEG. J Clin Neurophysiol 18:162–165

    Article  PubMed  CAS  Google Scholar 

  5. Firosh Khan S, Ashalatha R, Thomas SV, Sarma PS (2005) Emergent EEG is helpful in neurology critical care practice. Clin Neurophysiol 116:2454–2459

    Article  PubMed  CAS  Google Scholar 

  6. Praline J, de Toffol B, Mondon K, et al (2004) EEG d’urgence: indications réelles et résultats. Neurophysiol Clin 34:175–181

    PubMed  CAS  Google Scholar 

  7. Praline J, Grujic J, Corcia P, et al (2007) Emergent EEG in clinical practice. Clin Neurophysiol 118:2149–2155

    Article  PubMed  Google Scholar 

  8. Yigit O, Eray O, Mihci E, et al (2011) The utility of EEG in the emergency department. Emerg Med doi:10.1136/emj.2011.112888

  9. ACEP Clinical Policies Committee and the Clinical Policies Subcommittee on Seizures (2004) Critical issues in the evaluation and management of adult patients presenting to the emergency department with seizures. Ann Emerg Med 43:605–625

    Article  Google Scholar 

  10. Chen JL, Dorfman GS, Li MC, Cranon JJ (1996) Use of computed tomography scanning before and after sitting in an emergency department. Acad Radiol 3:678–682

    Article  PubMed  CAS  Google Scholar 

  11. LaRoche (2011) Seizures and Encephalopathy. Semin Neurol 31:194–201

    Article  PubMed  Google Scholar 

  12. Bloetzer C, Carota A, Augsburger M, et al (2007) Zopiclone intoxication: value of electroencephalography in the emergency room. Eur Neurol 58:246–247

    Article  PubMed  Google Scholar 

  13. Boutte C, Vercueil L, Durand M, et al (2006) EEG contribution to the diagnosis of baclofen overdose. Neurophysiol Clin 36:85–89

    Article  PubMed  CAS  Google Scholar 

  14. Nordli DR, Moshe SL, Shinnar S (2010) The role of EEG in febrile status epilepticus Brain Dev 32:37–41

    Article  PubMed  CAS  Google Scholar 

  15. DeLorenzo RJ, Waterhouse EJ, Towne AR, et al (1998) Persistent nonconvulsive status epilepticus after the control of convulsive status epilepticus. Epilepsia 39:833–840

    Article  PubMed  CAS  Google Scholar 

  16. Privitera M, Hoffman M, Moore JL, et al (1994) EEG detection of nontonic-clonic status epilepticus in patients with altered consciousness. Epilepsy Res 18:155–166

    Article  PubMed  CAS  Google Scholar 

  17. Privitera MD, Strawsburg RH (1994) Electroencephalographic monitoring in the emergency department. Emerg Med Clin North Am 12:1089–1100

    PubMed  CAS  Google Scholar 

  18. Claassen J, Mayer SA, Kowalski RG, et al (2004) Detection of electrographic seizures with continuous EEG monitoring in critically ill patients. Neurology 62:1743–1748

    PubMed  CAS  Google Scholar 

  19. Claassen J, Jette N, Chum F, et al (2007) Electrographic seizures and periodic discharges after intracerebral hemorrhage. Neurology 69:1356–1365

    Article  PubMed  CAS  Google Scholar 

  20. Korabathina K, Benbadis SR (2007) EEG diagnosis of nonconvulsive status epilepticus: generalized periodic patterns: status or not? Expert Rev Neurother 7:1643–1644

    Article  PubMed  Google Scholar 

  21. Towne AR, Waterhouse EJ, Boggs JG, et al (2000) Prevalence of nonconvulsive status epilepticus in comatose patients. Neurology 54:340–345

    PubMed  CAS  Google Scholar 

  22. Waterhouse EJ (2004) EEG 24/7: the use of emergency EEG to diagnose status epilepticus. Epilepsy Curr 4:53–54

    Article  PubMed  Google Scholar 

  23. Sutter R, Fuhr P, Grize L, et al (2011) Continuous video-EEG monitoring increases detection rate of nonconvulsive status epilepticus in the ICU. Epilepsia 52:453–457

    Article  PubMed  Google Scholar 

  24. Wittman JJ, Hirsch LJ (2005) Continuous electroencephalogram monitoring in the critically ill. Neurocritical Care 2:330–341

    Article  PubMed  Google Scholar 

  25. Drislane FW (2000) Presentation, evaluation, and treatment of nonconvulsive status epilepticus. Epilepsy Behav 1:301–314

    Article  PubMed  CAS  Google Scholar 

  26. Gueguen B, Raynaud P, Guedj MJ (1998) Indications de l’EEG dans les confusions mentales et les troubles du comportement. Neurophysiol Clin 28:134–143

    Article  PubMed  CAS  Google Scholar 

  27. Alroughani R, et al (2009) Nonconvulsive status epilepticus; the rate of occurrence in a general hospital. Seizure 18:38–42

    Article  PubMed  CAS  Google Scholar 

  28. Mauricio EA, Freeman WD (2011) Status epilepticus in the elderly: differential diagnosis and treatment. Neuropsychiatr Dis Treat 7:161–166

    PubMed  Google Scholar 

  29. Sheth RD, Drazkowski JF, Sirven JI, et al (2006) Protracted ictal confusion in elderly patients. Arch Neurol 63:529–532

    Article  PubMed  Google Scholar 

  30. Veran O, Kahane P, Thomas P, et al (2010) De novo epileptic confusion in the elderly: a 1-year prospective study. Epilepsia 51:1030–1035

    Article  PubMed  Google Scholar 

  31. Bautista RE, Godwin S, Caro D (2007) Incorporating abbreviated EEGs in the initial workup of patients who present to the emergency room with mental status changes of unknown etiology. J Clin Neurophysiol 24:16–21

    Article  PubMed  Google Scholar 

  32. Szurhaj W, Derambure P (2004) Place de l’EEG dans l’épilepsie. Rev Neurol (Paris) 160:1113–1119

    CAS  Google Scholar 

  33. Tardy B, Lafond P, Convers P, et al (1995) Adult first generalized seizure: etiology, biological tests, EEG, CT-scan, in an ED. Am J Emerg Med 13:1–5

    Article  PubMed  CAS  Google Scholar 

  34. Beghi E, De Maria G, Gobbi G, et al (2006) Diagnosis and treatment of the first epileptic seizure: guidelines of the Italian League against Epilepsy. Epilepsia 47(Suppl 5):2–8

    Article  PubMed  CAS  Google Scholar 

  35. Willmore LJ (1998) Epilepsy emergencies: the first seizure and status epilepticus. Neurology 51(Suppl 4):S34–S38

    PubMed  CAS  Google Scholar 

  36. Beghi E, Carpio A, Forsgren L et al (2009) Recommendation for a definition of acute symptomatic seizure. Epilepsia 51:671–675

    Article  PubMed  Google Scholar 

  37. Bhatt H, Matharu MS, Henderson K, et al (2005) An audit of first seizures presenting to an Accident and Emergency department. Seizure 14:58–61

    Article  PubMed  Google Scholar 

  38. Dunn MJG, Breen DP, Davenport RJ, et al (2005) Early management of adults with an uncomplicated first generalised seizure. Emerg Med J 22:237–242

    Article  PubMed  CAS  Google Scholar 

  39. Caplan LR (2008) Funny turns. They do mean something. Arch Neurol 65:301–302

    Article  Google Scholar 

  40. Wilcken N (2003) Periodic funny turns. Lancet Oncol 4:772–773

    Article  PubMed  Google Scholar 

  41. Smith D, Barotolo R, Pickles RM, Tedman BM (2001) Requests for electroencephalography in a district general hospital: retrospective and prospective audit. BMJ 322:954–957

    Article  PubMed  CAS  Google Scholar 

  42. Howell SJL, Owen K, Chadwick DW (1989) Pseudostatus epilepticus. QJM 71:507–519

    PubMed  CAS  Google Scholar 

  43. Alehan FK, Morton LD, Pellock JM (2001) Utility of electroencephalography in the pediatric emergency department. J Child Neurol 16:484–487

    PubMed  CAS  Google Scholar 

  44. Tatum WO, Dworetzky BA, Freeman WD, Shomer DL (2011) Artifact: recording EEG in special care unit. J Clin Neurophysiol 28:264–277

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Exploration fonctionnelle du système nerveux, pôle de psychiatrie et de neurologie, CHU de Grenoble, F-38043, Grenoble cedex 09, France

    L. Vercueil

Authors
  1. L. Vercueil
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to L. Vercueil.

About this article

Cite this article

Vercueil, L. Apport de l’EEG en médecine d’urgence: principales indications et contribution au diagnostic et à la prise en charge. Ann. Fr. Med. Urgence 1, 395–402 (2011). https://doi.org/10.1007/s13341-011-0119-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13341-011-0119-z

Mots clés

Keywords

Search

Navigation