EEG Monitoring Clinical Pathway, PICU, N/IICU and CICU – Cohort

EEG Monitoring Clinical Pathway — PICU, N/IICU, and CICU

Cohort

This pathway guides the care of children in the PICU, N/IICU, or CICU who require EEG monitoring and seizure management.

Indications for EEG Monitoring

NeuroICU Consultation should be initiated in parallel with EEG order, but it is not required for initiation.

EEG Monitoring Indication Duration (Hours) Comments
Assessing event(s) of unknown etiology (abnormal movements, vital sign fluctuations) to determine whether they are ictal or non-ictal As needed
  • Pushbutton by ICU RN or parent required
  • Multiple events may be needed
Persisting encephalopathy following termination of convulsive status epilepticus 24-48  
Acute encephalopathy of unclear etiology 24-48  
  • Acute encephalopathy/acute neurologic disorder
    • Stroke (ischemic, hemorrhagic, SVT)
    • Encephalitis
    • Moderate to severe TBI (accidental or abusive)
    • Post-op neurosurgical patient < 2 yrs
 24-48  
  • Hypoxic-ischemic encephalopathy (HIE)
    • Cardiac arrest
    • Non-fatal drowning
    • Neonatal HIE
 24-96
  • Burst-suppression management of
    • Intracranial hypertension
    • Refractory seizures/status epilepticus
 As needed Medication management and dose titration
ECMO ~ 48  
Neonates (< 1 mo corrected age) following cardiac surgery with bypass ~ 48 Initiate immediately post-op while infant is still sedated