Quantitative Electroencephalography for Early Detection of Elevated Intracranial Pressure in Critically Ill Children: Case Series and Proposed Protocol

J Child Neurol. 2022 Jan;37(1):5-11. doi: 10.1177/08830738211015012. Epub 2021 Nov 22.

Abstract

Objective: To describe quantitative EEG (electroencephalography) suppression ratio in children with increased intracranial pressure comparing acute suppression ratio changes to imaging and/or examination findings.

Methods: We retrospectively reviewed the suppression ratio from patients with neuroimaging and /or examination findings of increased intracranial pressure while on continuous EEG. The time of the first change in the suppression ratio was compared to the time of the first image and/or examination change confirming increased intracranial pressure.

Results: Thirteen patients with a median age of 3.1 years(interquartile range 1.8-6.3) had a rise in the suppression ratio with median time from identification to acute neuroimaging or examination of increased intracranial pressure of 3.12 hours (interquartile range 2.2-33.5) after the first increase in the suppression ratio.

Conclusions: Acute suppression ratio increase is seen prior to imaging and/or examination findings of increased intracranial pressure. With further study, the suppression ratio can be targeted with intracranial pressure-lowering agents to prevent morbidity and mortality associated with increased intracranial pressure.

Keywords: continuous electroencephalography; increased intracranial pressure; pediatric intensive care unit; quantitative electroencephalography.

Publication types

  • Evaluation Study

MeSH terms

  • Child
  • Child, Preschool
  • Clinical Protocols*
  • Critical Care / methods*
  • Critical Illness
  • Early Diagnosis*
  • Electroencephalography / methods*
  • Evaluation Studies as Topic
  • Female
  • Humans
  • Infant
  • Intracranial Hypertension / diagnosis*
  • Intracranial Hypertension / physiopathology*
  • Male
  • Retrospective Studies