Seizure Burden - 10 Minutes of Seizures Associated with Decline in Neurologic Function

As little as 10 Minutes of Seizures in One Hour of any Hour of cEEG is Associated with Short-term Neurologic Deficits

Increased Electrographic Seizures Burden among Critical Ill Children is Associated with a Decline in Neurologic Function at Hospital Discharge.

Payne, E., Hahn, C., et al, Brain, March, 2013

"We found that paediatric patients who experienced a seizure burden of more than 12 minutes in a given hour of cEEG recording had significantly worse short-term outcome, even after controlling for diagnosis and illness severity. "

Prospective observational study of all infants and children admitted to our Pediatric and Cardiac Intensive Care Units who underwent clinically ordered video-­cEEG monitoring over a 3-­year period.

Seizure burden was quantified for each subject by calculating the maximum percentage of any hour that was occupied by Electrographic Seizures (ES).

A decline in Pediatric Cerebral Performance Category Scale (PCPC) score was observed in 67% of subjects, who had a mean maximum ES burden of 15.7% per hour, compared to 1.8% per hour for those without decline (p<0.0001).

Seizure Burden = % that seizure occupies in 1 hr of cEEG monitoring

ES burden remained significantly associated with PCPC decline, a diagnosis of acute brain injury, the presence of clinical seizures in the acute, or an unreactive EEG background.

For every 1% increase in maximum hourly ES burden, the odds of PCPC decline increased by 1.13 fold.