Prevalence of electrographic seizures in hospitalized patients with altered mental status with no significant seizure risk factors who underwent continuous EEG monitoring.

Abstract

Abstract Objectives To evaluate the prevalence of electrographic seizures in hospitalized patients with altered mental status and no significant risk factors for seizures.Methods We retrospectively reviewed over a six-year period (2013–2019) the medical records of all adults admitted at Ohio State University Wexner Medical Center (OSUWMC), who underwent cEEG monitoring for ≥ 48 hours. Our primary objective was to identify the prevalence of electrographic seizures in patients with altered mental status and no significant acute or remote risk factors for seizures.Results A total of 1966 patients were screened for the study, 1892 were excluded (96.2%) and 74 patients met inclusion criteria. Electrographic seizures were identified in seven of 74 (9.45%). We found a significant correlation between electrographic seizures and history of hepatic cirrhosis, n = 4 (57%), (p = 0.035), acute on chronic hepatic failure during admission, 71% (n = 5), (p = 0.027), and hyperammonemia (p = 0.009).Conclusion In this retrospective study of patients with altered mental status and with no significant acute or remote risk factors for seizures who underwent cEEG monitoring for ≥ 48 hours, electrographic seizures were identified in 9.45%. Electrographic seizures were associated with hepatic dysfunction and hyperammonemia. Based on our results, cEEG monitoring should be considered in patients with altered mental status and hepatic dysfunction even in the absence of other seizure risk factors.