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New Frontiers in Neurology: Continuous EEG Monitoring: 

Digital EEG equipment and a highly specialized team of technicians can provide continuous EEG (cEEG) monitoring, measuring brain dysfunction in patients who are at risk of developing seizures or ischemia.

For years, Huntington Memorial Hospital’s ICU patients have received continuous cardiac telemetry, and now, thanks to new developments in technology and a recently expanded neurophysiology laboratory, we have the capability to also monitor the brains of critically ill patients. Although cEEG is considered a standard of care for critically ill neurological patients in a university setting, Huntington Hospital is one of the few community hospitals in Southern California to offer this leading-edge advancement.

“We are able to perform cEEG monitoring because of advances in digital technology as well as computer memory storage and the ability to review from a remote location,” said Yafa Minazad, D.O., a Huntington Hospital neurologist, fellowship trained in epilepsy and neurophysiology.   “Most important, cEEG allows us to discover sub-clinical seizures or status epilepticus in patients that might otherwise go undetected, resulting in conditions that, untreated, may lead to permanent disabilities or death,” she adds.

Encephalography is an invaluable tool in the detection of and management of seizure activity, but for ICU patients traditional EEG is too static to definitively detect the presence of volatile, sub-clinical, non-convulsive seizure activity.   Abnormal brain activity is not always obvious in critically ill and often unconscious patients, and cEEG provides ongoing, consistent monitoring – enabling both the detection of sub-clinical activity and the ability to gauge corresponding medical intervention.  There is also the opportunity to identify evidence of early stage, acute stroke, thereby further reducing the risk of permanent disability.

Patients most likely to benefit from continuous EEG monitoring include those with impaired consciousness from acute brain injury or without clear explanation.  Patients most likely to be demonstrating non-convulsive seizures usually have had a prior epilepsy diagnosis, CNS infection, brain tumor, a recent neurosurgical procedure or those under 18 years old.   Patients in anesthesia comas are also very vulnerable to seizures and should be monitored via cEEG.

As the only trauma center in the San Gabriel Valley, it is crucial that Huntington provides quality, state-of-the-art treatment to patients suffering brain injuries.  This commitment ha s extended beyond cEEG monitoring and includes expanding our neurophysiology laboratory and conducting research projects in outcomes, prognostication and future treatment for comatose or otherwise brain-injured patients.