Patient
63 y/o male w PMH of epilepsy on phenobarbital at home
Timeline
- 1505: Patient arrived at the ED via EMS with concern for seizure after his sister noted persistent altered mental status
- No reports of missing ASMs at home
- AMS workup initiated, labs within normal limits
- 1856: Ceribell applied to evaluate for possible NCSE
- Seizure burden immediately reached 100% upon application and alarmed, alerting the bedside team of suspected NCSE
- Midazolam given at 1956, 2037, and 2044
- Levetiracetam given at 1956 and 2044
- Phenobarbital given at 2354
- Seizure burden dropped to 0%
- Patient observed overnight with no witnessed seizure or increase in seizure burden
- Mental status improved
- Patient discharged home the following day
Impact
- POC EEG enabled prompt detection of suspected NCSE in ED
- Real-time monitoring of patient response to medications allowed for rapid escalation of treatment to break seizures and helped patient avoid ICU admission
Case study is representative of real medical events.