A Growing Consensus: EEG is Necessary to Diagnose and Manage Seizures

Multiple societies recognize non-convulsive seizure as a significant risk, commonly occurring with the underlying primary condition and requiring EEG for prompt diagnosis and management

“EEG should be initiated within one hour of suspected SE in all patients.”

NCS Guidelines for Evaluation and Management of Status Epilepticus¹

American Heart Association

“Recommend promptly performing and interpreting EEG for the diagnosis of seizures in patients who do not follow commands after ROSC.”

AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care²𝄒³

The Joint Commission

“Growing evidence suggests that [comprehensive post–cardiac arrest care] is critical for both patient survival and optimal neurological outcome.”

R3 Report on Resuscitation Standards for Hospitals⁴

American Heart Association

“EEG [is recommended] for a change in mental status or depressed mental status out of proportion to the stroke.”

AHA Comprehensive Nursing Care Scientific Statement for Care of the Patient with Acute Ischemic Stroke⁵

American Heart Association

“New-onset seizures in the context of spontaneous ICH are relatively common […] and most of these seizures occur within the first 24 hours of the hemorrhage.”

AHA/ASA Guidelines for the Management of Patients With Spontaneous Intracerebral Hemorrhage⁶

American Heart Association

“Monitoring with continuous EEG can detect nonconvulsive seizures, especially in patients with depressed consciousness or fluctuating neurological examination.”

AHA/ASA Guidelines for the Management of Patients With Aneurysmal Subarachnoid Hemorrhage⁷

“CCEEG has an important role in detection of secondary injuries such as seizures and ischemia in critically ill adults and children with altered mental status.”

ACNS Consensus Statement on Continuous EEG in Critically Ill Adults and Children⁸

“We recommend EEG in all patients with ABI [Acute Brain Injury] and unexplained and persistent altered consciousness […and] in patients with cSE that do not return to functional baseline within 60 minutes after seizure medication.”

Consensus Summary Statement of the International Multidisciplinary Consensus Conference on Multimodality Monitoring in Neurocritical Care⁹

Neurocritical Care Society

2012 NCS Guidelines for the Evaluation and Management of Status Epilepticus¹

“EEG should be initiated within one hour of suspected SE in all patients.”

READ GUIDELINES
American Heart Association

*Guideline Table Excerpt


The Joint Commission

American Heart Association

2021 AHA/ASA Comprehensive Nursing Care Scientific Statement for Care of the Patient with Acute Ischemic Stroke⁵

“Neurological complications, including […] poststroke seizures result in early neurological deterioration, associated with poor outcomes.”

READ THE STATEMENT

American Heart Association

2022 AHA/ASA Guideline for the Management of Patients with Spontaneous Intracerebral Hemorrhage⁶

“New-onset seizures in the context of spontaneous ICH are relatively common […] and most of these seizures occur within the first 24 hours of the hemorrhage.”

READ GUIDELINES

American Heart Association

2023 AHA/ASA G​uideline for the Management of Patients With Aneurysmal Subarachnoid Hemorrhage⁷

“Monitoring with continuous EEG can detect nonconvulsive seizures, especially in patients with depressed consciousness or fluctuating neurological examination.”

READ GUIDELINES

2015 ACNS Consensus Statement on Continuous EEG in Critically Ill Adults and Children⁸

“CCEEG has an important role in detection of secondary injuries such as seizures and ischemia in critically ill adults and children with altered mental status.”

READ THE STATEMENT

“We recommend EEG in all patients with ABI [Acute Brain Injury] and unexplained and persistent altered consciousness […and] in patients with cSE that do not return to functional baseline within 60 minutes after seizure medication.”

Other Resources