Assessment of Routine, On-Demand Electroencephalograms for Seizure Detection in the Intensive Care Unit of a Major Saudi Tertiary Center.

PMID 42238830 | PMCID PMC13169251 | DOI 10.17712/1658-3183.1010 · Neurosciences (Riyadh, Saudi Arabia) · 2026

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OBJECTIVES: To investigate the occurrence and characteristics of seizures using routine electroencephalograms (EEGs) in intensive care unit (ICU) patients. METHODS: We conducted a retrospective analysis on routine, portable EEGs of 188 adult ICU patients (53% male) in a large tertiary hospital in Riyadh, Kingdom of Saudi Arabia. We compared variables of interest using a t-test and chi-squared analyses and explored significant associations using binary logistic regression analysis. RESULTS: We found significant associations between the occurrence of seizures on EEGs and several variables, including patient age, ICU admission due to status epilepticus, history of epilepsy or previous neurosurgical procedure, coma state, and convulsions at the time of EEG (p < 0.05). Logistic regression analysis revealed that age, ICU admission due to status epilepticus, and a history of epilepsy were independently associated with the occurrence of seizures on EEG. Epileptiform abnormalities were observed in 14.9% of patients; periodic abnormalities were identified in 14.3%. Electrographic seizures were evident in 11.2% of patients, and 63 comatose patients did not exhibit any evidence of seizures in their EEGs. CONCLUSION: Routine EEGs play a vital role in investigating altered mental status in ICU patients, particularly for seizure evaluation. Age, ICU admission due to status epilepticus, and a history of epilepsy are significant factors associated with seizure occurrence on EEG. Future studies should validate these findings and explore the comparative effectiveness of routine and continuous EEGs in ICU settings.