ICU and Continuous EEG Monitoring Flashcards
7 cards from real EEG practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 ICU and Continuous EEG Monitoring flashcards as text
In a mechanically ventilated ICU patient, which artifact most commonly mimics rhythmic ictal activity on cEEG and must be systematically excluded?
Answer: Ventilator artifact
Ventilator artifact produces rhythmic movement-related potentials synchronous with breathing cycles that can closely resemble rhythmic epileptiform activity, especially in frontal and central channels.
Which of the following best defines the 'treatment threshold' concept for periodic discharges on the ictal-interictal continuum?
Answer: Treatment decisions depend on clinical context, imaging, and metabolic variables rather than EEG alone
The ictal-interictal continuum requires clinical integration — treatment thresholds depend on the overall clinical picture, not solely on discharge frequency or morphology.
What does a 'stimulus-induced rhythmic, periodic, or ictal discharges' (SIRPIDs) pattern indicate in a comatose ICU patient?
Answer: Preserved cortical reactivity with potential for seizure provocation
SIRPIDs indicate that the cortex retains reactivity to external stimuli but responds with potentially epileptiform activity, suggesting an irritable cortex susceptible to seizure induction.
In the setting of acute liver failure, which EEG pattern is characteristic and reflects hepatic encephalopathy grade III-IV?
Answer: Frontal dominant triphasic waves with anterior-to-posterior lag
Triphasic waves with a characteristic anterior-to-posterior phase lag are the classic EEG signature of moderate-to-severe hepatic encephalopathy, reflecting diffuse metabolic cortical dysfunction.
During cEEG monitoring in a TBI patient, what does the appearance of 'breach rhythm' indicate?
Answer: Skull defect causing amplitude enhancement and frequency changes
Breach rhythm occurs over skull defects (craniectomy or fracture) where the missing bone allows higher amplitude and sharper-appearing waveforms due to reduced electrical filtering.
Which cEEG finding in a post-cardiac arrest patient at 72 hours is most predictive of poor neurological outcome, even when therapeutic hypothermia has been applied?
Answer: Persistent burst suppression with isoelectric interburst intervals
Persistent burst suppression with flat (isoelectric) interburst intervals at 72 hours post-arrest is one of the strongest EEG predictors of poor neurological prognosis, even after therapeutic hypothermia.
When a cEEG technologist notes an abrupt change from background suppression to high-amplitude rhythmic activity during routine care in an ICU patient, what is the FIRST appropriate step?
Answer: Notify the interpreting neurologist and document the clinical state at onset
The technologist's immediate responsibility is to alert the interpreting neurologist and document concurrent clinical findings; treatment decisions are made by the physician after EEG review.