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Abstract Details

LRDA and LPDs EEG patterns association with seizures in critically ill patients: a systematic review
Epilepsy/Clinical Neurophysiology (EEG)
Epilepsy/Clinical Neurophysiology (EEG) Posters (7:00 AM-5:00 PM)
028
Conduct a systematic review to identify and compare the risk of seizures in critically ill patients with lateralized rhythmic delta activity (LRDA) and lateralized periodic discharges (LPDs) EEG patterns.
LPDs and LRDA are EEG patterns usually seen in critically ill ICU patients and associated with structural brain lesions such as intracranial and subarachnoid hemorrhage, encephalitis and tumors. It is well known that LPDs are associated with increased risk of seizures; however, LRDA is a newer term which was first studied and published in 2013 and was also found to be associated with increased risk of seizures.
We reviewed demographic data, EEG findings and risk of seizures based on EEG pattern in studies comparing LRDA to LPDS in critically ill patients with altered mental status. We searched for articles from January 2000 to October 2020 using the PubMed and EMBASE databases including retrospective studies, case reports and series. Search terms included LRDA, LPDs, EEG and Seizure. Our search resulted in 17 papers. We included 5 papers (n= 5461 patients) in this review.
All patients had altered mental status and were critically ill admitted to ICU. Most patients were male (60%). The median age was lower for patients with LRDA compared to those with LPDs; 54 years and 63 years respectively. One third of patients with LRDA had associated LPDs. LPDs was associated with seizures in 57% of cases compared to 46% in patients with LRDA. Interestingly, the risk for seizures was the highest in those patients who had both LPDS+LRDA (relative risk=65%).
Presence of LPDs, LRDA or both carries a high risk for seizures. Continuous video EEG monitoring is mandatory in this category of patients to guide treatment. While LPDs carries higher seizures risk than LRDA, our review indicated that LPDs and LRDA combined carries the highest risk for seizures.
Authors/Disclosures
Faisal A. Ibrahim, MD (Cleveland Clinic Foundation)
PRESENTER 		Dr. Ibrahim has nothing to disclose.
Ahmed Abbas, MD Dr. Abbas has nothing to disclose.
Ammar Tarabichi, MD Dr. Tarabichi has nothing to disclose.
Mohamed Tom, MD (.) Dr. Tom has received personal compensation for serving as an employee of Allegheny General Hospital . Dr. Tom has received personal compensation for serving as an employee of Mercy Hospital St. Louis .
Abdullah Al Sawaf, MD (Endeavor Health) Dr. Al Sawaf has nothing to disclose.