TY - JOUR
T1 - Altered mental status in moderate-severe traumatic brain injury in Indonesia
T2 - the clinical manifestation and EEG features of non-convulsive status epilepticus
AU - Octaviana, Fitri
AU - Harisman, Jeffri
AU - Wiratman, Winnugroho
AU - Budikayanti, Astri
N1 - Funding Information:
This article was presented at the 5th International Conference andExhibition on Indonesian Medical Education and Research Institute (5th Medicine, Universitas Indonesia. We thank the 5th ICE on the IMERI committee, who supported the peer review and manuscript preparation before submission to the journal
Publisher Copyright:
© 2021,Heliyon.All Rights Reserved.
PY - 2021/9
Y1 - 2021/9
N2 - Introduction: Moderate-to-severe traumatic brain injury (msTBI) can cause non-convulsive status epilepticus (NCSE). Electroencephalography (EEG) is employed as a diagnostic tool due to the non-specificity of clinical symptoms. This study aimed to identify clinical and EEG features related to NCSE in patients with msTBI. Methods: This was a cross-sectional study. Suspected NCSE in msTBI was examined using EEG data collected in consecutive patients from January 2017 to December 2019 at Dr. Cipto Mangunkusumo Hospital, Jakarta. Diagnoses of NCSE were made based on clinical manifestations and EEG features using the modified Salzburg Consensus Criteria for NCSE (mSCNC). Results: Of the 39 msTBI patients, 19 were diagnosed with NCSE; only two fulfilled the definitive criteria, and the remaining were possible NCSE. Delirium and perceptual impairment were only found in NCSE, while psychomotor agitation was higher (12.8% vs. 5.1% in NCSE vs. non-NCSE). The most common EEG feature was rhythmic activity (>0.5 Hz) without fluctuation, which improved with anti-epileptic drug administration. The Glasgow Coma Scale (GCS) score at onset and at hospitalisation discharge was significantly lower in patients with NCSE. The lesions in NCSE mostly originated from the temporal lobe. Injury to the temporal lobe had a significant relationship with NCSE occurrence (p ¼ 0.036, odds ratio 11.45 [95% confidence interval 1.17–111.6]). In this study, delirium, perceptual impairment, and psychomotor agitation were confirmed as NCSE using The most common discharge originated from the injured temporal lobe, and this site was a significant factor NCSE in patients with msTBI. in msTBI cases with clinical manifestations of altered mental status, psychomotor An injured temporal lobe was a susceptible site for the development of NCSE
AB - Introduction: Moderate-to-severe traumatic brain injury (msTBI) can cause non-convulsive status epilepticus (NCSE). Electroencephalography (EEG) is employed as a diagnostic tool due to the non-specificity of clinical symptoms. This study aimed to identify clinical and EEG features related to NCSE in patients with msTBI. Methods: This was a cross-sectional study. Suspected NCSE in msTBI was examined using EEG data collected in consecutive patients from January 2017 to December 2019 at Dr. Cipto Mangunkusumo Hospital, Jakarta. Diagnoses of NCSE were made based on clinical manifestations and EEG features using the modified Salzburg Consensus Criteria for NCSE (mSCNC). Results: Of the 39 msTBI patients, 19 were diagnosed with NCSE; only two fulfilled the definitive criteria, and the remaining were possible NCSE. Delirium and perceptual impairment were only found in NCSE, while psychomotor agitation was higher (12.8% vs. 5.1% in NCSE vs. non-NCSE). The most common EEG feature was rhythmic activity (>0.5 Hz) without fluctuation, which improved with anti-epileptic drug administration. The Glasgow Coma Scale (GCS) score at onset and at hospitalisation discharge was significantly lower in patients with NCSE. The lesions in NCSE mostly originated from the temporal lobe. Injury to the temporal lobe had a significant relationship with NCSE occurrence (p ¼ 0.036, odds ratio 11.45 [95% confidence interval 1.17–111.6]). In this study, delirium, perceptual impairment, and psychomotor agitation were confirmed as NCSE using The most common discharge originated from the injured temporal lobe, and this site was a significant factor NCSE in patients with msTBI. in msTBI cases with clinical manifestations of altered mental status, psychomotor An injured temporal lobe was a susceptible site for the development of NCSE
KW - Altered mental status
KW - Moderate-severe TBI
KW - mSCNC
KW - Non-convulsive status epilepticus
UR - http://www.scopus.com/inward/record.url?scp=85120866388&partnerID=8YFLogxK
U2 - 10.1016/j.heliyon.2021.e08067
DO - 10.1016/j.heliyon.2021.e08067
M3 - Article
AN - SCOPUS:85120866388
SN - 2405-8440
VL - 7
JO - Heliyon
JF - Heliyon
IS - 9
M1 - e08067
ER -