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Neurology

Monitoring in neurology

Neurological monitoring is critical in the ICU for assessing consciousness, seizures, and intracranial pressure in critically ill patients. Many neurological conditions, including stroke, traumatic brain injury (TBI), status epilepticus, and intracranial hypertension, require timely recognition and continuous monitoring to prevent secondary brain injury.

This section provides:

  • Guidance on neurological examination, including challenges posed by sedation and mechanical ventilation.
  • Electroencephalography (EEG) interpretation to detect seizures and altered brain activity.
  • Intracranial pressure (ICP) monitoring, crucial for managing brain injuries and preventing herniation.
  • Integration of imaging, electrophysiology, and clinical assessment for a comprehensive neurological evaluation.

By combining systematic bedside examination with advanced neuromonitoring tools, ICU professionals can enhance early diagnosis, optimize treatment strategies, and improve neurological outcomes in critically ill patients.


Neurological examination

Guideline

Neurological examination

Neurological examination of critically ill patients: a pragmatic approach. Report of an ESICM expert panel

Tarek Sharshar et al., Intensive Care Medicine (2014)

What’s inside

This article outlines a pragmatic approach to neurological examination in critically ill patients, providing practical guidelines for ICU professionals. It highlights how to assess neurological function despite challenges like sedation and mechanical ventilation.

Why it’s relevant

Neurological assessment is vital in the ICU to detect conditions like intracranial hypertension or seizures. This approach helps ICU professionals conduct accurate exams despite the complexities of critical care environments.

Key focus

  • Step-by-step neurological examination in critically ill patients
  • Assessing consciousness, cognition, and motor function
  • Overcoming challenges like sedation and intubation
  • Use of imaging and electrophysiology as adjuncts

Takeaway

This article equips ICU professionals with a systematic approach to neurological exams, aiding in accurate assessment and better management of critically ill patients.

Electroencephalography (EEG)

Review

Electroencephalography (EEG) in the ICU

Introduction to interpretation of the EEG in intensive care

L Sewell et al., BJA Education (2018)

What’s inside

This article introduces the interpretation of EEG in the ICU, providing an overview of key patterns, clinical relevance, and practical techniques for monitoring and diagnosing neurological conditions in critically ill patients.

Why it’s relevant

EEG is an important tool in the ICU for assessing brain activity, especially in patients with altered consciousness, seizures, or neurological impairment. This guide is essential for ICU professionals to improve diagnostic accuracy and patient management.

Key focus

  • Basics of EEG interpretation and key patterns to recognize
  • Use of EEG in monitoring neurological status in critically ill patients
  • Identifying seizures, non-convulsive status epilepticus, and other abnormalities
  • Practical tips for integrating EEG findings with clinical decision-making

Takeaway

This article provides ICU professionals with essential knowledge on EEG interpretation, helping to enhance neurological monitoring and improve patient care in the ICU.

Intracranial pressure monitoring

For monitoring in patients with intracranial hypertension, see here.

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