. 2023 May 23;25(1):9–19. doi: 10.1016/j.ccrj.2023.04.004

Table 2.

Summary of international guidelines and consensus statements on cEEG in the ICU.

Society/body	Summary of recommendations
American Clinical Neurophysiology Society⁶^,⁷^,⁹^,¹⁶¹	- Diagnosis of ESz, ESE, and paroxysmal events (recommended) - Assessment of efficacy of therapy for seizures and status epilepticus (recommended) - Identification of cerebral ischaemia (suggested) - Monitoring of sedation and high-dose intravenous anaesthetic therapy (suggested) - Assessment of severity of encephalopathy and prognostication (proposed)
International Multidisciplinary Consensus Conference on Multimodality Monitoring in Neurocritical Care⁵^,¹⁵⁹	- All patients with TBI and unexplained and persistent altered consciousness (strong recommendation, low quality of evidence) - ECSE with no return to functional baseline within 60 min after ASM and patients with refractory ESE (strong recommendation, low quality of evidence) - During therapeutic hypothermia and within 24 h of rewarming to exclude ESz in all comatose patients after cardiac arrest (strong recommendation, low quality of evidence) - Comatose ICU patients without an acute primary brain condition and with unexplained impairment of mental status or unexplained neurological deficits to exclude ESz, particularly in those with severe sepsis or renal/hepatic failure (weak recommendation, low quality of evidence)
European Academy of Neurology³	- Not waking 60 min post convulsive status epilepticus (Grade 1C evidence) - Refractory status epilepticus (Grade 1C evidence) - TBI, SAH, CH, encephalitis with unexplained altered consciousness (Grade 1C evidence) - Cardiac arrest with persistent coma (Grade 1C evidence) - Unexplained altered consciousness without primary brain injury (Grade 1 B evidence) - Severe TBI with high-risk features, e.g., large contusion (Grade 2C evidence) - Acute ischaemic stroke with unexplained altered consciousness (Grade 2D evidence) - Other nonseizure indications, e.g., SAH-associated cerebral ischaemia, prognostication in all ICU patients with unexplained coma, prognostication in cardiac arrest with persistent coma, prognostication in encephalitis with unexplained coma (Grade 2C evidence)
Neurointensive care section (European Society of Intensive Care Medicine)²	- Refractory SE: recommend urgent (within 60 min) cEEG in patients (strong recommendation, low quality of evidence—grade 1C) - TBI, SAH, ICH: recommend cEEG to rule out ESz in all patients with unexplained and persistent altered consciousness (strong recommendation, low quality of evidence—grade 1C). - Stroke: suggest cEEG to rule out ESz in all patients with unexplained and/or persistently altered consciousness (weak recommendation, very low quality of evidence—grade 2D) - Coma after cardiac arrest: recommend cEEG during therapeutic hypothermia and within 24 h after rewarming to rule out ESz in all patients (strong recommendation, low quality of evidence—grade 1C). - Infectious and noninfectious encephalitis: recommend cEEG if comatose or have unexplained neurological deficits to rule out ESz (strong recommendation, low quality of evidence—grade 1C) - Comatose ICU patients without primary brain injury: suggest cEEG if unexplained impairment of mental status or unexplained neurological deficits to rule out ESz, particularly in those with severe sepsis or renal/hepatic failure (weak recommendation, low quality of evidence—grade 2C).