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Ictal Interictal Continuum Patterns

  • Critical Care Neurology (KN Sheth, Section Editor)
  • Published:
Current Treatment Options in Neurology Aims and scope Submit manuscript

Abstract

Purpose of review

To present data available on the epidemiology and significance of rhythmic and periodic patterns that lie on the ictal interictal continuum and propose an algorithm for the clinical approach to patients exhibiting these patterns.

Recent findings

There is accumulating evidence on the prognostic implications of various rhythmic and periodic patterns in the critically ill population. These patterns are not only associated with increased seizure risk but have also been associated with worse outcome and increased long-term risk of epilepsy in recent studies. There is emerging evidence suggesting that certain EEG features as well as ancillary studies including serum, neuroimaging, and invasive multimodality monitory can assist in the risk stratification of neuronal injury associated with these patterns, allowing for a targeted approach to these patterns.

Summary

We present a case illustrating the clinical nuances of these patterns. We propose an algorithm for a personalized and targeted approach to ictal interictal patterns based on risk stratification according to clinical, EEG, imaging, and invasive monitoring markers.

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Authors and Affiliations

  1. Department of Neurology, Henry Ford Hospital, Detroit, Michigan, 48202, USA

    Gamaleldin M. Osman MD

  2. Federal University of Ceará School of Medicine, Fortaleza, CE, 60430-160, Brazil

    Davi F. Araújo MD-candidate

  3. Department of Neurology. Neurocritical Care Division, Yale University School of Medicine, New Haven, CT, 06520, USA

    Carolina B. Maciel MD

  4. Department of Neurology, Neurocritical Care Division, McKnight Brain Institute, 1149 Newell Dr/L3-185, Gainesville, FL, 32610, USA

    Carolina B. Maciel MD

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  1. Gamaleldin M. Osman MD
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  2. Davi F. Araújo MD-candidate
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  3. Carolina B. Maciel MD
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Correspondence to Carolina B. Maciel MD.

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Osman, G.M., Araújo, D.F. & Maciel, C.B. Ictal Interictal Continuum Patterns. Curr Treat Options Neurol 20, 15 (2018). https://doi.org/10.1007/s11940-018-0500-y

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