Innovative EEG Brain Monitoring Program Provides Optimal Care for Critically Ill Patients

ChristianaCare has launched an innovative electroencephalogram (EEG) brain monitoring program that represents a significant leap forward in the diagnosis and management of neurological conditions. The easy-to-use EEG program is the first of its kind that can be performed at the bedside to measure the electrical activity of the brain, providing a vital sign for brain function to help diagnose seizures more quickly.

ChristianaCare is the first hospital system in Delaware to use the Ceribell point-of-care EEG monitoring system, which can reduce the time it takes to diagnose certain neurological conditions from hours to mere minutes. Using the system, clinicians have immediate access to EEG information so they can triage at-risk patients in just five minutes and monitor patients for treatment optimization.

“With this new program, our team of expert clinicians will have the diagnostic information they need to provide high-risk patients with the right care at the right time, ensuring the best outcomes for our patients and their families,” said Kim Gannon, M.D., Ph.D., service line leader for Neurosciences at ChristianaCare.

New technology detects ‘silent seizures’

Critically ill patients are at high risk of harmful brain electrical discharges called seizures. Some of these patients experience a type of “silent seizure” with no noticeable symptoms (non-convulsive) that can only be detected using EEG. If prolonged, non-convulsive seizures can lead to permanent brain injury and higher risk of morbidity and mortality.

^{Demonstration of EEG device on patient at ChristianaCare Newark Campus.}

As a result, guidelines from the Neurocritical Care Society recommend EEG should be initiated within 15-60 minutes when these seizures are suspected.

Meeting these guidelines has proven difficult due to the limitations of conventional EEG systems, which were not designed for use in emergency situations. Even top academic centers that have 24/7 EEG capabilities may experience wait times of four hours or more for conventional equipment. When relying on clinical judgement alone while waiting for these conventional EEG systems, diagnostic accuracy has been shown to be only slightly better than chance (65%).

The value of this new technology for patients is that it provides accurate results quickly so that the care team can intervene early.

“The neuroscience and critical care teams at ChristianaCare believe that ‘time is brain’ not only applies to stroke but also when dealing with seizure,” Gannon said.

Gannon is referring to the fact that for every minute that passes when someone is having a stroke, 1.9 million brain cells are lost, increasing the chance of disability or death. That same kind of speed and urgency can now more easily be brought to bear for patients when a seizure is suspected.

“This monitoring system is easy to use and can be set up in about five minutes,” said Richard Choi, D.O., medical director of the Neurocritical Care Unit at Christiana Hospital. “It consists of a simple headband, pocket-sized recorder with intuitive software and an on-line portal for remote viewing. Using the system, we can review EEG data, assess response to treatment and optimize care, all in real-time.”

Neurosciences at ChristianaCare

ChristianaCare’s multidisciplinary neurosciences team provides comprehensive and advanced care for neurologic illnesses across the acute and ambulatory settings. As the largest and most comprehensive neurology practice in Delaware with more than 55,000 patient visits last year, ambulatory subspecialties include stroke, epilepsy, multiple sclerosis, movement disorders, neuromuscular disorders, headaches/migraines, pediatric neurology and Botox specialists. The inpatient team of experts includes neurosurgeons, neurointerventional surgeons, neurocritical care physicians and vascular neurologists. The Newark Campus serves as the only comprehensive stroke center in the state and includes the only Epilepsy Monitoring Unit in Delaware.