Impact of periictal nurse interventions on postictal generalized EEG suppression in generalized convulsive seizures

- Generalized postictal EEG suppression (PGES) is considered an EEG marker for SUDEP risk.
- Mixed findings have been reported on the impact of peri-ictal interventions on the occurrence and duration of PGES.
- Peri-ictal interventions shorten the duration of PGES, but early administration of oxygen did not prevent its occurrence.
- Peri-ictal interventions may reduce SUDEP risk, but whether early administration of oxygen affects PGES is uncertain.

ObjectivesThe objective of this study was to determine the impact of periictal nurse interventions on postictal generalized EEG suppression (PGES) in generalized convulsive seizures (GCS).MethodsWe retrospectively reviewed the video-EEG recordings of patients during long-term video-EEG monitoring. We compared the duration of seizures, seizure phases (tonic, clonic, and tonic-clonic phases), and the occurrence and duration of postictal generalized EEG suppression (PGES) in patients with and without periictal interventions (e.g., oxygen administration, suctioning, and repositioning). Statistical analyses were performed to determine the association between the seizure-related variables and the periictal interventions.ResultsA total of 109 patients with 150 GCS were included in the study. Periictal interventions were provided in 122 GCS, of which, ictal administration of oxygen was provided in 29 GCS. The duration of PGES was significantly shortened in GCS with interventions when compared with those without interventions (p = 0.003). However, the ictal administration of oxygen, assessed as an independent variable, did not influence the occurrence or duration of PGES.ConclusionPeriictal interventions significantly shortened the duration of PGES, and may, as a consequence, reduce the risk of SUDEP. However, ictal administration of oxygen did not influence the occurrence or duration of PGES.