Dr. Naim believes that postoperative CEEG is warranted to identify seizures because they are associated with worse neurodevelopmental outcomes. Recognizing seizures opens treatment with medications or other therapies to reduce seizure occurrence. Dr. Naim acknowledged that there is a lack of high-level data demonstrating that seizure treatment can improve outcomes in high-risk children, such as those undergoing cardiac surgery. However she cited the findings of the Boston Circulatory Arrest Study that showed that postoperative seizure occurrence was the medical variable most consistently related to worse long term neuropsychologic outcomes.
Dr. Backer and Dr. Marino raise another pragmatic issue: the costs and manpower required for CEEG, such as EEG technologists 24/7 and use of comprehensive 12-scalp electrode monitoring. "This level of sophisticated monitoring, of course, is not available at all institutions. What we need is a screening tool that is not as labor intensive. This would remove the expense and staffing associated with full EEG monitoring for the 92% of patients who do not have seizures."
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