Seizure Management in the ICU

In this episode of Critical Matters, Dr. Sergio Zanotti interviews Dr. Brandon Foreman about the management of seizures in the intensive care unit (ICU). Dr. Foreman emphasizes the surprisingly high incidence of seizures in ICU patients, particularly non-convulsive seizures, and the importance of early diagnosis and treatment to prevent secondary brain injuries. The discussion covers the main causes of seizures in ICU patients, diagnostic approaches including EEG, and treatment strategies, including the use of benzodiazepines and other anti-seizure drugs. They also discuss status epilepticus, refractory status epilepticus, and the ictal-interictal continuum, as well as new technologies for continuous EEG monitoring and seizure prophylaxis. Dr. Foreman stresses the importance of cognitive flexibility and hope in managing brain disorders in the ICU.