Train of four stimulation artifact mimicking a seizure during computerized automated ICU EEG monitoring

Abstract

A 54-year-old man was admitted to the intensive care unit with an aneurysmal subarachnoid hemorrhage and subsequently underwent mechanical ventilation and received neuromuscular blocking drugs to control refractory elevated intracranial pressure. During quantitative EEG monitoring, an automated alert was triggered by the train of four peripheral nerve stimulation artifacts. Real-time feedback was made possible due to remote monitoring. This case illustrates how computerized, automated artificial intelligence algorithms can be used beyond typical seizure detection in the intensive care unit for remote monitoring to benefit patient care.

Keywords

• Peripheral nerve stimulation
• Electroencephalogram
• Quantitative EEG
• Automatic seizure detection
• Intensive care unit