Academic Journal
Effects of midazolam and propofol on EEG detection of epileptiform activity in patients with altered consciousness.
| Τίτλος: | Effects of midazolam and propofol on EEG detection of epileptiform activity in patients with altered consciousness. |
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| Συγγραφείς: | Guinchard M; Emergency Department, Lausanne University Hospital (CHUV), Lausanne, Switzerland., Rossetti AO; Department of Clinical Neurosciences, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland., Schindler K; Sleep-Wake-Epilepsy-Center, Department of Neurology, Bern University Hospital (Inselspital), University of Bern, Bern, Switzerland., Rüegg S; Department of Neurology, University Hospital Basel and University of Basel, Basel, Switzerland., Alvarez V; Department of Neurology, Hôpital du Valais, Sion, Switzerland., Novy J; Department of Clinical Neurosciences, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland. Electronic address: jan.novy@chuv.ch. |
| Πηγή: | Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology [Clin Neurophysiol] 2026 Sep; Vol. 189, pp. 2111941. Date of Electronic Publication: 2026 May 23. |
| Τύπος έκδοσης: | Journal Article; Multicenter Study; Randomized Controlled Trial |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Country of Publication: Netherlands NLM ID: 100883319 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1872-8952 (Electronic) Linking ISSN: 13882457 NLM ISO Abbreviation: Clin Neurophysiol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Amsterdam : Elsevier, c1999- |
| Ιατρικοί όροι (MeSH): | Propofol*/administration & dosage , Propofol*/therapeutic use , Propofol*/pharmacology , Electroencephalography*/drug effects , Electroencephalography*/methods , Midazolam*/administration & dosage , Midazolam*/therapeutic use , Midazolam*/pharmacology , Hypnotics and Sedatives*/therapeutic use , Hypnotics and Sedatives*/administration & dosage , Hypnotics and Sedatives*/pharmacology , Consciousness Disorders*/physiopathology , Consciousness Disorders*/drug therapy , Consciousness Disorders*/diagnosis , Epilepsy*/diagnosis , Epilepsy*/physiopathology , Epilepsy*/drug therapy, Consciousness/drug effects ; Humans ; Female ; Male ; Middle Aged ; Retrospective Studies ; Adult ; Aged |
| Περίληψη: | Objective: Midazolam and propofol are the most frequently used sedative agents in intensive care units (ICU). Their effects on EEG in patients with altered consciousness received limited attention; we aim to assess their effects on diagnostic yield for epileptiform abnormalities. Methods: This retrospective analysis of a multicenter randomized clinical trial (CERTA) included adult patients with acute consciousness disorders. All patients had EEG recordings and they were randomized 1:1 to either a continuous EEG (cEEG) or two routine EEG (rEEG). Patients were stratified according whether or not they received sedative medications and their dosage (combining midazolam and propofol). Results: We analyzed 364 patients, 246 (67.6%) received sedative medication. Median dose of propofol was 0.89 mg/kg/h and 0.08 mg/kg/h for midazolam. Sedation was more frequent in structural brain injuries, and lower consciousness scores. Epileptiform discharges were more frequent in cEEG, women, higher consciousness scores, less severe condition, in patients with antiseizure medication (ASM). Sedation was not independently associated with EEG epileptiform activity. Conclusions: Despite its potential of suppressing epileptiform activity, we found no difference in terms of detection of epileptiform activity whether patients received sedation or not. Significance: Continuously administrated sedation may have less effect on EEG than when administered in bolus. (Copyright © 2026 The Authors. Published by Elsevier B.V. All rights reserved.) |
| Competing Interests: | Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. |
| Contributed Indexing: | Keywords: Acute consciousness disorders; Critical care; Electroencephalography; Midazolam; Propofol; Sedative medication |
| Substance Nomenclature: | YI7VU623SF (Propofol) R60L0SM5BC (Midazolam) 0 (Hypnotics and Sedatives) |
| Entry Date(s): | Date Created: 20260527 Date Completed: 20260612 Latest Revision: 20260617 |
| Update Code: | 20260617 |
| DOI: | 10.1016/j.clinph.2026.2111941 |
| PMID: | 42202614 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1872-8952 |
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| DOI: | 10.1016/j.clinph.2026.2111941 |