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This tool is educational and informational. It does not replace clinical judgment. Verify EEG urgency classification, NCSE risk factors, and evidence-based triage criteria against the cited source before acting.

Not prospectively validated. No clinical tool replaces bedside assessment.

This tool qualifies as non-device clinical decision support under the January 2026 FDA CDS guidance (21st Century Cures Act §3060). It does not acquire or analyze patient data, it displays the basis for its recommendations, it enables independent clinician review, and it is intended for use by trained healthcare professionals.

This runs entirely in your browser; we store nothing. Even so, enter only clinical data (age, vitals, exam findings) -- not names, MRNs, or other identifiers.

Tarvinder Singh, MD -- Vascular Neurologist. March 2026.

NeuroemergencyEpilepsy

Emergency EEG Triage

STAT vs urgent vs routine EEG in acute altered mental status.

18%

comatose ICU pts with occult NCSE

25-30%

of all SE is nonconvulsive

<1 hr

STAT EEG target for NCSE risk

Clinical Flags

Check all features present at this bedside assessment.

A. Event Context & History

Post-cardiac arrest

Resuscitated cardiac arrest survivor with altered consciousness

Acute structural brain injury

SAH, TBI, CVA, encephalitis, ADEM, CNS tumor

Prior seizures or epilepsy

Known epilepsy, prior seizure history, or recent convulsive event

B. Bedside Clinical Signs

Subtle motor phenomena

Eye deviation, facial twitching, rhythmic limb jerking, nystagmoid movements

Waxing/waning consciousness

Fluctuating alertness not fully explained by sedation or structural cause

Empiric benzodiazepine given

Lorazepam or midazolam administered empirically for suspected NCSE

C. Systemic & Pharmacologic Factors

Metabolic encephalopathy

Hypo/hypernatremia, hepatic failure, uremia, hypoglycemia, hyperammonemia

CNS infection / autoimmune encephalitis

Fever + AMS, LP pending, HSV, anti-NMDA-R, LGI1, CASPR2 suspected

Seizure-threshold-lowering drugs

Cefepime, carbapenems, tramadol, bupropion, clozapine, fluoroquinolones

Active Seizure on EEG?

If EEG confirms NCSE or refractory SE, initiate the Status Epilepticus Protocol for phase-locked weight-based treatment.

Evidence Base

Claassen et al., Neurology 2004

18% of comatose patients in medical/neuro ICU had NCSE detectable only by EEG -- not clinically apparent.

Hirsch et al., J Clin Neurophysiol 2021

ACNS 2021 critical care EEG terminology: defines ictal-interictal continuum patterns (LPDs, GPDs, LRDA) requiring urgent interpretation.

Meierkord & Holtkamp, Lancet Neurol 2007

NCSE accounts for 25-30% of all SE; mortality directly correlates with delay to EEG diagnosis and treatment.

Rossetti & Oddo, Ann Neurol 2010

Post-cardiac arrest: malignant EEG patterns (burst suppression, status epilepticus) are independent predictors of poor neurological outcome.