Status epilepticus is a life-threatening and time-sensitive emergency. Continuous EEG monitoring allows the detection of electrographic seizures and electrographic status epilepticus. Increasing evidence guides best practices for which patients to monitor for these conditions and appropriate duration of monitoring. The treatment of SE consists of benzodiazepines, non-benzodiazepines, antiepileptic drugs, and continuous infusions; cEEG monitoring is helpful in assessing the response to treatment. Interpretation of EEG after electrographic seizures requires care, as some patterns on the ictal-interictal continuum may be challenging. This chapter reviews current evidence regarding neuromonitoring and the management of status epilepticus and recurrent seizures.

EEG is useful to make prognostic estimations and evaluate for nonconvulsive seizures post cardiac arrest. Unfavorable EEG patterns portend poor outcomes, whereas early improvements including restoration of physiological rhythms are associated with better outcomes. The EEG has limitations; it should not be used in isolation to make prognostic estimations. Highly malignant EEG patterns are specifically associated with poor outcomes. Individual malignant patterns have low sensitivity and specificity for poor outcomes. Benign patterns (absence of malignant features) suggest favorable outcomes. Seizures and status epilepticus are common post cardiac arrest and may contribute to poor outcomes. Myoclonic status epilepticus is characterized by prolonged cortical myoclonus. Early myoclonic status epilepticus post cardiac arrest is typically associated with poor prognosis.