Electroencephalography Correlation of Ketamine-induced Clinical Excitatory Movements: A Systematic Review
Background: This is a systematic review investigating the correlation between seizures identifiable on electroencephalogram (EEG), clinical excitatory movements (CEM), and ketamine administration for procedural sedation. Methods: We searched MEDLINE, EMBASE, Cochrane CENTRAL, and Web of Science in A...
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eScholarship Publishing, University of California
2024-11-01
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| Series: | Western Journal of Emergency Medicine |
| Online Access: | https://escholarship.org/uc/item/1bq9g67d |
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| author | Emine M. Tunc Neil Uspal Lindsey Morgan Sue L. Groshong Julie C. Brown |
| author_facet | Emine M. Tunc Neil Uspal Lindsey Morgan Sue L. Groshong Julie C. Brown |
| author_sort | Emine M. Tunc |
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| description | Background: This is a systematic review investigating the correlation between seizures identifiable on electroencephalogram (EEG), clinical excitatory movements (CEM), and ketamine administration for procedural sedation. Methods: We searched MEDLINE, EMBASE, Cochrane CENTRAL, and Web of Science in April 2021. Search terms included variations for ketamine, myoclonus, seizures, status epilepticus, and electroencephalography. Two independent reviewers assessed papers based on eligibility criteria, which included human studies where EEG recordings were obtained during ketamine administration. Results: Eight papers were eligible for inclusion with 141 subjects (24 children). Seven studies (133 subjects) reported epilepsy history; 70% (94/133) of these subjects had a pre-existing epilepsy diagnosis. No (0/39) subjects without epilepsy and 28% (26/94) of subjects with epilepsy had electrographic seizures after ketamine administration. In four studies where pediatric and adult subjects could be separated, children with epilepsy had electrographic seizures in 60% (3/5) of cases compared to 28% (6/33) of cases of adults with epilepsy. Of the subjects with epilepsy, 14% (10/74) had CEMs vs 5% (1/21) in subjects without epilepsy. Most CEMs (9/11) were temporally correlated with electrographic seizures. Conclusions: Our findings indicate that in subjects with epilepsy, electrographic seizures were frequently seen with ketamine administration and were correlated with CEMs. No seizure activity after ketamine was seen in subjects without epilepsy. While the clinical significance of these findings needs further investigation, clinicians may want to consider patients’ seizure history when providing counseling on the risks and benefits of ketamine sedation. |
| format | Article |
| id | doaj-art-a12042af4947472988f1c6e2cbd4ba8e |
| institution | Kabale University |
| issn | 1936-900X 1936-9018 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj-art-a12042af4947472988f1c6e2cbd4ba8e2025-02-07T16:29:04ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-900X1936-90182024-11-0126114715410.5811/westjem.1861118611Electroencephalography Correlation of Ketamine-induced Clinical Excitatory Movements: A Systematic ReviewEmine M. Tunc0Neil Uspal1Lindsey Morgan2Sue L. Groshong3Julie C. Brown4University of Texas Southwestern, Department of Pediatrics, Division of Emergency Medicine, Dallas, TexasUniversity of Washington, Department of Pediatrics, Division of Emergency Medicine, Seattle, WashingtonUniversity of Washington, Department of Pediatrics, Division of Neurology, Seattle, WashingtonSeattle Children’s Hospital and Research Institute, Library and Information Commons, Seattle, WashingtonUniversity of Washington, Department of Pediatrics, Division of Emergency Medicine, Seattle, WashingtonBackground: This is a systematic review investigating the correlation between seizures identifiable on electroencephalogram (EEG), clinical excitatory movements (CEM), and ketamine administration for procedural sedation. Methods: We searched MEDLINE, EMBASE, Cochrane CENTRAL, and Web of Science in April 2021. Search terms included variations for ketamine, myoclonus, seizures, status epilepticus, and electroencephalography. Two independent reviewers assessed papers based on eligibility criteria, which included human studies where EEG recordings were obtained during ketamine administration. Results: Eight papers were eligible for inclusion with 141 subjects (24 children). Seven studies (133 subjects) reported epilepsy history; 70% (94/133) of these subjects had a pre-existing epilepsy diagnosis. No (0/39) subjects without epilepsy and 28% (26/94) of subjects with epilepsy had electrographic seizures after ketamine administration. In four studies where pediatric and adult subjects could be separated, children with epilepsy had electrographic seizures in 60% (3/5) of cases compared to 28% (6/33) of cases of adults with epilepsy. Of the subjects with epilepsy, 14% (10/74) had CEMs vs 5% (1/21) in subjects without epilepsy. Most CEMs (9/11) were temporally correlated with electrographic seizures. Conclusions: Our findings indicate that in subjects with epilepsy, electrographic seizures were frequently seen with ketamine administration and were correlated with CEMs. No seizure activity after ketamine was seen in subjects without epilepsy. While the clinical significance of these findings needs further investigation, clinicians may want to consider patients’ seizure history when providing counseling on the risks and benefits of ketamine sedation.https://escholarship.org/uc/item/1bq9g67d |
| spellingShingle | Emine M. Tunc Neil Uspal Lindsey Morgan Sue L. Groshong Julie C. Brown Electroencephalography Correlation of Ketamine-induced Clinical Excitatory Movements: A Systematic Review Western Journal of Emergency Medicine |
| title | Electroencephalography Correlation of Ketamine-induced Clinical Excitatory Movements: A Systematic Review |
| title_full | Electroencephalography Correlation of Ketamine-induced Clinical Excitatory Movements: A Systematic Review |
| title_fullStr | Electroencephalography Correlation of Ketamine-induced Clinical Excitatory Movements: A Systematic Review |
| title_full_unstemmed | Electroencephalography Correlation of Ketamine-induced Clinical Excitatory Movements: A Systematic Review |
| title_short | Electroencephalography Correlation of Ketamine-induced Clinical Excitatory Movements: A Systematic Review |
| title_sort | electroencephalography correlation of ketamine induced clinical excitatory movements a systematic review |
| url | https://escholarship.org/uc/item/1bq9g67d |
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