SeizuresNCT03419260
Electrographic Seizure Management and Neurobehavioral Outcomes in Critically Ill Children
An observational study of Seizures, run by Children's Hospital of Philadelphia at 1 site in United States.
Trial summary
Electrographic seizures are common in critically ill patients leading to increased use of resource-intense continuous EEG monitoring for seizure identification and management. When identified, electrographic seizures are generally treated with anti-seizure medications, but there are very limited data available… Read more about this study
- Who is it for?
- Ages 1 month to 18 years
- Conditions the study is for
- Seizures
- What is being tested?
- Clinically indicated EEG monitoring.
- How many people
- 2,500 participants
- Where
- 1 siteUnited States
- Study dates
- 13 Mar 2017to 1 Jan 2028
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 1 month to 18 years
- All sexes
- No healthy volunteers
- Child, Adult
Study population: This study is a prospective observational study of consecutive patients undergoing clinically indicated EEG monitoring in the Children's Hospital of Philadelphia Pediatric ICU as guided by an institutional ICU EEG Monitoring Pathway. Each subject will participate from the time of EEG monitoring initiation until the time of hospital discharge. This duration will generally be from several days to several weeks depending on the duration of the hospitalization.
Who may be able to join
- Care in the Children's Hospital of Philadelphia Pediatric ICU.
- Clinically indicated continuous EEG monitoring.
- Age > 1 month to 18 years.
Who cannot join
- Admitted for Phase 2 (intracranial) EEG monitoring.
- Intensivist expects to discontinue technological support in the next two days given underlying medical or neurological problems.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
United States1 site, 1 recruiting
- Recruiting
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, 19104
Nichoals S Abend, MD, 215-590-1719
About this study
Electrographic seizures are common in critically ill patients leading to increased use of resource-intense continuous EEG monitoring for seizure identification and management. When identified, electrographic seizures are generally treated with anti-seizure medications, but there are very limited data available regarding optimal treatment in terms of the efficacy or safety of specific anti-seizure medications or overall management strategies.
This is a single-center prospective observational study. The investigators aim to: (1) track critically ill patients undergoing clinically indicated EEG monitoring and seizure management to identify risk factors for electrographic seizures, (2) create prediction models guiding EEG monitoring resources to the patients at highest risk for seizures, and (3) evaluate our current management strategy in terms of safety.
Read the detailed description
Context: Electrographic seizures are common in critically ill patients leading to increased use of resource-intense continuous EEG monitoring for seizure identification and management. When identified, electrographic seizures are generally treated with anti-seizure medications, but there are very limited data available regarding optimal treatment in terms of specific medication selections or overall management strategies. The Children's Hospital of Philadelphia (CHOP) has a formal ICU EEG Monitoring Pathway aiming to standardize EEG monitoring and seizure management. This is a single-center prospective observational study of patients undergoing clinically indicated EEG monitoring to identify risk factors for electrographic seizures and create prediction models guiding limited EEG monitoring resources to the patients at highest risk for seizures, and also to evaluate the current seizure management strategy in terms of safety.
Objectives: The primary objective is to identify risk factors for electrographic seizures in critically ill patients and use these risk factors to create and validate a seizure prediction model. The secondary objective is to evaluate the safety of a targeted and timely electrographic seizure identification and management strategy among critically ill patients guided by a CHOP ICU EEG Monitoring Pathway.
Study Design: Single center observational study of consecutive patients undergoing clinically indicated EEG monitoring.
Setting/Participants: Single-center study of critically ill children in the Pediatric ICU at CHOP undergoing clinically indicated EEG monitoring and seizure management.
- Conditions
- Seizures
- Being tested
- Clinically indicated EEG monitoring.
- Keywords
- seizures, status epilepticus, EEG monitoring
- Medical subject headings
- Seizures, Status Epilepticus
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Clinically indicated EEG monitoring.Other
Children enrolled in the study will be undergoing clinically indicated EEG monitoring. Some children will undergo clinically indicated electrographic seizure management.
| Study group | Role | What they receive |
|---|---|---|
| Cohort | Critically ill child undergoing clinically indicated EEG monitoring and electrographic seizure management. Receives: Other: Clinically indicated EEG monitoring. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Electrographic Seizure Occurrence
Percentage of subjects who experience electrographic seizures.
Measured: 3 days
Secondary outcomes (4)
Safety - Mortality
Percentage of subjects with mortality related to electrographic seizure management.
Measured: 5 days
Safety - Occurrence of Cardiopulmonary adverse effects
Percentage of subjects with cardiopulmonary adverse effects related to electrographic seizure management. Cardiopulmonary problems include subcategories of anaphylactic reactions, bradycardia (<5th percentile for age), hypotension (<5th percentile for age), hypoxemia (saturation <90%), lactic acidosis (>2 mmol/l), and intubation requirement.
Measured: 5 days
Safety - Occurrence of Organ Dysfunction
Percentage of subjects with organ dysfunction adverse effects related to electrographic seizure management. Organ dysfunction that will include subcategories of allergic skin manifestations, acute kidney injury, hepatitis and acute liver injury, coagulopathy, and cytopenias (rbc, wbc, platelets).
Measured: 5 days
Safety -Occurrence of Hospital Acquired Infections
Percentage of subjects with hospital acquired infection adverse effects related to electrographic seizure management. Hospital acquired infections that will include subcategories of central line associated bloodstream infections, urinary tract infection, and ventilator associated pneumonia.
Measured: 5 days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted1 Feb 2018
- Study start13 Mar 2017
- Primary completion1 Jan 2028 (estimated)
- Study completion1 Jan 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (10)Papers the sponsor has linked to this study.
- Other trials for SeizuresStudies of the same condition, open and under way.
- More trials run by Children's Hospital of PhiladelphiaThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 2,500 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Children's Hospital of Philadelphia
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Nicholas S Abend, MD, Principal investigator, Children's Hospital of Philadelphia
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03419260
- Sponsor's protocol ID
- 17-013808
- Other IDs
- K02NS096058
- Status last verified
- Jun 2026
- First submitted
- 24 Jan 2018
- Last updated
- 29 Jun 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Fung FW, Jacobwitz M, Vala L, Parikh D, Donnelly M, Xiao R, Topjian AA, Abend NS. Electroencephalographic seizures in critically ill children: Management and adverse events. Epilepsia. 2019 Oct;60(10):2095-2104. doi: 10.1111/epi.16341. Epub 2019 Sep 20.
PubMed 31538340Fung FW, Jacobwitz M, Parikh DS, Vala L, Donnelly M, Fan J, Xiao R, Topjian AA, Abend NS. Development of a model to predict electroencephalographic seizures in critically ill children. Epilepsia. 2020 Mar;61(3):498-508. doi: 10.1111/epi.16448. Epub 2020 Feb 20.
PubMed 32077099Fung FW, Parikh DS, Donnelly M, Xiao R, Topjian AA, Abend NS. Electrographic Seizure Characteristics and Electrographic Status Epilepticus Prediction. J Clin Neurophysiol. 2025 Jan 1;42(1):64-72. doi: 10.1097/WNP.0000000000001068. Epub 2024 Jan 9.
PubMed 38194638Fung FW, Parikh DS, Massey SL, Fitzgerald MP, Vala L, Donnelly M, Jacobwitz M, Kessler SK, Xiao R, Topjian AA, Abend NS. Periodic Discharges in Critically Ill Children: Predictors and Outcome. J Clin Neurophysiol. 2024 May 1;41(4):297-304. doi: 10.1097/WNP.0000000000000986. Epub 2023 Dec 1.
PubMed 38079254Fung FW, Parikh DS, Donnelly M, Jacobwitz M, Topjian AA, Xiao R, Abend NS. EEG Monitoring in Critically Ill Children: Establishing High-Yield Subgroups. J Clin Neurophysiol. 2024 May 1;41(4):305-311. doi: 10.1097/WNP.0000000000000995. Epub 2023 Mar 8.
PubMed 36893385Fung FW, Fan J, Parikh DS, Vala L, Donnelly M, Jacobwitz M, Topjian AA, Xiao R, Abend NS. Validation of a Model for Targeted EEG Monitoring Duration in Critically Ill Children. J Clin Neurophysiol. 2023 Nov 1;40(7):589-599. doi: 10.1097/WNP.0000000000000940. Epub 2022 Apr 20.
PubMed 35512186Fung FW, Parikh DS, Massey SL, Fitzgerald MP, Vala L, Donnelly M, Jacobwitz M, Kessler SK, Topjian AA, Abend NS. Periodic and rhythmic patterns in critically ill children: Incidence, interrater agreement, and seizures. Epilepsia. 2021 Dec;62(12):2955-2967. doi: 10.1111/epi.17068. Epub 2021 Oct 12.
PubMed 34642942Fung FW, Wang Z, Parikh DS, Jacobwitz M, Vala L, Donnelly M, Topjian AA, Xiao R, Abend NS. Electrographic Seizures and Outcome in Critically Ill Children. Neurology. 2021 May 31;96(22):e2749-e2760. doi: 10.1212/WNL.0000000000012032.
PubMed 33893203Fung FW, Parikh DS, Jacobwitz M, Vala L, Donnelly M, Wang Z, Xiao R, Topjian AA, Abend NS. Validation of a model to predict electroencephalographic seizures in critically ill children. Epilepsia. 2020 Dec;61(12):2754-2762. doi: 10.1111/epi.16724. Epub 2020 Oct 16.
PubMed 33063870Fung FW, Fan J, Vala L, Jacobwitz M, Parikh DS, Donnelly M, Topjian AA, Xiao R, Abend NS. EEG monitoring duration to identify electroencephalographic seizures in critically ill children. Neurology. 2020 Sep 15;95(11):e1599-e1608. doi: 10.1212/WNL.0000000000010421. Epub 2020 Jul 20.
PubMed 32690798
Study at a glance
From the registry record, last updated by the sponsor on 29 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Electrographic Seizure Management and Neurobehavioral Outcomes in Critically Ill Children
- ClinicalTrials.gov ID
- NCT03419260
- Acronym / sponsor ID
- 17-013808
- Conditions
- Seizures
- Keywords
- seizures, status epilepticus, EEG monitoring
- Study type
- Observational
- Recruitment status
- Recruiting
- Enrolment
- 2,500 participants (estimated)
- Lead sponsor
- Children's Hospital of PhiladelphiaUniversity, hospital or other
- Collaborators
- National Institute of Neurological Disorders and Stroke (NINDS)
- Study start
- 13 Mar 2017 (actual)
- Primary completion
- 1 Jan 2028 (estimated)
- Study completion
- 1 Jan 2028 (estimated)
- First posted
- 1 Feb 2018 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Electrographic seizures are common in critically ill patients leading to increased use of resource-intense continuous EEG monitoring for seizure identification and management. When identified, electrographic seizures are generally treated with anti-seizure medications, but there are very limited data available regarding optimal treatment in terms of the efficacy or safety of specific anti-seizure medications or overall management strategies.
This is a single-center prospective observational study. The investigators aim to: (1) track critically ill patients undergoing clinically indicated EEG monitoring and seizure management to identify risk factors for electrographic seizures, (2) create prediction models guiding EEG monitoring resources to the patients at highest risk for seizures, and (3) evaluate our current management strategy in terms of safety.
Detailed description
Context: Electrographic seizures are common in critically ill patients leading to increased use of resource-intense continuous EEG monitoring for seizure identification and management. When identified, electrographic seizures are generally treated with anti-seizure medications, but there are very limited data available regarding optimal treatment in terms of specific medication selections or overall management strategies. The Children's Hospital of Philadelphia (CHOP) has a formal ICU EEG Monitoring Pathway aiming to standardize EEG monitoring and seizure management. This is a single-center prospective observational study of patients undergoing clinically indicated EEG monitoring to identify risk factors for electrographic seizures and create prediction models guiding limited EEG monitoring resources to the patients at highest risk for seizures, and also to evaluate the current seizure management strategy in terms of safety.
Objectives: The primary objective is to identify risk factors for electrographic seizures in critically ill patients and use these risk factors to create and validate a seizure prediction model. The secondary objective is to evaluate the safety of a targeted and timely electrographic seizure identification and management strategy among critically ill patients guided by a CHOP ICU EEG Monitoring Pathway.
Study Design: Single center observational study of consecutive patients undergoing clinically indicated EEG monitoring.
Setting/Participants: Single-center study of critically ill children in the Pediatric ICU at CHOP undergoing clinically indicated EEG monitoring and seizure management.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Cohort | – | Other: Clinically indicated EEG monitoring.Critically ill child undergoing clinically indicated EEG monitoring and electrographic seizure management. |
Who may qualify
- Ages
- 1 month to 18 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult
- Study population
- This study is a prospective observational study of consecutive patients undergoing clinically indicated EEG monitoring in the Children's Hospital of Philadelphia Pediatric ICU as guided by an institutional ICU EEG Monitoring Pathway. Each subject will participate from the time of EEG monitoring initiation until the time of hospital discharge. This duration will generally be from several days to several weeks depending on the duration of the hospitalization.
Key inclusion criteria (3 listed)
- Care in the Children's Hospital of Philadelphia Pediatric ICU.
- Clinically indicated continuous EEG monitoring.
- Age > 1 month to 18 years.
Key exclusion criteria (2 listed)
- Admitted for Phase 2 (intracranial) EEG monitoring.
- Intensivist expects to discontinue technological support in the next two days given underlying medical or neurological problems.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Clinically indicated EEG monitoring.Children enrolled in the study will be undergoing clinically indicated EEG monitoring. Some children will undergo clinically indicated electrographic seizure management. | Other | Cohort |
Primary outcome
Electrographic Seizure Occurrence
Time frame: 3 days
Percentage of subjects who experience electrographic seizures.
4 secondary outcomes
Safety - Mortality
Time frame: 5 days
Safety - Occurrence of Cardiopulmonary adverse effects
Time frame: 5 days
Safety - Occurrence of Organ Dysfunction
Time frame: 5 days
Safety -Occurrence of Hospital Acquired Infections
Time frame: 5 days
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 Jun 2026.
- Background: PubMed 31538340Fung FW, Jacobwitz M, Vala L, Parikh D, Donnelly M, Xiao R, Topjian AA, Abend NS. Electroencephalographic seizures in critically ill children: Management and adverse events. Epilepsia. 2019 Oct;60(10):2095-2104. doi: 10.1111/epi.16341. Epub 2019 Sep 20.
- Background: PubMed 32077099Fung FW, Jacobwitz M, Parikh DS, Vala L, Donnelly M, Fan J, Xiao R, Topjian AA, Abend NS. Development of a model to predict electroencephalographic seizures in critically ill children. Epilepsia. 2020 Mar;61(3):498-508. doi: 10.1111/epi.16448. Epub 2020 Feb 20.
- Background: PubMed 38194638Fung FW, Parikh DS, Donnelly M, Xiao R, Topjian AA, Abend NS. Electrographic Seizure Characteristics and Electrographic Status Epilepticus Prediction. J Clin Neurophysiol. 2025 Jan 1;42(1):64-72. doi: 10.1097/WNP.0000000000001068. Epub 2024 Jan 9.
- Background: PubMed 38079254Fung FW, Parikh DS, Massey SL, Fitzgerald MP, Vala L, Donnelly M, Jacobwitz M, Kessler SK, Xiao R, Topjian AA, Abend NS. Periodic Discharges in Critically Ill Children: Predictors and Outcome. J Clin Neurophysiol. 2024 May 1;41(4):297-304. doi: 10.1097/WNP.0000000000000986. Epub 2023 Dec 1.
- Background: PubMed 36893385Fung FW, Parikh DS, Donnelly M, Jacobwitz M, Topjian AA, Xiao R, Abend NS. EEG Monitoring in Critically Ill Children: Establishing High-Yield Subgroups. J Clin Neurophysiol. 2024 May 1;41(4):305-311. doi: 10.1097/WNP.0000000000000995. Epub 2023 Mar 8.
- Background: PubMed 35512186Fung FW, Fan J, Parikh DS, Vala L, Donnelly M, Jacobwitz M, Topjian AA, Xiao R, Abend NS. Validation of a Model for Targeted EEG Monitoring Duration in Critically Ill Children. J Clin Neurophysiol. 2023 Nov 1;40(7):589-599. doi: 10.1097/WNP.0000000000000940. Epub 2022 Apr 20.
- Background: PubMed 34642942Fung FW, Parikh DS, Massey SL, Fitzgerald MP, Vala L, Donnelly M, Jacobwitz M, Kessler SK, Topjian AA, Abend NS. Periodic and rhythmic patterns in critically ill children: Incidence, interrater agreement, and seizures. Epilepsia. 2021 Dec;62(12):2955-2967. doi: 10.1111/epi.17068. Epub 2021 Oct 12.
- Background: PubMed 33893203Fung FW, Wang Z, Parikh DS, Jacobwitz M, Vala L, Donnelly M, Topjian AA, Xiao R, Abend NS. Electrographic Seizures and Outcome in Critically Ill Children. Neurology. 2021 May 31;96(22):e2749-e2760. doi: 10.1212/WNL.0000000000012032.
- Background: PubMed 33063870Fung FW, Parikh DS, Jacobwitz M, Vala L, Donnelly M, Wang Z, Xiao R, Topjian AA, Abend NS. Validation of a model to predict electroencephalographic seizures in critically ill children. Epilepsia. 2020 Dec;61(12):2754-2762. doi: 10.1111/epi.16724. Epub 2020 Oct 16.
- Background: PubMed 32690798Fung FW, Fan J, Vala L, Jacobwitz M, Parikh DS, Donnelly M, Topjian AA, Xiao R, Abend NS. EEG monitoring duration to identify electroencephalographic seizures in critically ill children. Neurology. 2020 Sep 15;95(11):e1599-e1608. doi: 10.1212/WNL.0000000000010421. Epub 2020 Jul 20.
- Individual participant dataSharing planned: No
Related trials for Seizures
RecruitingPhase 3
Investigate Efficacy and Safety of Carisbamate as Adjunctive Treatment for Seizures Associated With LGS in Children and Adults
Seizures, Lennox Gastaut Syndrome
RecruitingPhase 3
Study Evaluating the Efficacy and Safety of RAP-219 in Adult Participants With Focal Seizures
Focal Seizure, Epilepsy
RecruitingPhase 3
A Study to Test the Efficacy and Safety of Staccato Alprazolam in Study Participants 12 Years of Age and Older With Stereotypical Prolonged Seizures
Stereotypical Prolonged Seizures
RecruitingPhase 3
Study Evaluating the Efficacy and Safety of RAP-219 in Adult Participants With Focal Seizures FOCUS-1
Focal Seizure, Epilepsy
Not yet recruitingPhase 4
Study of Electrocardiogram (ECG) Safety of Sezaby in Neonatal Seizures
Neonatal Seizure
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Nicholas S Abend, MD principal investigator
Children's Hospital of Philadelphia
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Seizures, run by Children's Hospital of Philadelphia at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 29 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Nicholas S Abend, MD (215-590-1719, abend@chop.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Electrographic Seizure Occurrence (time frame: 3 days). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03419260, which also lists 10 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Jun 2026.