{
  "abstract": "Background ICANS is a life-threatening neurological toxicity occurring in 50% of patients treated with CAR T-cell therapy. Advances in understanding its pathophysiology, recognition, and management have improved outcomes. However, in the absence of randomised controlled trials, management strategies vary across published guidelines.Methods A retrospective observational study of EEG use and utility in ICANS management at University College London Hospitals (UCLH) haemato-oncology service between May 2019 - December 2022.Results ICANS occurred in 48% patients treated(100/208), clinical seizure activity in 11%(11/100), EEG performed in 48% (48/100).Mild EEG abnormalities in 73% patients with low grade (LG) and 33% of patients with high grade (HG) ICANS. Mild to moderate EEG abnormalities in 11% with HG and 9% LG ICANS. Moderate and severe EEG abnormalities only in HG ICANS. A strong correlation between EEG abnormalities and ICANS severity (τ = 0.265, p = 0.039).10.6% of EEGs in HG ICANS were normal.EEG findings directly impacted treatment decisions in 17% patients. Escalation of anti-seizure therapy in 50% (NCSE), immunosuppression de-escalation in 37.5% (serial improvement in slow wave activity) and 12.5% treatment for viral encephalitis (EEG: features).Conclusion EEG is not a sensitive and specific diagnostic biomarker in ICANS but can guide therapeutic decision making.frederick.vonberg@nhs.net",
  "authors": [
    {
      "affiliations": [
        "National Hospital for Neurology",
        "Department of Neurology, Imperial College Hospital, London"
      ],
      "name": "Wijayendran S Bhairavi"
    },
    {
      "affiliations": [
        "National Hospital for Neurology",
        "Department of Neuromuscular Diseases, Institute of Neurology, University College London, London"
      ],
      "name": "Vonberg Frederick"
    },
    {
      "affiliations": [
        "Department of Haematology, University College London Hospitals"
      ],
      "name": "Malik Imran"
    },
    {
      "affiliations": [
        "Department of Neurophysiology, University College London Hospitals"
      ],
      "name": "Holder David"
    },
    {
      "affiliations": [
        "Department of Haematology, University College London Hospitals"
      ],
      "name": "O’Reilly Maeve"
    },
    {
      "affiliations": [
        "Department of Haematology, University College London Hospitals",
        "Cancer Institute, University College London"
      ],
      "name": "Roddie Claire"
    },
    {
      "affiliations": [
        "National Hospital for Neurology",
        "Department of Neuromuscular Diseases, Institute of Neurology, University College London, London"
      ],
      "name": "Carr Aisling"
    }
  ],
  "title": "130 Use and utility of EEG in immune effector cell-associated neurotoxicity syndrome (ICANS)",
  "uid": "a1ee5770-6a7e-5835-9411-2ce116789615"
}