According to the stated guidance, seizures on EEG or status epilepticus should:

• A. be used as the primary predictor of outcome.
• B. never be used to predict poor outcome.
• C. may be associated with poor outcome but should not be used alone to predict it.
• D. indicate a good prognosis when treated.

Answer: (C)

Seizures seen on EEG or a state of ongoing nonconvulsive status epilepticus after brain injury signal significant brain distress and are often linked with worse outcomes, because they reflect ongoing neuronal dysfunction and metabolic stress. But prognosis after such events cannot be based on EEG findings alone. The most trustworthy predictions come from a multimodal view that includes clinical examination (when feasible), imaging, laboratory biomarkers, and the patient’s overall trajectory over time. Treating electrographic seizures can sometimes improve outcomes, and some patients recover despite early EEG abnormalities, especially when the underlying issue is reversible and seizures are controlled. Therefore, EEG seizures or status epilepticus may be associated with poor outcome, yet they should not be used in isolation to predict prognosis.