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Metabolic and Inflammatory Cerebral Diseases: Electrophysiological Aspects

Published online by Cambridge University Press:  18 September 2015

G.B. Young*
Affiliation:
Department of Clinical Neurological Sciences, The London Health Sciences Centre, London, Ontario
*
Department of Clinical Neurological Sciences, London Health Sciences Centre, 375 South Street, London, Ontario, Canada N6A 4G5
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Abstract

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The electroencephalogram (EEG) is an important diagnostic tool in coma. Although comatose patients may be similar on neurological examination, the EEG reveals a wide range of abnormalities. For metabolic and septic encephalopathies, the “anesthesia model” is a useful analogy. The EEG is very sensitive to the depth or severity of brain dysfunction in coma as well as the direction of the process if serial tracings or continuous recordings are used. While the EEG is rarely specific for the etiology of coma, it may help determine the class or general category of disease process. In conditions capable of causing neuronal death, e.g., anoxia-ischemia, the EEG can be of prognostic value.

Type
Research Article
Copyright
Copyright © Canadian Neurological Sciences Federation 1998

References

REFERENCES

1.Glaser, G. Metabolic, endocrine and toxic diseases. In: Remond, A , ed. Handbook of Electroencephalography and Clinical Neurophysiology. Amsterdam: Elsevier 1972-1977; 15: 15C-3-15C-15.Google Scholar
2.Creutzfeldt, OD, Meisch, JJ. Changes in cortical neuronal activity and EEG changes during hypoglycemia. In: Hernandez-Peon, E,. ed. The Physiological Basis of Mental Activity. Electroencephalogr Clin Neurophysiol 1963; Suppl 24: 158171.Google ScholarPubMed
3.Young, GB, Leung, LS, Campbell, V, et al. The electroencephalogram in metabolic/toxic coma. Am J EEG Technol 1992; 32: 243259.CrossRefGoogle Scholar
4.Hockaday, JM, Potts, F, Epstein, C, Bonazzi, A, Schwabb, RS. Electroencephalographic changes in acute cerebral anoxia from cardiac or respiratory arrest. Electroencephalogr Clin Neurophysiol 1965; 18: 575586.CrossRefGoogle ScholarPubMed
5.Young, GB, Bolton, CF, Austin, TW, Archibald, Y, Wells, GA. The encephalopathy associated with septic illness. Clin Investig Med 1990; 13: 297304.Google ScholarPubMed
6.Hughes, JR. Limitations of the EEG in coma and brain death. Ann NY Acad Sci 1978; 315: 121136.CrossRefGoogle ScholarPubMed
7.Paschen, W, Bengtsson, F, Rohn, G, et al. Cerebral polyamine metabolism in reversible hypoglycemia in the rat: relation to energy metabolism and calcium. J Neurochem 1991; 57: 204215.CrossRefGoogle Scholar
8.Aoki, Y, Lombroso, CT. Prognostic value of electroencephalography in Reye’s syndrome. Neurology 1973; 23: 333343.CrossRefGoogle ScholarPubMed
9.Yamada, T, Young, S, Kimura, J. Significance of positive spike bursts in Reye syndrome. Arch Neurol 1977; 34: 376380.CrossRefGoogle ScholarPubMed
10.Stockard, JJ, Bickford, RG. The neurophysiology of anesthesia. In: Gordon, E, ed. A Basis and Practice of Neuroanesthesia. 2 Amsterdam: Excerpta Medica 1975: 346.Google Scholar
11.Turrell, RC, Roseman, E. Electroencephalographic studies of the encephalopathies. IV. Serial studies in meningococcal meningitis. Arch Neurol Psychiatry 1955; 73: 141148.CrossRefGoogle Scholar
12.Vas, GA, Cracco, JB. Diffuse encephalopathies. In: Daly, DD, Pedley, TA, eds. Current Practice of Clinical Electroencephalography. New York: Raven Press, 1990: 371399.Google Scholar
13.Gloor, P, Kalabay, O, Giard, N. The electroencephalogram in diffuse encephalopathies. Brain 1968; 91: 779802.CrossRefGoogle Scholar
14.Illis, LS, Taylor, FM. The electroencephalogram in herpes simiplex encephalitis. Lancet 1972; 1: 718721.CrossRefGoogle ScholarPubMed
15.Gupta, PC, Seth, P. Periodic complexes in herpes simplex encephalitis. A clinical and experimental study. Electroencephalogr Clin Neurophysiol 1973; 35: 6774.CrossRefGoogle ScholarPubMed
16.Skoldenberg, B, Forsgren, M, Alestig, K, et al. Acyclovir versus vidarabine in herpes simplex encephalitis. Lancet 1984; 2: 707711.CrossRefGoogle ScholarPubMed
17.Young, GB, Bolton, CF, Austin, TW, Archibald, Y, Wells, GA. The electroencephalogram in sepsis-associated encephalopathy. J Clin Neurophysiol 1992; 9: 145152.CrossRefGoogle ScholarPubMed
18.Fishgold, H, Mathis, P. Obnubilations Comas et stupeurs: etudes electroencephalographiques. Electroencephalogr Clin Neurophysiol 1959; Suppl 11: 2768.Google Scholar
19.Karnaze, DS, Bickford, RG. Triphasic waves: a reassessment of their significance. Electroencephalogr Clin Neurophysiol 1984: 57: 193198.CrossRefGoogle ScholarPubMed
20.Cant, BR, Shaw, NA, Monitoring by compressed spectral array in prolonged coma. Neurology 1984; 34: 3539.CrossRefGoogle ScholarPubMed
21.Sharbrough, FW. EEG in different states of consciousness, purposeful responsiveness, including comatose and vegetative states. Presented at American EEG Society Meeting, June 9, 1981.Google Scholar
22.Young, GB, Blume, WT, Campbell, VM, et al. Alpha, theta and alpha-theta coma: a clinical outcome study using serial recordings. Electroencephalogr Clin Neurophysiol 1994; 91: 9299.CrossRefGoogle Scholar
23.Synek, VM. Validity of a revised EEG coma scale for predicting survival in anoxic encephalopathy. Clin Exp Neurol 1989; 26: 119127.Google ScholarPubMed
24.Hockaday, JM, Potts, F, Epstein, E, Bonazzi, A, Schwabb, RS. Electroencephalographic changes in acute cerebral anoxia from cardiac or respiratory arrest. Electroencephalogr Clin Neurophysiol 1965; 18: 575586.CrossRefGoogle ScholarPubMed
25.Rae-Grant, AD, Barbour, PJ, Reed, J. Development of a novel EEG rating scale for head injury using dichotomous variables. J Clin Neurophysiol 1991; 79: 349357.Google ScholarPubMed
26.Hughes, JR, Boshes, B, Leesma, J. Electroclinical and pathological correlations in comatose patients. Clin EEG 1976; 7: 1330.Google Scholar
27.Synek, VM. Prognostically important EEG coma patterns in diffuse anoxic and traumatic encephalopathies in adults. J Clin Neurophysiol 1988; 5: 161174.CrossRefGoogle ScholarPubMed
28.Aoki, Y, Lombroso, CT. Prognostic value of electroencephalography in Reye’s syndrome. Neurology 1973; 23: 333343.CrossRefGoogle ScholarPubMed
29.Hansotia, P, Gottschalk, P, Green, P, Zais, D. Spindle coma: incidence, clinicopathological correlates and prognostic value. Neurology 1981; 31: 8387.CrossRefGoogle ScholarPubMed
30.Nuwer, MR. Quantitative EEG: I. Techniques and problems of frequency analysis and topographic mapping. J Clin Neurophysiol 1988; 5: 143.CrossRefGoogle Scholar
31.Nuwer, MR. Quantitative EEG: II. Frequency analysis and topographic mapping in clinical settings. J Clin Neurophysiol 1988; 5: 4585.CrossRefGoogle ScholarPubMed
32.Bickford, RG. Newer methods of recording and analyzing EEGs. In: Klass, DW, Daly, DD, eds. Current Practice of Clinical Electroencephalography. New York: Raven Press, 1979: 451480.Google Scholar
33.Chiappa, KH, Hoch, DB. Electrophysiologic monitoring. In: Ropper, AH, ed. Neurological and Neurosurgical Intensive Care. 3rd Edition. New York: Raven, 1993: 147183.Google Scholar
34.Hill, RA, Chiappa, KH. Electrophysiological monitoring in the intensive care unit. Can J Neurol Sci 1994; 21: S12-S16.CrossRefGoogle ScholarPubMed
35.Chen, R, Bolton, CF, Young, GB. Prediction of outcome in patients with anoxic coma: a clinical and electroencephalograhic study. Crit Care Med 1996; 24: 672678.CrossRefGoogle Scholar
36.Madl, C, Grim, G, Kramer, L, et al. Early prediction of individual outcome after cardiopulmonary resuscitation. Lancet 1993; 341: 855858.CrossRefGoogle ScholarPubMed
37.Young, GB, McLachlan, RS, Kreeft, JH, Demelo, JD. An electroencephalographic classification for coma. Can J Neurol Sci, 1997; 24: 320325.CrossRefGoogle ScholarPubMed