The use of mexidol, MDM and HBO in the treatment of patients with encephalopathy due to poisoning with neurotoxicants on the stage of rehabilitation improved the indicators of functional brain activity and cognitive functions.

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Objective: to evaluate the indicators of electrical activity of the brain using frequency- spectral analysis and data of three- dimensional localization of sources of pathological activity for an approach to the analysis of possible neurophysiological mechanisms of the brain of patients whose EEG recorded the phenomenon of ‘burst- suppression’.Material and methods: 45 electroencephalograms recorded in 22 patients (average age 51.05; 11 women, 11 men) were analyzed. In 12 patients, the EEG study was performed in dynamics from 1 to 8 times. At the time of the first registration, the ‘burst- suppression’phenomenon was recorded in the EEG of all patients. The level of wakefulness of all patients, with the exception of patients who were under anesthesia, was 3 points on the Glasgow coma scale.EEG recording was performed on electroencephalographs ‘Encephalan-  EEGR-19/26’, ‘Mitsar-  EEG-10/70–201’, ‘Mitsar-  EEG-SmartBCI’, ‘Neuron-  Spectrum-5’and ‘Neuron- Spectrum-65’in accordance with the International scheme of arrangement of electrodes 10–20 %. A frequency- spectral analysis of the power of the ‘burst’and ‘suppression’periods was carried out — the fast Fourier transform method was used. The program ‘BrainLoc 6.1’(Russia) was used for localization of equivalent dipole sources of pathological electrical activity of the ‘burst’period.Results: during the first EEG recording, the ‘burst- suppression’phenomenon was recorded in all patients. In seven patients, the ‘burst’period in the ‘burstsuppression’phenomenon was visually represented by slow-wave oscillations, in 15 patients, the ‘burst’periods resembled epileptiform discharges. In frequency- spectral analysis EEG in all patients in the ‘burst’period, the dominance of the power of slow-wave oscillations (mainly in the delta range) was noted. According to the program ‘BrainLoc 6.1’, equivalent dipole sources of pathological activity of the ‘burst’period were recorded at the level of the thalamus, in the medio- basal parts of the frontal and temporal lobes on both sides. A favorable outcome of the ‘burst- suppression’phenomenon was observed in only five patients of 22, all other patients had an unfavorable outcome.Conclusion: a favorable outcome of the ‘burst- suppression’phenomenon was observed only in patients under sevorane anesthesia and in some patients after acute poisoning with drugs that affect the central nervous system, while patients after brain anoxia had an unfavorable outcome. In prognostic terms, our data are comparable to the literature data. The changes revealed during the frequency-spectral analysis of the EEG in the form of the dominance of the power of slow-wave oscillations (mainly in the delta range), as well as the localization of the supposed generators of electrical activity in the ‘burst’ period at the level of the thalamus, in the mediobasal parts of the frontal and temporal lobes (according to the ‘BrainLoc 6.1’program), may to some extent be consistent with the data of experimental works and mathematical models of the ‘burst–suppression’phenomenon If the ‘burst-  suppression’ phenomenon is detected during EEG registration, it is advisableto conduct a dynamic EEG study or EEG monitoring.

Objective: to assess the safety of indicators of electrical activity of the brain for the approach to the analysis of the basic neurophysiological mechanisms of the brain in patients after cardiac arrest.Materials and methods: 52 patients were examined (age — 54,68 ± 19,33) after cardiac arrest. At the time of recording the electroencephalogram (EEG), the level of wakefulness of the examined patients on the Glasgow coma scale was in the range of 3 to 13 points. In 35 patients, EEG recording was performed starting from the first three days from the moment of cardiac arrest, in 17 patients — from the fourth to the 18th day. EEG was registered on electroencephalographs ‘Encephalan–EEGR–19/26’ by ‘Medikom MTD’, ‘Neuron-Spectrum–5/EP’ and ‘Neuron-Spectrum–65’ by ‘Neurosoft’ in accordance with the recommendations of the International Federation of Clinical Neurophysiologists (IFCN). The duration of a single EEG recordings lasted at least 30 min. To localize equivalent dipole sources of pathological activity we used the program ‘BrainLoc 6.0’, (Russia). In 19 patients EEG was recorded in dynamics from 2 to 8 times.Results: all patients showed EEG changes of varying severity, which can be divided into three groups (according to the severity of changes in the EEG: moderate, severe and rough). In the group of patients with gross changes in EEG can be identified 4 variants: the first variant — absence of the alpha rhythm and the dominance of slow-wave fluctuations of the frequency spectrum; variant II — continuous generalized paroxysmal activity; variant III — phenomenon of ‘burst-suppression’; variant IV — a marked decrease in the amplitude of electrical activity of the brain to the level of 2–4 microvolt.Conclusions: based on the dynamics of the EEG pattern in patients after cardiac arrest, it is possible to assume with a certain degree of probability the level of violations in the basic mechanisms of the brain.

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