Clinical Significance of Periodic EEG Patterns

Kuroiwa, Yoshihiro; Celesia, Gastone G.

doi:10.1001/archneur.1980.00500500045005

Cited by 165 publications

(115 citation statements)

References 37 publications

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“…Triphasic waves were traditionally described as an electrographic phenomenon consisting of periodic sharp waves with a triphasic "check mark" waveform in association with metabolic encephalopathies from hepatic or renal etiology [66], or alternatively after anoxic-ischemic encephalopathy, Creutzfeldt-Jakob disease, or toxicity from lithium, valproate, or baclofen toxicity [67][68][69][70][71]. Other conditions causing triphasic waves include brainstemdiencephalic tumors or infarcts, or alternatively diffuse or multifocal encephalopathy from vascular white matter disease or lymphoma [72].…”

Section: Triphasic Waves and Discharges With Triphasic Morphologymentioning

confidence: 99%

The Utility of EEG, SSEP, and Other Neurophysiologic Tools to Guide Neurocritical Care

Rosenthal

2012

Neurotherapeutics

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Neuromonitoring is an emerging field that aims to characterize real-time neurophysiology to tailor therapy for acute injuries of the central nervous system. While cardiac telemetry has been used for decades among patients requiring critical care of all kinds, neurophysiology and neurotelemetry has only recently emerged as a routine screening tool in comatose patients. The increasing utilization of electroencephalography in comatose patients is primarily due to the recognition of the common occurrence of nonconvulsive seizures among comatose patients, the development of quantitative measures to detect regional ischemia, and the appreciation of electroencephalography phenotypes that indicate prognosis after cardiac arrest. Other neuromonitoring tools, such as somatosensory evoked potentials have a complementary role, surveying the integrity of the neuroaxis as an indicator of prognosis or illness progression in both acute brain and spinal injuries.

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Section: Triphasic Waves and Discharges With Triphasic Morphologymentioning

confidence: 99%

The Utility of EEG, SSEP, and Other Neurophysiologic Tools to Guide Neurocritical Care

Rosenthal

2012

Neurotherapeutics

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“…Various hypotheses have been proposed to explain the appearance of periodic patterns in EEGs (10,(15)(16)(17)(18), easily occurs in the cerebral cortex, especially in the parietooccipital region, basal ganglia and cerebellum (2). In anoxic coma, such a wide range of damageto the cortex and subcortex may play an important role in producing a variety of periodic patterns by transforming electrical discharges from thalamus, brainstem reticular formation, and hippocampus.…”

Section: Discussionmentioning

confidence: 99%

“…However, the prognostic relevance of EEGshas not been established. Periodic patterns of EEGshave been noticed in several neurological diseases including anoxic brain damage (9,10). However, various periodic patterns such as generalized patterns of periodic suppression bursts, periodic slow-wave complexes, repetitive sharp transients, and periodic triphasic waves, which were classified by Kuroiwa and Celesia (10), have not been correlated with prognosis of patients after resuscitation.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Value of Electroencephalogram(EEG) in Anoxic Encephalopathy after Cardiopulmonary Resuscitation: Relationship among Anoxic Period, EEG Grading and Outcome.

Yamashita

Morinaga²,

Ohgo

et al. 1995

Intern. Med.

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We studied the prognostic applicability of electroencephalograms (EEGs) of seventy-nine patients within 24 hours after successful cardiopulmonary resuscitation. The EEGswere classified into five grades according to a modified Hockaday's scale. The EEGs of grades I and II implied full recovery, while those of grade III gave a varied but generally unfavorable prognosis. Patients with grades IV and V EEGssurvived in a vegetative condition or died without awakening. Eighteen patients showed EEGwith periodic patterns, all of which led to a fatal or vegetative outcome. One case showed EEGs associated with periodic triphasic waves and repetitive sharp transients in the same record. Several cases showed EEGswith different periodic patterns in consecutive records.Weconclude that an EEGis a good indicator of patient prognosis after cardiopulmonary resuscitation. However, the clinical significance of morphological differences of various periodic patterns that can occur during an EEGremains to be established. (Internal Medicine 34: 71-76, 1995)

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“…Among the clinical manifestations, seizures are the most important and striking feature associated with PLEDs, occurring with a frequency from 58 to 100% 2,[8][9][10][11] . This wide range probably reflects the heterogeneity of patient selection and study design.…”

mentioning

confidence: 99%

“…This wide range probably reflects the heterogeneity of patient selection and study design. Focal motor seizures are usually seen in this clinical setting, often presenting as status epilepticus (epilepsia partialis continua) or as repetitive focal motor seizures 2,[8][9][10][11] .…”

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confidence: 99%

Periodic electroencephalographic patterns: usefulness of definition and classification

Garzón¹

2012

Arq. Neuro-Psiquiatr.

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F ourteen years after Cobb and Hill 1 first applied the term 'periodic' to characteristic electroencephalographic (EEG) changes, in 1950, Chatrian et al. 2 identified a periodic and lateralized pattern, which they described as periodic lateralized epileptiform discharges (PLEDs). The acronym encapsulates the essential characteristics of PLEDs, namely, wide distribution, polymorphism, one or more sharp components in a repetitive way (usually at the rate of one to two seconds), and localization over the hemisphere. Subsequent studies have described other variable periodic patterns as two independent PLED types in the same EEG (BIPLEDs), multifocal PLEDs, generalized periodic epileptiform discharges (GPEDs), and stimulus-induced rhythmic, periodic, or ictal discharges (SIRPIDs) [3][4][5][6] .PLEDs are usually observed in the context of acute, large, and destructive cortical processes, such as hemispheric stroke, supratentorial tumor, or encephalitis. Corresponding widespread lesions are thought to lead to a marginal zone of cortical hyperexcitability that serves as the 'pacemaker' for a spatially extended, synchronous EEG discharge 7 . Neuroimaging findings have demonstrated that while an acute cortical lesion is the most common structural substrate of PLEDs, subcortical lesions, chronic lesions, and nonlesional scans are not uncommon 7 . The spatially variable nature of brain lesions in PLEDs could point to their origin in variable segments of a cortical and subcortical ' system', assuming that it -whatever its precise components are -comprises a large-scale interconnected network, prone to synchronous oscillation springing from injury to any component 7 .Despite the frequent use of the term periodic, little attention has been paid to, or agreement reached on, how periodicity is defined or how the term should be used with respect to EEG phenomena. It has been suggested that the rate for a given patient should not vary more than 20% 8 . However, the method of measurement, the number of intervals that should be measured, and the putative clinical relevance of this value have not been discussed.Most of these studies were retrospective, with EEGs being performed at arbitrary and widely varying time points in the course of the disease, with detailed information about these variables being provided in only a few instances. The importance of EEG timing in the detection of epileptiform abnormalities has not been generally appreciated, despite the fact that at least one study has clearly demonstrated that the incidence of periodic EEG patterns increases when they are performed earlier in the course of the disease process 8,9 .Among the clinical manifestations, seizures are the most important and striking feature associated with PLEDs, occurring with a frequency from 58 to 100% 2,[8][9][10][11] . This wide range probably reflects the heterogeneity of patient selection and study design. Focal motor seizures are usually seen in this clinical setting, often presenting as status epilepticus (epilepsia partialis continua) or as ...

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Clinical Significance of Periodic EEG Patterns

Cited by 165 publications

References 37 publications

The Utility of EEG, SSEP, and Other Neurophysiologic Tools to Guide Neurocritical Care

The Utility of EEG, SSEP, and Other Neurophysiologic Tools to Guide Neurocritical Care

Prognostic Value of Electroencephalogram(EEG) in Anoxic Encephalopathy after Cardiopulmonary Resuscitation: Relationship among Anoxic Period, EEG Grading and Outcome.

Periodic electroencephalographic patterns: usefulness of definition and classification

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