scholarly journals Triphasic Waves Versus Nonconvulsive Status Epilepticus: EEG Distinction

2006 ◽  
Vol 33 (2) ◽  
pp. 175-180 ◽  
Author(s):  
Jean-Martin Boulanger ◽  
Charles Deacon ◽  
Diane Lécuyer ◽  
Sylvie Gosselin ◽  
Jean Reiher
Keyword(s):  
Status Epilepticus ◽  
Clinical Diagnosis ◽  
Auditory Stimulation ◽  
Morphological Features ◽  
Nonconvulsive Status Epilepticus ◽  
Metabolic Encephalopathy ◽  
Epileptiform Discharges ◽  
Morphological Criteria ◽  
Level Of Consciousness

ABSTRACT:Background:Triphasic waves (TWs) and generalized nonconvulsive status epilepticus (GNCSE) share morphological features that may create diagnostic ambiguity.Objective::To describe electroencephalographic differences between TWs and GNCSE.Methods:We retrospectively compared the electroencephalograms (EEGs) of two groups of patients presenting with decreased level of consciousness; those with TWs associated with metabolic encephalopathy and those with GNCSE. We studied the following: demographics, etiology and EEG morphological features. All EEGs were classified blindly (TWs or GNCSE) by two expert EEGers. Agreement between experts and concordance with clinical diagnosis were measured.Results:We analysed 87 EEGs (71 patients) with TWs and 27 EEGs (13 patients) with GNCSE. Agreement between experts and concordance with clinical diagnosis were excellent. When compared to TWs, epileptiform discharges associated with GNCSE had a higher frequency (mean=2.4Hz vs 1.8Hz) (p<0.001), a shorter duration of phase one (p=0.001), extra-spikes components (69% vs 0%) (p<0.001) and less generalized background slowing (15.1% vs 91.1%) (p<0.001). Amplitude predominance of phase two was common with TWs (40.8% vs 0%) (p=0.01). Lag of phase two was absent in all cases of GNCSE but present in 40.8% of patients with TWs. Noxious or auditory stimulation frequently increased the TWs (51%) while it had no effect on the epileptiform pattern (p=0.008).Conclusion:Certain EEG morphological criteria and the response to stimulation are very helpful in distinguishing TWs from GNCSE.

Early Epileptiform Discharges and Clinical Signs Predict Nonconvulsive Status Epilepticus on Continuous EEG

2018 ◽  
Vol 29 (3) ◽  
pp. 388-395 ◽  
Author(s):  
Johannes Koren ◽  
Johannes Herta ◽  
Simone Draschtak ◽  
Georg Pötzl ◽  
Franz Fürbass ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Clinical Signs ◽  
Nonconvulsive Status Epilepticus ◽  
Epileptiform Discharges ◽  
Continuous Eeg

Nonconvulsive Status Epilepticus in Metabolic Encephalopathy in Indonesia Referral Hospital

2021 ◽  
Vol 69 (2) ◽  
pp. 354 ◽  
Author(s):  
Fitri Octaviana ◽  
AndrianiP Bestari ◽  
AnastasiaM Loho ◽  
LuhA Indrawati ◽  
Winnugroho Wiratman ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Referral Hospital ◽  
Nonconvulsive Status Epilepticus ◽  
Metabolic Encephalopathy

scholarly journals Refractory nonconvulsive status epilepticus in coma: analysis of the evolution of ictal patterns

2012 ◽  
Vol 70 (7) ◽  
pp. 501-505 ◽  
Author(s):  
Paulo Breno Noronha Liberalesso ◽  
Eliana Garzon ◽  
Elza Marcia T. Yacubian ◽  
Américo C. Sakamoto
Keyword(s):  
Status Epilepticus ◽  
Natural History ◽  
Nonconvulsive Status Epilepticus ◽  
Morbidity And Mortality ◽  
Loss Of Consciousness ◽  
Epileptiform Discharges ◽  
Neurological Morbidity ◽  
History Of ◽  
The Relationship

OBJECTIVE: Nonconvulsive status epilepticus (NCSE) is currently considered as one of the most frequent types of status epilepticus (SE). The objective of the present study was to identify the natural history of the electrographical evolution of refractory NCSE and to establish the relationship between ictal patterns and prognosis. METHODS: We analyzed, retrospectively, 14 patients with loss of consciousness and NCSE. The ictal patterns were classified as discrete seizures (DS), merging seizures (MS), continuous ictal discharges (CID), continuous ictal discharges with flat periods (CID-F), and periodic lateralized epileptiform discharges (PLEDs). RESULTS: The ictal patterns were DS (n=7; 50.0%), PLEDs (n=3; 1.4%), CID (n=2; 14.3%), MS (n=1; 7.1%), and CID-F (n=1; 7.1%). CONCLUSIONS: NCSE electrographic findings are heterogeneous and do not follow a stereotyped sequence. PLEDs were related to a higher probability of neurological morbidity and mortality.

scholarly journals Creutzfeldt-Jakob Disease Presenting as Nonconvulsive Status Epilepticus

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Aleksei Rakitin ◽  
Riina Vibo ◽  
Vaiko Veikat ◽  
Anne Õunapuu ◽  
Aive Liigant ◽  
...  
Keyword(s):  
Case Report ◽  
Status Epilepticus ◽  
Clinical Presentation ◽  
Epileptiform Activity ◽  
Epileptic Activity ◽  
Accurate Diagnosis ◽  
Morphological Features ◽  
Nonconvulsive Status Epilepticus ◽  
Spongiform Encephalopathy ◽  
Jakob Disease

Creutzfeldt-Jakob disease is a rare, rapidly progressive spongiform encephalopathy in humans. EEG plays an important role in diagnosing this disease. In some patients, epileptic activity and encephalopathy from various aetiologies may share morphological features on EEG. This similarity could create difficulties in EEG interpretation, especially if the patient presents with disturbed consciousness. In this case report, a 74-year-old female with Creutzfeldt-Jakob disease presented initially with rapidly progressive impairment of consciousness and focal epileptiform activity on EEG. An EEG performed 25 days later showed periodic sharp-wave complexes with triphasic morphology at a rate of 0.5 Hz, compatible with a diagnosis of Creutzfeldt-Jakob disease. Based on these results, we recommend that a diagnosis of Creutzfeldt-Jakob disease be considered in patients presenting with a rapid deterioration of consciousness and a clinical presentation of nonconvulsive status epilepticus. Monitoring these patients with serial EEGs could be useful to establish an accurate diagnosis.

Nonconvulsive status epilepticus in patients suffering spontaneous subarachnoid hemorrhage

2007 ◽  
Vol 106 (5) ◽  
pp. 805-811 ◽  
Author(s):  
Andrew S. Little ◽  
John F. Kerrigan ◽  
Cameron G. McDougall ◽  
Joseph M. Zabramski ◽  
Felipe C. Albuquerque ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Subarachnoid Hemorrhage ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Outcome Data ◽  
Nonconvulsive Status Epilepticus ◽  
High Rate ◽  
Treatment Regimens ◽  
Epileptiform Discharges ◽  
Fisher Grade ◽  
Spontaneous Subarachnoid Hemorrhage

Object Nonconvulsive status epilepticus (NCSE) is an underrecognized and poorly understood complication of aneurysmal subarachnoid hemorrhage (SAH). The authors evaluated the risk factors, electroencephalographic (EEG) characteristics, hospital course, and clinical outcomes associated with NCSE in a population with SAH treated at a single institution. Methods The hospitalization and outcome data were reviewed in 11 patients who had received a diagnosis of NCSE and SAH. The study included individuals from a cohort of 389 consecutive patients with SAH who were treated between March 2003 and June 2005, and who were analyzed retrospectively. The patients' medical history, neurological grade, events of hospitalization, EEG morphological patterns, and disposition were analyzed. Advanced age, female sex, need for ventriculostomy, poor neurological grade (Hunt and Hess Grade III, IV, or V), thick cisternal blood clots, and structural lesions (intracerebral hemorrhage and stroke) were common in the population with NCSE. Patients with normal results on angiograms, good neurological grade (Hunt and Hess Grade I or II), and minimal SAH (Fisher Grade 1 or 2) were at lower risk. The most common ictal patterns were intermittent, and consisted of generalized periodic epileptiform discharges. Medical complications were also frequent, and the outcome of these patients was poor despite aggressive treatment regimens. Conclusions Nonconvulsive status epilepticus is a devastating complication of SAH with a high rate of associated morbidity. Based on these findings it appears that the patients at highest risk for NCSE can be identified, and this should provide a basis for further studies designed to determine the clinical significance of various EEG patterns and to develop preventative strategies.

Triphasic waves on electroencephalogram in patients with encephalopathy and their diagnosis significance. A review

2021 ◽  
pp. 38-43
Author(s):  
E. A. Baranova ◽  
M. V. Sinkin
Keyword(s):  
Status Epilepticus ◽  
High Amplitude ◽  
Subcortical White Matter ◽  
Nonconvulsive Status Epilepticus ◽  
Metabolic Disturbances ◽  
Metabolic Encephalopathy ◽  
Continuous Eeg ◽  
Continuous Eeg Monitoring ◽  
Low Amplitude ◽  
Eeg Pattern

Triphasic waves are high-amplitude (>70 µV) positive sharp transients preceded and followed by relatively low-amplitude negative waves. The distribution is generalized and tends to have a repetition rate of approximately 1 to 2 Hz. This EEG-pattern is traditionally associated with hepatic encephalopathy, although they have been observed in a wide array of neurological disorders including subcortical white-matter disease, infections, metabolic disturbances and nonconvulsive status epilepticus.American Clinical Neurophysiology Society suggested Standardized Critical Care EEG Terminology (2012). One of the goals was to eliminate terms with clinical connotations, such as ‘triphasic waves’, a term that implies a metabolic encephalopathy with no relationship to seizures for many clinicians. The term ‘triphasic waves’ was replaced by ‘Generalized periodic discharges (GPDs) with triphasic morphology’. The clinical significance ofthese waveforms and their relationship with seizures and prognosis has been debated, and differentiation between interictal patterns, patternsassociated with seizures, and the patterns representing nonconvulsive status epilepticus have been concluded to be a challenge. In cases of uncertainty, the decision to treat should follow on a thorough evaluation with a continuous EEG monitoring and using a short-acting benzodiazepine or non-sedating antiepileptic drugs in order to discern the effects of the pattern on the patient’s clinical exam and EEG.

scholarly journals Topography of generalized periodic epileptiform discharges in postanoxic nonconvulsive status epilepticus

2017 ◽  
Vol 2 (4) ◽  
pp. 472-475 ◽  
Author(s):  
Dimitris Fotis Sakellariou ◽  
George Kostantinos Kostopoulos ◽  
Mark Philip Richardson ◽  
Michalis Koutroumanidis
Keyword(s):  
Status Epilepticus ◽  
Nonconvulsive Status Epilepticus ◽  
Epileptiform Discharges
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