Prognostic value of periodic electroencephalographic discharges for neurological patients with profound disturbances of consciousness.
OBJECTIVE
To examine if periodic EEG discharges (PDs) predict poor outcome and development of epilepsy in patients with acute brain illnesses irrespective of underlying cerebral pathology.


METHODS
In case-control study we retrospectively analyzed outcome of 102 patients with PDs and 102 age-, gender- and etiology matched controls without PDs.


RESULTS
Of cases, 46.1% had lateralized PDs (LPDs), 3.9% bilateral PDs (BIPDs), 15.7% generalized PDs (GPDs) and 34.3% had combinations thereof.


BACKGROUND
Stroke was most common cause of LPDs (53%), cardiac arrest of GPDs (10.5%), previous stroke, CNS infection, anoxia and metabolic encephalopathy all caused 1 case of BIPDs.


RESULTS
Mortality rate and acquired disability was significantly higher in patients with PDs than in controls, odds ratio (OR) 2.5, 95% CI 1.43-4.40 (p = 0.001). Patients with PDs without superimposed EEG activity had worse outcome than patients with superimposed EEG activity. Tardive epilepsy: Patients with LPDs associated with fast superimposed EEG activity (LPDs-plus) had higher risk for tardive epilepsy than patients with LPDs alone (p = 0.034).


CONCLUSIONS
PDs predicted poor functional outcome and patients with LPDs-plus had higher risk for later development of epilepsy.


CONCLUSIONS
Detailed evaluation of PDs provided valuable prognostic information in neurological patients with disturbed consciousness.
Department of Clinical Neurophysiology, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark.
Gyrithe L
GL
Pedersen
Stine B
SB
Rasmussen
Jesper
J
Gyllenborg
Krisztina
K
Benedek
Martin
M
Lauritzen
D000368:Aged; D000927:Anticonvulsants / Q000494:pharmacology / Q000627:therapeutic use; D015331:Cohort Studies; D003244:Consciousness Disorders / Q000145:classification / Q000209:etiology / Q000503:physiopathology*; D004569:Electroencephalography; D004827:Epilepsy / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000150:complications / Q000503:physiopathology*; D059906:Neuroimaging; D011379:Prognosis; D012307:Risk Factors; D017741:Survivors; D016896:Treatment Outcome
D000927:Anticonvulsants