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42 Cards in this Set
- Front
- Back
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Common patterns in coma states |
Lethargic Stuporous Light coma Profound coma |
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Lethargic in EEG |
Mild to moderate slowing Theta may be background or theta/alpha mix EEG is reactive, increased frequencies seen |
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Stuporous in EEG |
More delta slowing seen May still see alpha when fully alerted |
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Light coma in EEG |
Diffuse delta, EEG responsive to tactile or auditory stimulation |
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Profound coma in EEG |
Diffusely abnormal, may be burst suppression or ECI |
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Slowing: 3 patterns |
1. Background slowing without diffuse theta or delta 2. Diffuse theta and delta with normal background 3. Slow background with diffuse theta and delta |
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In general, slow background indicates... |
Cortical dysfunction |
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In general, the delta-theta slow waves signify... |
White matter disease |
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In general, if there is a slow background and theta/delta, it indicates... |
Dysfunction of both |
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Background slowing without diffuse delta |
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Normal background with delta intermixed |
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Slow background and theta/delta |
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Delta coma |
Widespread delta without theta or alpha background High voltage with or without reactivity to stimuli Low voltage, typically non-reactive |
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Diffuse delta with theta background |
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Delta coma, high amplitude |
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Delta coma, worse because low amp and low reactivity |
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Alpha coma |
Abundant alpha activity Diffuse or anterior dominant Non-reactive to external stimuli Little to no slow activity Poor prognosis Most commonly seen with brain stem lesions, severe trauma Transitional pattern to low voltage pattern, burst suppression, and ECI |
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Alpha coma |
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Theta coma |
Similar to alpha coma but slightly slower waveforms Brief suppression’s seen Also very poor prognosis May see in transition to alpha coma |
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Theta coma |
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?apindle |
Suppression with tactile stimulation- not a good thing but better than seeing no change what so ever |
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Spindle coma |
Diffuse slow with spindle activity seen Components may be more frontal V-waves and K-complexes also seen Most commonly seen with traumatic brain injury Others such as anoxia, viral encephalitis, subarchanoid hemorrhage, drug intoxication Better prognosis with k-complexes seen- reactive Patient is not arousable Typically better prognosis than other coma types, may see as cerebral function is improving |
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Spindle coma |
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Spindle coma with propofol infusion |
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What does the EEG show with brain death? |
Shows no cerebral activity over 2 uV when recording from scalp electrode pairs 10 or more centimeters apart |
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Beta coma |
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Beta with sedation |
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Spindle coma with propofol infusion |
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Burst suppression |
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Burst suppression |
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Beta with sedation |
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Burst suppression with sedation |
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Burst suppression |
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Burst suppression |
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Burst suppression may also be seen with... |
Sedation during procedures or surgical monitoring. Medically induced coma may be required with refractive SE -neurologist wants a burst every 5-10 second -burst suppression is maintained for a period of time -pentobarbital, midazolam used |
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ECI |
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Low voltage EEG |
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IV drip artifact |
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Stimulating patient |
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Photo cell artifact |
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Artifact improved |
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Electrocerebral inactivity |
Must rule out causes for reversible ECI -hypothermia(<32C, more likely <20C) -barbiturate or sedative drug intoxication -sever metabolic derangements |
