High-Frequency Oscillations in the Scalp EEG of Intensive Care Unit Patients With Altered Level of Consciousness

Purpose: In comatose patients, distinguishing between nonconvulsive status epilepticus and diffuse structural or metabolic encephalopathies is often challenging. Both conditions can generate periodic discharges on EEG with similar morphology and periodicity. We investigated the occurrence of high-frequency oscillations—potential biomarkers of epileptogenesis—on scalp EEG of comatose patients with periodic discharges in the EEG. Methods: Fifteen patients were included. Patients were divided into three groups, according to underlying etiology: Group 1, seizure related; group 2, structural; group 3, nonstructural. EEG recordings were compared with respect to the presence and rates of gamma (30–80 Hz) and ripples (80–250 Hz). Results: Patients were 23 to 106 years old (median, 68 years); 60% were female. 206 channels were eligible for analysis (median, 15 channels/patient). Overall, 43% of channels showed gamma, and 24% had ripples. Group 2 showed the highest proportion of channels with gamma (47%), followed by group 1 (38%) and group 3 (36%). Mean gamma rates were higher in group 2 (4.65 gamma/min/channel) than in group 1 (1.52) and group 3 (1.44) (P
Source: Journal of Clinical Neurophysiology - Category: Neurology Tags: Original Research Source Type: research