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EEG im Status epilepticus und bei Enzephalopathie

Diagnostische Möglichkeiten und Grenzen

EEG in status epilepticus and encephalopathy

Diagnostic possibilities and limits

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Zusammenfassung

Der Status epilepticus ist ein medizinischer Notfall und bedarf der sofortigen Therapie. Klinisch pragmatische Gründe sprechen für die Einteilung in konvulsive Status (CSE) und nichtkonvulsive Status (NCSE). Das EEG ist wesentlich für die Diagnose des NCSE. Bei Fehlen eindeutiger klinischer Hinweise ist die Diagnose eines Status epilepticus nur mithilfe des EEG zu stellen. Eine besondere Herausforderung stellen hierbei komatöse Patienten dar. Die Spannbreite des EEG bei den Enzephalopathien ist sehr groß, lässt sich aber in Verlangsamungen und rhythmische EEG-Koma-Muster einteilen. Typische Muster in Abhängigkeit von der Schwere der Enzephalopathie werden vorgestellt.

Abstract

Status elepiticus is a medical emergency and requires immediate treatment. Clinically pragmatic reasons argue for a division into convulsive status (CSE) and nonconvulsive status (NCSE). The EEG is essential for diagnosis of NCSE. If distinct clinical symptoms are lacking, the EEG can assist in the diagnosis of status epilepticus. A special challenge is the presentation of comatose patients. The spectrum of the EEG in encephalopathies is very broad and can be divided into slow and rhythmic EEG coma patterns. Typical patterns depending on the severity of the encephalopathy are presented.

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Notes

  1. MELAS ist das Akronym für Myopathie-Enzephalopathie-Laktatacidose-Schlaganfall.

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  1. Epilepsie-Zentrum, Neurologische Klinik und Poliklinik, Klinikum der Universität München-Großhadern, Marchioninistr. 15, 81377, München, Deutschland

    B. Feddersen &  S. Noachtar

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  1. B. Feddersen
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  2. S. Noachtar
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Correspondence to S. Noachtar.

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Feddersen, B., Noachtar, S. EEG im Status epilepticus und bei Enzephalopathie. Z. Epileptol. 24, 286–291 (2011). https://doi.org/10.1007/s10309-011-0208-4

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