Skip to main content
SpringerLink
Log in
Book cover

Status Epilepticus pp 43–64Cite as

Periodic EEG Patterns

  • Chapter
  • First Online:

  • 1590 Accesses

Part of the book series: Current Clinical Neurology ((CCNEU))

Abstract

Periodic and rhythmic patterns are encountered with increasing frequency as continuous electroenchephalography (EEG) monitoring is adopted more widely across hospitals and intensive care units for seizure detection and brain monitoring. A standardized nomenclature has provided a common way to describe these abnormal patterns. Periodic and rhythmic discharges in most cases do not point to a specific underlying diagnosis, but instead represent a common expression of a variety of underlying pathologies. Lateralized periodic discharges in particular may independently impact outcome, and there is mounting evidence that periodic discharges exacerbate underlying acute brain injury. Lateralized and generalized periodic discharges, lateralized rhythmic delta, and stimulus-induced rhythmic, periodic, or ictal discharges are highly associated with electrographic seizures during continuous EEG monitoring, and it is critical to consider any periodic or rhythmic pattern as potentially indicative of an epileptic seizure if there is a clinical correlate, evidence of ongoing neuronal injury, or a positive response to an anti-seizure medication.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. DeLorenzo RJ, Waterhouse EJ, Towne AR, Boggs JG, Ko D, DeLorenzo GA, et al. Persistent nonconvulsive status epilepticus after the control of convulsive status epilepticus. Epilepsia. 1998;39(8):833–40.

    Article  CAS  PubMed  Google Scholar 

  2. Drislane FW, Schomer DL. Clinical implications of generalized electrographic status epilepticus. Epilepsy Res. 1994;19(2):111–21.

    Article  CAS  PubMed  Google Scholar 

  3. Husain AM, Horn GJ, Jacobson MP. Non-convulsive status epilepticus: usefulness of clinical features in selecting patients for urgent EEG. J Neurol Neurosurg Psychiatry. 2003;74:189–91.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Hirsch LJ, LaRoche SM, Gaspard N, Gerard E, Svoronos A, Herman ST, et al. American clinical neurophysiology society’s standardized critical care EEG terminology: 2012 version. J Clin Neurophysiol. 2013;30(1):1–27.

    Article  CAS  PubMed  Google Scholar 

  5. Gaspard N, Hirsch LJ, LaRoche SM, Hahn CD, Westover MB. Critical care EEG monitoring research consortium. Interrater agreement for critical care EEG terminology. Epilepsia. 2014;55(9):1366–73.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Cobb WA. Evidence on the periodic mechanism in herpes simplex encephalitis. Electroencephalogr Clin Neurophysiol. 1979;46(3):345–50.

    Article  CAS  PubMed  Google Scholar 

  7. Gloor P, Kalabay O, Giard N. The electroencephalogram in diffuse encephalopathies: electroencephalographic correlates of grey and white matter lesions. Brain. 1968;91(4):779–802.

    Article  Google Scholar 

  8. Gutnick MJ, Connors BW, Prince DA. Mechanisms of neocortical epileptogenesis in vitro. J Neurophysiol. 1982;48(6):1321–35.

    CAS  PubMed  Google Scholar 

  9. Traub RD, Dingledine R. Model of synchronized epileptiform bursts induced by high potassium in CA3 region of rat hippocampal slice. Role of spontaneous EPSPs in initiation. J Neurophysiol. 1990;64(3):1009–18.

    CAS  PubMed  Google Scholar 

  10. Csicsvari J, Hirase H, Czurko A, Buzsáki G. Reliability and state dependence of pyramidal cell-interneuron synapses in the hippocampus: an ensemble approach in the behaving rat. Neuron. 1998;21(1):179–89.

    Article  CAS  PubMed  Google Scholar 

  11. Kalamangalam GP, Slater JD. Periodic lateralized epileptiform discharges and after discharges: common dynamic mechanisms. J Clin Neurophysiol. 2015;32(4):331–40.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Garzon E, Fernandes RM, Sakamoto AC. Serial EEG during human status epilepticus: evidence for PLED as an ictal pattern. Neurology. 2001;57(7):1175–83.

    Article  CAS  PubMed  Google Scholar 

  13. de Curtis M, Manfridi A, Biella G. Activity-dependent pH shifts and periodic recurrence of spontaneous interictal spikes in a model of focal epileptogenesis. J Neurosci. 1998;18(18):7543–51.

    PubMed  Google Scholar 

  14. Trevelyan AJ, Baldeweg T, van Drongelen W, Yuste R, Whittington M. The source of afterdischarge activity in neocortical tonic clonic epilepsy. J Neurosci. 2007;27(49):13513–9.

    Article  CAS  PubMed  Google Scholar 

  15. Smith EH, Liou JY, Davis TS, Merricks EM, Kellis SS, Weiss SA, et al. The ictal wavefront is the spatiotemporal source of discharges during spontaneous human seizures. Nat Commun. 2016;7:11098.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Waziri A, Claassen J, Stuart RM, Arif H, Schmidt JM, Mayer SA, et al. Intracortical electroencephalography in acute brain injury. Ann Neurol. 2009;66(3):366–77.

    Article  PubMed  Google Scholar 

  17. Vespa P, Tubi M, Claassen J, Blanco M, McArthur D, Velazquez AG, et al. Metabolic crisis occurs with seizures and periodic discharges after brain trauma. Ann Neurol. 2016;79(4):579–90.

    Article  PubMed  Google Scholar 

  18. Ruijter BJ, van Putten MJ, Hofmeijer J. Generalized epileptiform discharges in postanoxic encephalopathy: quantitative characterization in relation to outcome. Epilepsia. 2015;56(11):1845–54.

    Article  PubMed  Google Scholar 

  19. Lothman EW, Bertram EH, Bekenstein JW, Perlin JB. Self-sustaining limbic status epilepticus induced by ‘continuous’ hippocampal stimulation: electrographic and behavioral characteristics. Epilepsy Res. 1989;3(2):107–19.

    Article  CAS  PubMed  Google Scholar 

  20. Kristiansen K, Courtois G. Rhythmic electrical activity from isolated cerebral cortex. Electroencephalogr Clin Neurophysiol. 1949;1(3):265–72.

    Article  CAS  PubMed  Google Scholar 

  21. Sutter R, Kaplan PW. Uncovering clinical and radiological associations of triphasic waves in acute encephalopathy: a case-control study. Eur J Neurol. 2014;21(4):660–6.

    Article  CAS  PubMed  Google Scholar 

  22. Chatrian GE, Shaw CM, Leffman H. The significance of periodic lateralized epileptiform discharges in EEG: an electrographic, clinical and pathological study. Electroencephalogr Clin Neurophysiol. 1964;17:177–93.

    Article  CAS  PubMed  Google Scholar 

  23. Treiman DM, Walton NY, Kendrick C. A progressive sequence of electroencephalographic changes during generalized convulsive status epilepticus. Epilepsy Res. 1990;5(1):49–60.

    Article  CAS  PubMed  Google Scholar 

  24. Koplovitz I, Skvorak JP. Electrocorticographic changes during generalized convulsive status epilepticus in soman intoxicated rats. Epilepsy Res. 1998;30(2):159–64.

    Article  CAS  PubMed  Google Scholar 

  25. Snodgrass SM, Tsuburaya K, Ajmone-Marsan C. Clinical significance of periodic lateralized epileptiform discharges: relationship with status epilepticus. J Clin Neurophysiol. 1989;6(2):159–72.

    Article  CAS  PubMed  Google Scholar 

  26. Hartings JA, Williams AJ, Tortella FC. Occurrence of nonconvulsive seizures, periodic epileptiform discharges, and intermittent rhythmic delta activity in rat focal ischemia. Exp Neurol. 2003;179(2):139–49.

    Article  PubMed  Google Scholar 

  27. Pohlmann-Eden B, Hoch DB, Cochius JI, Chiappa KH. Periodic lateralized epileptiform discharges—a critical review. J Clin Neurophysiol. 1996;13(6):519–30.

    Article  CAS  PubMed  Google Scholar 

  28. Westover MB, Shafi MM, Bianchi MT, Moura LM, O’Rourke D, Rosenthal ES, et al. The probability of seizures during EEG monitoring in critically ill adults. Clin Neurophysiol. 2015;126(3):463–71.

    Article  PubMed  Google Scholar 

  29. Claassen J, Mayer SA, Kowalski RG, Emerson RG, Hirsch LJ. Detection of electrographic seizures with continuous EEG monitoring in critically ill patients. Neurology. 2004;62(10):1743–8.

    Article  CAS  PubMed  Google Scholar 

  30. Foreman B, Claassen J, Abou Khaled K, Jirsch J, Alschuler DM, Wittman J, et al. Generalized periodic discharges in the critically ill: a case-control study of 200 patients. Neurology. 2012;79(19):1951–60.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Brophy GM, Bell R, Claassen J, Alldredge B, Bleck TP, Glauser T, et al. Neurocritical care society status epilepticus guideline writing committee. Guidelines for the evaluation and management of status epilepticus. Neurocrit Care. 2012;17(1):3–23.

    Article  PubMed  Google Scholar 

  32. Abend NS, Dlugos DJ, Hahn CD, Hirsch LJ, Herman ST. Use of EEG monitoring and management of non-convulsive seizures in critically ill patients: a survey of neurologists. Neurocrit Care. 2010;12(3):382–9.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Schwartz MS, Prior PF, Scott DF. The occurrence and evolution in the EEG of a lateralized periodic phenomenon. Brain J Neurol. 1973;96(3):613–22.

    Article  CAS  Google Scholar 

  34. Orta DSJ, Chiappa KH, Quiroz AZ, Costello DJ, Cole AJ. Prognostic implications of periodic epileptiform discharges. Arch Neurol. 2009;66(8):985–91.

    PubMed  Google Scholar 

  35. Markand ON, Daly DD. Pseudoperiodic lateralized paroxysmal discharges in electroencephalogram. Neurology. 1971;21(10):975–81.

    Article  CAS  PubMed  Google Scholar 

  36. Reiher J, Rivest J, Grand’Maison F, Leduc CP. Periodic lateralized epileptiform discharges with transitional rhythmic discharges: association with seizures. Electroencephalogr Clin Neurophysiol. 1991;78(1):12–7.

    Article  CAS  PubMed  Google Scholar 

  37. Dauben RD, Adams AH. Periodic lateralized epileptiform discharge in EEG: a review with special attention to etiology and recurrence. Clin EEG Neurosci. 1977;8(3):116–24.

    Google Scholar 

  38. Westmoreland BF, Klass DW, Sharbrough FW. Chronic periodic lateralized epileptiform discharges. Arch Neurol. 1986;43(5):494–6.

    Article  CAS  PubMed  Google Scholar 

  39. Ong C, Gilmore E, Claassen J, Foreman B, Mayer SA. Impact of prolonged periodic epileptiform discharges on coma prognosis. Neurocrit Care. 2012;17(1):39–44.

    Article  PubMed  Google Scholar 

  40. Gaspard N, Manganas L, Rampal N, Petroff OAC, Hirsch LJ. Similarity of lateralized rhythmic delta activity to periodic lateralized epileptiform discharges in critically ill patients. JAMA Neurol. 2013;70(10):1288–95.

    PubMed  Google Scholar 

  41. Sen-Gupta I, Schuele SU, Macken MP, Kwasny MJ, Gerard EE. “Ictal” lateralized periodic discharges. Epilepsy Behav. 2014;36:165–70.

    Article  PubMed  Google Scholar 

  42. Liguori C, Romigi A, Placidi F, Izzi F, Albanese M, Sancesario G, Marciani MG. Pure ictal sensory seizures may represent a clinical manifestation of PLEDs. Epilepsy Behav. 2012;23(4):509.

    Article  PubMed  Google Scholar 

  43. Assal F, Papazyan JP, Slosman DO, Jallon P, Goerres GW. SPECT in periodic lateralized epileptiform discharges (PLEDs): a form of partial status epilepticus? Seizure. 2001;10(4):260–5.

    Article  CAS  PubMed  Google Scholar 

  44. Kuroiwa Y, Celesia GG. Clinical significance of periodic EEG patterns. Arch Neurol. 1980;37(1):15–20.

    Article  CAS  PubMed  Google Scholar 

  45. Lesser RP, Lüders H, Dinner DS, Morris HH. Epileptic seizures due to thrombotic and embolic cerebrovascular disease in older patients. Epilepsia. 1985;26(6):622–30.

    Article  CAS  PubMed  Google Scholar 

  46. Fitzpatrick W, Lowry N. PLEDs: clinical correlates. Can J Neurol Sci. 2007;34(4):443–50.

    Article  CAS  PubMed  Google Scholar 

  47. Walsh JM, Brenner RP. Periodic lateralized epileptiform discharges—long-term outcome in adults. Epilepsia. 1987;28(5):533–6.

    Article  CAS  PubMed  Google Scholar 

  48. Marino D, Vatti G, Rufa A, Malandrini A, Rocchi R, Bracco S, et al. Transient periodic lateralised epileptiform discharges (PLEDs) following internal carotid artery stenting. Epileptic Disord. 2012;14(1):85–9.

    PubMed  Google Scholar 

  49. Schraeder PL, Singh N. Seizure disorders following periodic lateralized epileptiform discharges. Epilepsia. 1980;21(6):647–53.

    Article  CAS  PubMed  Google Scholar 

  50. Chen K-S, Kuo M-F, Wang HS, Huang SC. Periodic lateralized epileptiform discharges of pediatric patients in Taiwan. Pediatr Neurol. 2003;28(2):100–3.

    Article  PubMed  Google Scholar 

  51. Marks DA, Ehrenberg BL. Migraine-related seizures in adults with epilepsy, with EEG correlation. Neurology. 1993;43(12):2476–83.

    Article  CAS  PubMed  Google Scholar 

  52. Gastaut JL, Yermenos E, Bonnefoy M, Cros D. Familial hemiplegic migraine: EEG and CT scan study of two cases. Ann Neurol. 1981;10(4):392–5.

    Article  CAS  PubMed  Google Scholar 

  53. Chu NS. Periodic lateralized epileptiform discharges with preexisting focal brain lesions. Role of alcohol withdrawal and anoxic encephalopathy. Arch Neurol. 1980;37(9):551–4.

    Article  CAS  PubMed  Google Scholar 

  54. Baykan B, Kinay D, Gökyigit A, Gürses C. Periodic lateralized epileptiform discharges: association with seizures. Seizure. 2000;9(6):402–6.

    Article  CAS  PubMed  Google Scholar 

  55. Wilkinson JT, Adams HP, Wright CB. Convulsions after carotid endarterectomy. JAMA. 1980;244(16):1826–8.

    Article  CAS  PubMed  Google Scholar 

  56. Reigel MM, Hollier LH, Sundt TM, Piepgras DG, Sharbrough FW, Cherry KJ. Cerebral hyperperfusion syndrome: a cause of neurologic dysfunction after carotid endarterectomy. J Vasc Surg. 1987;5(4):628–34.

    Article  CAS  PubMed  Google Scholar 

  57. Funakawa I, Yasuda T, Terao A. Periodic lateralized epileptiform discharges in mitochondrial encephalomyopathy. Electroencephalogr Clin Neurophysiol. 1997;103(3):370–5.

    Article  CAS  PubMed  Google Scholar 

  58. Greenberg DA, Weinkle DJ, Aminoff MJ. Periodic EEG complexes in infectious mononucleosis encephalitis. J Neurol Neurosurg Psychiatry. 1982;45(7):648–51.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  59. Kurita A, Furushima H, Yamada H, Inoue K. Periodic lateralized epileptiform discharges in influenza B-associated encephalopathy. Intern Med. 2001;40(8):813–6.

    Article  CAS  PubMed  Google Scholar 

  60. Baysal-Kirac L, Tuzun E, Altindag E, Ekizoglu E, Kinay D, Bilgic B, et al. Are there any specific EEG findings in autoimmune epilepsies? Clin EEG Neurosci. 2016;47(3):224–34.

    Article  PubMed  Google Scholar 

  61. Shin YW, Lee ST, Shin JW, Moon J, Lim JA, Byun JI, et al. VGKC-complex/LGI1-antibody encephalitis: clinical manifestations and response to immunotherapy. J Neuroimmunol. 2013;265(1–2):75–81.

    Article  CAS  PubMed  Google Scholar 

  62. Janati A, Chesser MZ, Husain MM. Periodic lateralized epileptiform discharges (PLEDs): a possible role for metabolic factors in pathogenesis. Clin EEG Electroencephalogr. 1986;17(1):36–43.

    CAS  Google Scholar 

  63. Weiss J, Arfel G. [E.E.G. sequences of deep hypothermia]. Rev Prat. 1960;103:220–2. (Article in French).

    Google Scholar 

  64. Raymond AA, Fish DR, Sisodiya SM, Alsanjari N, Stevens JM, Shorvon SD. Abnormalities of gyration, heterotopias, tuberous sclerosis, focal cortical dysplasia, microdysgenesis, dysembryoplastic neuroepithelial tumour and dysgenesis of the archicortex in epilepsy. Clinical, EEG and neuroimaging features in 100 adult patients. Brain J Neurol. 1995;118(Pt 3):629–60.

    Google Scholar 

  65. Franck G. Border zone (“watershed area”) cerebral ischemia. Electroencephalogr Clin Neurophysiol. 1982;35:297–306.

    Google Scholar 

  66. García-Morales I, García MT, Galán-Dávila L, Gómez-Escalonilla C, Saiz-Díaz R, Martínez-Salio A. Periodic lateralized epileptiform discharges: etiology, clinical aspects, seizures, and evolution in 130 patients. J Clin Neurophysiol. 2002;19(2):172–7.

    Article  PubMed  Google Scholar 

  67. Sainju RK, Manganas LN, Gilmore EJ, Petroff OA, Rampal N, Hirsch LJ, Gaspard N. Clinical correlates and prognostic significance of lateralized periodic discharges in patients without acute or progressive brain injury: a case-control study. J Clin Neurophysiol. 2015;32(6):495–500.

    Article  PubMed  Google Scholar 

  68. Claassen J, Jetté N, Chum F, Green R, Schmidt M, Choi H, et al. Electrographic seizures and periodic discharges after intracerebral hemorrhage. Neurology. 2007;69(13):1356–65.

    Article  CAS  PubMed  Google Scholar 

  69. Claassen J, Hirsch LJ, Frontera JA, Fernandez A, Schmidt M, Kapinos G, et al. Prognostic significance of continuous EEG monitoring in patients with poor-grade subarachnoid hemorrhage. Neurocrit Care. 2006;4(2):103–12.

    Article  PubMed  Google Scholar 

  70. Al-Shekhlee A, Kocharian N, Suarez JJ. Re-evaluating the diagnostic methods in herpes simplex encephalitis. Herpes. 2006;13(1):17–9.

    PubMed  Google Scholar 

  71. Jaitly R, Sgro JA, Towne AR, Ko D, DeLorenzo RJ. Prognostic value of EEG monitoring after status epilepticus: a prospective adult study. J Clin Neurophysiol. 1997;14(4):326–34.

    Article  CAS  PubMed  Google Scholar 

  72. Nei M, Lee JM, Shanker VL, Sperling MR. The EEG and prognosis in status epilepticus. Epilepsia. 1999;40(2):157–63.

    Article  CAS  PubMed  Google Scholar 

  73. Mayer S, Claassen J, Lokin J, Mendelsohn F, Dennis LJ, Fitzsimmons BF. Refractory status epilepticus: frequency, risk factors, and impact on outcome. Arch Neurol. 2002;59(2):205–10.

    Article  PubMed  Google Scholar 

  74. Pedersen GL, Rasmussen SB, Gyllenborg J, Benedek K, Lauritzen M. Prognostic value of periodic electroencephalographic discharges for neurological patients with profound disturbances of consciousness. Clin Neurophysiol. 2013;124(1):44–51.

    Article  PubMed  Google Scholar 

  75. Lowenstein DH, Bleck T, Macdonald RL. It’s time to revise the definition of status epilepticus. Epilepsia. 1999;40(1):120–2.

    Article  CAS  PubMed  Google Scholar 

  76. Claassen J, Perotte A, Albers D, Kleinberg S, Schmidt JM, Tu B, et al. Nonconvulsive seizures after subarachnoid hemorrhage: multimodal detection and outcomes. Ann Neurol. 2013;74(1):53–64.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Beniczky S, Hirsch LJ, Kaplan PW, Pressler R, Bauer G, Aurlien H, et al. Unified EEG terminology and criteria for nonconvulsive status epilepticus. Epilepsia. 2013;54(Suppl 6):28–9.

    Article  PubMed  Google Scholar 

  78. Handforth A, Cheng JT, Mandelkern MA, Treiman DM. Markedly increased mesiotemporal lobe metabolism in a case with PLEDs: further evidence that PLEDs are a manifestation of partial status epilepticus. Epilepsia. 1994;35(4):876–81.

    Article  CAS  PubMed  Google Scholar 

  79. Devous MD, Thisted RA, Morgan GF, Leroy RF, Rowe CC. SPECT brain imaging in epilepsy: a meta-analysis. J Nucl Med. 1998;39(2):285–93.

    PubMed  Google Scholar 

  80. Siclari F, Prior JO, Rossetti AO. Ictal cerebral positron emission tomography (PET) in focal status epilepticus. Epilepsy Res. 2013;105(3):356–61.

    Article  PubMed  Google Scholar 

  81. Claassen J. How I treat patients with EEG patterns on the ictal–interictal continuum in the neuro ICU. Neurocrit Care. 2009;11(3):437–44.

    Article  PubMed  Google Scholar 

  82. Aellen J, Abela E, Buerki SE, Kottke R, Springer E, Schindler K, et al. Focal hemodynamic patterns of status epilepticus detected by susceptibility weighted imaging (SWI). Eur Radiol. 2014;24(11):2980–8.

    Article  PubMed  Google Scholar 

  83. Pizzini FB, Farace P, Manganotti P, Zoccatelli G, Bongiovanni LG, Golay X, et al. Cerebral perfusion alterations in epileptic patients during peri-ictal and post-ictal phase: PASL versus DSC-MRI. Magn Reson Imaging. 2013;31(6):1001–5.

    Article  PubMed  Google Scholar 

  84. Szabo K, Poepel A, Pohlmann-Eden B, Hirsch J, Back T, Sedlaczek O, et al. Diffusion-weighted and perfusion MRI demonstrates parenchymal changes in complex partial status epilepticus. Brain J Neurol. 2005;128(Pt 6):1369–76.

    Article  Google Scholar 

  85. Rennebaum F, Kassubek J, Pinkhardt E, Hübers A, Ludolph AC, Schocke M, Fauser S. Status epilepticus: clinical characteristics and EEG patterns associated with and without MRI diffusion restriction in 69 patients. Epilepsy Res. 2016;120:55–64.

    Article  PubMed  Google Scholar 

  86. Katramados AM, Burdette D, Patel SC, Schultz LR, Gaddam S, Mitsias PD. Periictal diffusion abnormalities of the thalamus in partial status epilepticus. Epilepsia. 2009;50(2):265–75.

    Article  PubMed  PubMed Central  Google Scholar 

  87. Huang YC, Weng HH, Tsai YT, Huang YC, Hsiao MC, Wu CY, et al. Periictal magnetic resonance imaging in status epilepticus. Epilepsy Res. 2009;86(1):72–81.

    Article  PubMed  Google Scholar 

  88. Milligan TA, Zamani A, Bromfield E. Frequency and patterns of MRI abnormalities due to status epilepticus. Seizure. 2009;18(2):104–8.

    Article  PubMed  Google Scholar 

  89. Cianfoni A, Caulo M, Cerase A, Della Marca G, Falcone C, Di Lella GM, et al. Seizure-induced brain lesions: a wide spectrum of variably reversible MRI abnormalities. Eur J Radiol. 2013;82(11):1964–72.

    Article  CAS  PubMed  Google Scholar 

  90. Terzano MG, Parrino L, Mazzucchi A, Moretti G. Confusional states with periodic lateralized epileptiform discharges (PLEDs): a peculiar epileptic syndrome in the elderly. Epilepsia. 1986;27(4):446–57.

    Article  CAS  PubMed  Google Scholar 

  91. Jirsch J, Hirsch LJ. Nonconvulsive seizures: developing a rational approach to the diagnosis and management in the critically ill population. Clin Neurophysiol. 2007;118(8):1660–70.

    Article  CAS  PubMed  Google Scholar 

  92. Sivaraju A, Gilmore EJ. Understanding and managing the ictal-interictal continuum in neurocritical care. Curr Treat Options Neurol. 2016;18(2):8. doi:10.1007/s11940-015-0391-0.

    Article  PubMed  Google Scholar 

  93. O’Rourke D, Chen PM, Gaspard N, Foreman B, McClain L, Karakis I, et al. Response rates to anticonvulsant trials in patients with triphasic-wave EEG patterns of uncertain significance. Neurocrit Care. 2016;24(2):233–9.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  94. Litt B, Wityk RJ, Hertz SH, Mullen PD, Weiss H, Ryan DD, Henry TR. Nonconvulsive status epilepticus in the critically ill elderly. Epilepsia. 1998;39(11):1194–202.

    Article  CAS  PubMed  Google Scholar 

  95. Claassen J, Hirsch LJ, Mayer SA. Treatment of status epilepticus: a survey of neurologists. J Neurol Sci. 2003;211(1–2):37–41.

    Article  PubMed  Google Scholar 

  96. Brenner RP. Is it status? Epilepsia. 2002;43(Suppl 3):103–13.

    Article  PubMed  Google Scholar 

  97. Foreman B, Mahulikar A, Tadi P, Claassen J, Szaflarski J, Halford JJ, et al. Critical care EEG monitoring research consortium (CCEMRC). Generalized periodic discharges and “triphasic waves”: a blinded evaluation of inter-rater agreement and clinical significance. Clin Neurophysiol. 2016;127(2):1073–80.

    Article  PubMed  Google Scholar 

  98. Drislane FW, Lopez MR, Blum AS, Schomer DL. Detection and treatment of refractory status epilepticus in the intensive care unit. J Clin Neurophysiol. 2008;25(4):181–6.

    Article  PubMed  Google Scholar 

  99. Fountain NB, Waldman WA. Effects of benzodiazepines on triphasic waves: implications for nonconvulsive status epilepticus. J Clin Neurophysiol. 2001;18(4):345–52.

    Article  CAS  PubMed  Google Scholar 

  100. Temkin NR, Dikmen SS, Wilensky AJ, Keihm J, Chabal S, Winn HR. A randomized, double-blind study of phenytoin for the prevention of post-traumatic seizures. N Engl J Med. 1990;323(8):497–502.

    Article  CAS  PubMed  Google Scholar 

  101. Szaflarski JP, Sangha KS, Lindsell CJ, Shutter LA. Prospective, randomized, single-blinded comparative trial of intravenous levetiracetam versus phenytoin for seizure prophylaxis. Neurocrit Care. 2010;12(2):165–72.

    Article  CAS  PubMed  Google Scholar 

  102. de la Paz D, Brenner RP. Bilateral independent periodic lateralized epileptiform discharges: clinical significance. Arch Neurol. 1981;38(11):713–5.

    Article  PubMed  Google Scholar 

  103. Fushimi M, Matsubuchi N, Sekine A, Shimizu T. Benign bilateral independent periodic lateralized epileptiform discharges. Acta Neurol Scand. 2003;108(1):55–9.

    Article  CAS  PubMed  Google Scholar 

  104. Husain AM, Mebust KA, Radtke RA. Generalized periodic epileptiform discharges: etiologies, relationship to status epilepticus, and prognosis. J Clin Neurophysiol. 1999;16(1):51–8.

    Article  CAS  PubMed  Google Scholar 

  105. Yemisci M, Gurer G, Saygi S, Ciger A. Generalised periodic epileptiform discharges: clinical features, neuroradiological evaluation and prognosis in 37 adult patients. Seizure. 2003;12(7):465–72.

    Article  PubMed  Google Scholar 

  106. Martínez-Rodríguez JE, Barriga FJ, Santamaria J, Iranzo A, Pareja JA, Revilla M, dela Rosa CR. Nonconvulsive status epilepticus associated with cephalosporins in patients with renal failure. Am J Med. 2001;111(2):115–9.

    Article  PubMed  Google Scholar 

  107. Bahamon-Dussan JE, Celesia GG, Grigg-Damberger MM. Prognostic significance of EEG triphasic waves in patients with altered state of consciousness. J Clin Neurophysiol. 1989;6(4):313–9.

    Article  CAS  PubMed  Google Scholar 

  108. Henchey R, Cibula J, Helveston W, Malone J, Gilmore RL. Electroencephalographic findings in Hashimoto’s encephalopathy. Neurology. 1995;45(5):977–81.

    Article  CAS  PubMed  Google Scholar 

  109. Aguglia U, Gambardella A, Oliveri RL, Lavano A, Quattrone A. Nonmetabolic causes of triphasic waves: a reappraisal. Clin EEG Electroencephalogr. 1990;21(3):120–5.

    Article  CAS  Google Scholar 

  110. Eriksson B, Wictor L. EEG with triphasic waves in Borrelia burgdorferi meningoencephalitis. Acta Neurol Scand. 2007;116(2):133–6.

    Article  CAS  PubMed  Google Scholar 

  111. Niimi Y, Hiratsuka H, Tomita H, Inaba Y, Moriiwa M, Kato M, Tanaka K. [A case of metrizamide encephalopathy with triphasic waves on EEG]. Nō Shinkei Brain Nerve. 1984;36(12):1167–72. (Article in Japanese).

    Google Scholar 

  112. Pugin D, Perrig S, Jallon P. Reversible non-metabolic triphasic waves. Neurophysiol Clin Neurophysiol. 2005;35(4):145–6.

    Article  CAS  Google Scholar 

  113. Brenner RP, Schaul N. Periodic EEG patterns: classification, clinical correlation, and pathophysiology. J Clin Neurophysiol. 1990;7(2):249–67.

    Article  CAS  PubMed  Google Scholar 

  114. Hofmeijer J, Tjepkema-Cloostermans MC, van Putten MJ. Burst-suppression with identical bursts: A distinct EEG pattern with poor outcome in postanoxic coma. Clin Neurophysiol. 2014;125(5):947–54.

    Article  PubMed  Google Scholar 

  115. Tjepkema-Cloostermans MC, Hindriks R, Hofmeijer J, van Putten MJ. Generalized periodic discharges after acute cerebral ischemia: Reflection of selective synaptic failure? Clin Neurophysiol. 2014;125(2):255–62.

    Article  PubMed  Google Scholar 

  116. Khazipov R, Congar P, Ben-Ari Y. Hippocampal CA1 lacunosum-moleculare interneurons: comparison of effects of anoxia on excitatory and inhibitory postsynaptic currents. J Neurophysiol. 1995;74(5):2138–49.

    CAS  PubMed  Google Scholar 

  117. Bolay H, Gürsoy-Ozdemir Y, Sara Y, Onur R, Can A, Dalkara T. Persistent defect in transmitter release and synapsin phosphorylation in cerebral cortex after transient moderate ischemic injury. Stroke J Cereb Circ. 2002;33(5):1369–75.

    Article  CAS  Google Scholar 

  118. Hofmeijer J, Mulder AT, Farinha AC, van Putten MJ, le Feber J. Mild hypoxia affects synaptic connectivity in cultured neuronal networks. Brain Res. 2014;1557:180–9.

    Article  CAS  PubMed  Google Scholar 

  119. Valentin A, Nguyen HQ, Skupenova AM, Agirre-Arrizubieta Z, Jewell S, Mullatti N, et al. Centromedian thalamic nuclei deep brain stimulation in refractory status epilepticus. Brain Stimulat. 2012;5(4):594–8.

    Article  Google Scholar 

  120. Foley JM, Watson CW, Adams RD. Significance of the electroencephalographic changes in hepatic coma. Trans Am Neurol Assoc. 1950;51:161–5.

    CAS  PubMed  Google Scholar 

  121. Towne AR, Waterhouse EJ, Boggs JG, Garnett LK, Brown AJ, Smith JR, DeLorenzo RJ. Prevalence of nonconvulsive status epilepticus in comatose patients. Neurology. 2000;54(2):340–5.

    Article  CAS  PubMed  Google Scholar 

  122. Kaya D, Bingol CA. Significance of atypical triphasic waves for diagnosing nonconvulsive status epilepticus. Epilepsy Behav. 2007;11(4):567–77.

    Article  PubMed  Google Scholar 

  123. Sundaram MB, Blume WT. Triphasic waves: clinical correlates and morphology. Can J Neurol Sci. 1987;14(2):136–40.

    Article  CAS  PubMed  Google Scholar 

  124. Boulanger J-M, Deacon C, Lécuyer D, Gosselin S, Reiher J. Triphasic waves versus nonconvulsive status epilepticus: EEG distinction. Can J Neurol Sci. 2005;33(2):175–80.

    Article  Google Scholar 

  125. Kaplan PW, Sutter R. Affair with triphasic waves—their striking presence, mysterious significance, and cryptic origins: what are they? J Clin Neurophysiol. 2015;32(5):401–5.

    Article  PubMed  Google Scholar 

  126. Ruijter BJ, van Putten MJ, Horn J, Blans MJ, Beishuizen A, van Rootselaar AF, Hofmeijer J; TELSTAR study group. Treatment of electroencephalographic status epilepticus after cardiopulmonary resuscitation (TELSTAR): study protocol for a randomized controlled trial. Trials. 2014;15:433.

    Google Scholar 

  127. Jones DP, Nevin S. Subacute cortical degeneration with myoclonus and epilepsy. Trans Am Neurol Assoc. 1954;13(79th Meeting):144–7.

    Google Scholar 

  128. Kovács GG, Puopolo M, Ladogana A, Pocchiari M, Budka H, van Duijn C, et al.; EUROCJD. Genetic prion disease: the EUROCJD experience. Hum Genet. 2005;118(2):166–74.

    Google Scholar 

  129. Wieser HG, Schindler K, Zumsteg D. EEG in Creutzfeldt-Jakob disease. Clin Neurophysiol. 2006;117(5):935–51.

    Article  PubMed  Google Scholar 

  130. Levy SR, Chiappa KH, Burke CJ, Young RR. Early evolution and incidence of electroencephalographic abnormalities in Creutzfeldt-Jakob disease. J Clin Neurophysiol. 1986;3(1):1–21.

    Article  CAS  PubMed  Google Scholar 

  131. Schäffler L, Karbowski K, Meier C. [Long-term EEG course study in patients with Creutzfeldt-Jacob disease]. 1983;14(1):6–11. (Article in German).

    Google Scholar 

  132. Burger LJ, Rowan AJ, Goldensohn ES. Creutzfeldt-Jakob disease. An electroencephalographic study. Arch Neurol. 1972;26(5):428–33.

    CAS  PubMed  Google Scholar 

  133. Furlan AJ, Henry CE, Sweeney PJ, Mitsumoto H. Focal EEG abnormalities in Heidenhain’s variant of Jakob-Creutzfeldt disease. Arch Neurol. 1981;38(5):312–4.

    Article  CAS  PubMed  Google Scholar 

  134. Au WJ, Gabor AJ, Vijayan N, Markand ON. Periodic lateralized epileptiform complexes (PLEDs) in Creutzfeldt-Jakob disease. Neurology. 1980;30(6):611–7.

    Article  CAS  PubMed  Google Scholar 

  135. Steinhoff BJ, Zerr I, Glatting M, Schulz-Schaeffer W, Poser S, Kretzschmar HA. Diagnostic value of periodic complexes in Creutzfeldt-Jakob disease. Ann Neurol. 2004;56(5):702–8.

    Article  PubMed  Google Scholar 

  136. Zerr I, Pocchiari M, Collins S, Brandel JP, de Pedro Cuesta J, Knight RS, et al. Analysis of EEG and CSF 14-3-3 proteins as aids to the diagnosis of Creutzfeldt-Jakob disease. Neurology. 2000;55(6):811–5.

    Article  CAS  PubMed  Google Scholar 

  137. Yoo JY, Hirsch LJ. Limbic encephalitis associated with anti-voltage-gated potassium channel complex antibodies mimicking Creutzfeldt-Jakob disease. JAMA Neurol. 2014;71(1):79–82.

    Article  PubMed  Google Scholar 

  138. Geschwind MD, Tan KM, Lennon VA, Barajas RF, Haman A, Klein CJ, et al. Voltage-gated potassium channel autoimmunity mimicking creutzfeldt-jakob disease. Arch Neurol. 2008;65(10):1341–6.

    Article  PubMed  PubMed Central  Google Scholar 

  139. Doherty CP, Schlossmacher M, Torres N, Bromfield E, Samuels MA, Folkerth R. Hashimoto’s encephalopathy mimicking Creutzfeldt-Jakob disease: brain biopsy findings. J Neurol Neurosurg Psychiatry. 2002;73(5):601–2.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  140. Brigo F. Intermittent rhythmic delta activity patterns. Epilepsy Behav. 2011;20(2):254–6.

    Article  PubMed  Google Scholar 

  141. Accolla EA, Kaplan PW, Maeder-Ingvar M, Jukopila S, Rossetti AO. Clinical correlates of frontal intermittent rhythmic delta activity (FIRDA). Clin Neurophysiol. 2011;122(1):27–31.

    Article  PubMed  Google Scholar 

  142. Pierre Cordeau J. Monorhythmic frontal delta activity in the human electroencephalogram: a study of 100 cases. Electroencephalogr Clin Neurophysiol. 1959;11:733–46.

    Google Scholar 

  143. Watemberg N, Alehan F, Dabby R, Lerman-Sagie T, Pavot P, Towne A. Clinical and radiologic correlates of frontal intermittent rhythmic delta activity. J Clin Neurophysiol. 2002;19(6):535–9.

    Article  PubMed  Google Scholar 

  144. Fariello RG, Orrison W, Blanco G, Reyes PF. Neuroradiological correlates of frontally predominant intermittent rhythmic delta activity (FIRDA). Electroencephalogr Clin Neurophysiol. 1982;54(2):194–202.

    Article  CAS  PubMed  Google Scholar 

  145. Fernández-Torre JL. Rhythmic delta activity as ictal pattern in nonconvulsive status epilepticus. Epilepsy Behav. 2008;13(2):417; author reply 423.

    Google Scholar 

  146. Tashiro K, Ogata K, Goto Y, Taniwaki T, Okayama A, Kira JI, Tobimatsu S. EEG findings in early-stage corticobasal degeneration and progressive supranuclear palsy: a retrospective study and literature review. Clin Neurophysiol. 2006;17(10):2236–42.

    Article  Google Scholar 

  147. Pietrini V, Terzano MG, D’Andrea G, Parrino L, Cananzi AR, Ferro-Milone F. Acute confusional migraine: clinical and electroencephalographic aspects. Cephalalgia Int J Headache. 1987;7(1):29–37.

    Article  CAS  Google Scholar 

  148. Roks G, Korf ES, van der Flier WM, Scheltens P, Stam CJ. The use of EEG in the diagnosis of dementia with Lewy bodies. J Neurol Neurosurg Psychiatry. 2008;79(4):377–80.

    Article  CAS  PubMed  Google Scholar 

  149. Kaplan PW, Rossetti AO, Kaplan EH, Wieser HG. Proposition: limbic encephalitis may represent limbic status epilepticus. A review of clinical and EEG characteristics. Epilepsy Behav. 2012;24(1):1–6.

    Article  PubMed  Google Scholar 

  150. Hirsch LJ, Claassen J, Mayer SA, Emerson RG. Stimulus-induced rhythmic, periodic, or ictal discharges (SIRPIDs): a common EEG phenomenon in the critically ill. Epilepsia. 2004;45(2):109–23.

    Article  PubMed  Google Scholar 

  151. Braksick SA, Burkholder DB, Tsetsou S, Martineau L, Mandrekar J, Rossetti AO, et al. Associated factors and prognostic implications of stimulus-induced rhythmic, periodic, or ictal discharges. JAMA Neurol. 2016;73(5):585–90.

    Article  PubMed  Google Scholar 

  152. Alvarez V, Oddo M, Rossetti AO. Stimulus-induced rhythmic, periodic or ictal discharges (SIRPIDs) in comatose survivors of cardiac arrest: characteristics and prognostic value. Clin Neurophysiol. 2013;124(1):204–8.

    Article  PubMed  Google Scholar 

  153. Van Straten AF, Fesler JR, Hakimi R, Sheng T, Thompson DM, Hakimi AS. SIRPIDs: prevalence and outcome in critically ill patients. J Clin Neurophysiol. 2014;31(5):418–21.

    Article  PubMed  Google Scholar 

  154. Smith CC, Tatum WO, Gupta V, Pooley RA, Freeman WD. SPECT-negative SIRPIDs: less aggressive neurointensive care? J Clin Neurophysiol. 2014;31(3):e6–10.

    Article  PubMed  Google Scholar 

  155. Zeiler SR, Turtzo LC, Kaplan PW. SPECT-negative SIRPIDs argues against treatment as seizures. J Clin Neurophysiol. 2011;28(5):493–6.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurology & Rehabilitation Medicine, Division of Neurocritical Care, University of Cincinnati Medical Center, 231 Albert Sabin Way, ML0517, Cincinnati, OH, 45267, USA

    Jonah Grossman & Brandon Foreman

Authors
  1. Jonah Grossman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Brandon Foreman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Brandon Foreman .

Editor information

Editors and Affiliations

  1. Department of Neurology, Harvard Medical School, Comprehensive Epilepsy Center, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA

    Frank W. Drislane

  2. Department of Neurology, Johns Hopkins Bayview Medical Center, Baltimore, Maryland, USA

    Peter W. Kaplan MBBS

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer Science+Business Media LLC

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Grossman, J., Foreman, B. (2018). Periodic EEG Patterns. In: Drislane, F., Kaplan MBBS, P. (eds) Status Epilepticus. Current Clinical Neurology. Springer, Cham. https://doi.org/10.1007/978-3-319-58200-9_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-58200-9_5

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-58198-9

  • Online ISBN: 978-3-319-58200-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation