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Importantly, disturbances in thalamocortical relays can be associated with structural or metabolic abnormalities. Another theory proposes that it is primarily a disturbance at the thalamic level with changes in the potential field observed on the cortical surface reflected through thalamocortical relays. This activation ultimately increases cerebral inhibition by increased gamma–aminobutyric acid (GABA) tone and astrocytic and cytotoxic edema.
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In patients with hepatic encephalopathy, it is believed to be associated with hyperammonemia and N-methyl-D-aspartate activation. The underlying pathogenesis of TW is largely unknown. TW have been linked with various diseases such as hypertensive encephalopathy, hypernatremia/hyponatremia, hypoglycemia, hypercalcemia, brain abscesses, septic shock and sepsis-related encephalopathy, postictal states, lithium and baclofen toxicity, stroke, and renal and/or liver disease. TW are conspicuous complexes that are frequently encountered on CEEG monitoring in patients with encephalopathy. Another pattern associated with cerebral edema and oftentimes metabolic derangement on the ictal-interictal continuum is generalized periodic discharges (GPDs) with triphasic wave (TW) morphology. EEG patterns that correlate with increased intracranial pressure (ICP) include focal slowing of underlying rhythms or global EEG suppression progressing to burst suppression or flat EEG. Several patterns on CEEG are of diagnostic and prognostic significance in patients with cerebral edema that lie on the ictal-interictal continuum. CEEG is tightly linked to cerebral metabolism and, thus, sensitive to changes in cerebral blood flow. CEEG can detect convulsive and nonconvulsive seizures and can be used to assess degree of encephalopathy. IntroductionĬontinuous electroencephalography (CEEG) monitoring is commonly used in critically ill patients. We have proposed a preliminary understanding of the relationship between TW and intracranial hypertension, which may be helpful in formulating future studies involving larger cohorts. This study highlights a possible favorable prognostic marker of finding TW in a patient with intracranial hypertension. The TW diminished during episodes of intracranial hypertension but reappeared with reduction of the intracranial pressure. A patient with severe TBI and no underlying metabolic abnormalities was admitted to the neurocritical care unit. We present a case highlighting the relationship of TW with ICP in a case with severe traumatic brain injury (TBI). The underlying role and prognostic significance of TW in relationship to intracranial pressure (ICP) remain unknown. A commonly seen encephalopathic pattern on CEEG is generalized periodic discharges with triphasic wave (TW) morphology. Continuous electroencephalography (CEEG) monitoring is used for detection of convulsive and nonconvulsive seizures and assessing the degree of encephalopathy in critically ill patients.
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User Comments About This Question: 0 user entries Please log in if you'd like to add a comment.Background. Douglas Miles, (C) 2006-2009, all rights reserved. Saunders Company, Philadelphia.į - Neurology Review Questions - Neurology Boards - Board Review - Residency Inservice Training Exam - RITE Exam Review Electroencephalography: Basic Principles, Clinical Applications, and Related Fields. Niedermeyer (Editor), Fernando Lopes, M.D., Ph.D. Incidence of triphasic waves in hepatic encephalopathy is estimated to be about 25%. However, triphasic waves are not specific for hepatic encephalopathy. Patients with hepatic encephalopathy frequently have triphasic waves on EEG. ( See References)Į) are associated with hepatic encephalopathy Triphasic waves are not characteristic of Sturge-Weber syndrome. ( See References)ĭ) are associated with Sturge-Weber syndrome Triphasic waves are not specific nor pathognomonic for hepatic encephalopathy. ( See References)Ĭ) are pathognomonic for hepatic encephalopathy They EEG pattern characteristically associated with West syndrome is hypsarrhythmia. Triphasic waves are not characteristic of West syndrome. Please log in if you want to rate questions.
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The typical EEG finding in hypocalcemia is diffuse slowing. Triphasic waves are not characteristic of hypocalcemia. This question was last modified on April 28, 2007. This question was created on Apby jdmiles. = How users like you have rated this question. = Enter detailed rating for this question! = Use this question as a template to create a totally NEW question. = Load a random question from the database. = Reload a different version of this question (). C) Are pathognomonic for hepatic encephalopathyĭ) Are associated with Sturge-Weber syndromeĮ) Are associated with hepatic encephalopathy