image: eeg0090

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EEG Report or Clinical history: CLINICAL HISTORY: This is a 58 year old woman with dementia and Parkinson’s disease who suffered respiratory arrest after choking on food and is now intubated in the ICU, comatose, and off sedation.

Day 1:

EEG Description: A posterior dominant rhythm was not observed. The background included generalized bursts of high amplitude, sharply contoured mixed frequency activity lasting 1 to 4 seconds interspersed by periods of diffuse generalized severe voltage suppression lasting 10-20 seconds. Approximately 12 to 18 hours into the recording, the distinction between bursts and periods of suppression pattern became less distinct, with lower amplitude of bursts and shorter period of suppression and a background consisting predominantly of diffuse asynchronous theta activity. In addition, the bursts of the left and right hemispheres became asynchronous.

Clinical and electrographic events: None.

Day 2:

EEG Description: During the second day of recording, there was a gradual attenuation of activity of all frequencies. By the end of the recording, there was generalized suppression of all frequencies to below approximately 10 microvolts.

Clinical and electrographic events: None.

EEG Interpretation: This is an abnormal EEG due to burst suppression progressing to an abnormal pattern with features of theta coma and subsequently to severe generalized suppression. These findings are consistent with severe irreversible anoxic brain injury. These findings were communicated daily to the ICU attending physician.


tags: burst suppression