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Chapter 15 - Coma

from Part II - Case-Based Approach to Specific Conditions

Published online by Cambridge University Press:  22 February 2024

Neville M. Jadeja  and
Kyle C. Rossi
Neville M. Jadeja
Affiliation:
University of Massachusetts Medical School
Kyle C. Rossi
Affiliation:
University of Massachusetts Medical School
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Summary

This chapter uses a case-based approach to describe electrographic patterns associated with coma. These are rare and, though non-specific, may suggest particular underlying etiologies. The electrographic pattern of extreme delta brush (EDB) may be seen with anti-NMDA receptor encephalitis. Alpha-coma is a pattern of continuous unreactive alpha or alpha-theta range activity that may be seen in coma after cardiac arrest or in those with pontine injury. It may resemble normal wakefulness. Spindle-coma and beta-coma are also described. Electrocerebral inactivity (ECI) is the absence of all non-artifactual electrical activity on an EEG, when recording using minimal specified technical standards in patients with cerebral death (brain death).

Keywords

extreme delta brushEDBalpha-comaelectrocerebral inactivityECIspindle comabeta-comatheta-comaanoxic brain injurypontine injury
Type
Chapter
Information
Critical Care EEG Basics
Rapid Bedside EEG Reading for Acute Care Providers
 , pp. 204 - 210
Publisher: Cambridge University Press
Print publication year: 2024

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References

Schmitt, SE, Pargeon, K, Frechette, ES, Hirsch, LJ, Dalmau, J, Friedman, D. Extreme delta brush: A unique EEG pattern in adults with anti-NMDA receptor encephalitis. Neurology. 2012 Sep 11;79(11):1094–100.Google Scholar
Nathoo, N, Anderson, D, Jirsch, J. Extreme delta brush in anti-NMDAR encephalitis correlates with poor functional outcome and death. Frontiers in Neurology. 2021;12.Google Scholar
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Nakagawa, TA, Ashwal, S, Mathur, M, Mysore, M, Committee for Determination of Brain Death in Infants Children. Guidelines for the determination of brain death in infants and children: An update of the 1987 task force recommendations – executive summary. Annals of Neurology. 2012 Apr;71(4):573–85.Google Scholar
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  • Coma
  • Neville M. Jadeja, University of Massachusetts Medical School, Kyle C. Rossi, University of Massachusetts Medical School
  • Book: Critical Care EEG Basics
  • Online publication: 22 February 2024
  • Chapter DOI: https://doi.org/10.1017/9781009261159.018
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Save book to Dropbox

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  • Coma
  • Neville M. Jadeja, University of Massachusetts Medical School, Kyle C. Rossi, University of Massachusetts Medical School
  • Book: Critical Care EEG Basics
  • Online publication: 22 February 2024
  • Chapter DOI: https://doi.org/10.1017/9781009261159.018
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Coma
  • Neville M. Jadeja, University of Massachusetts Medical School, Kyle C. Rossi, University of Massachusetts Medical School
  • Book: Critical Care EEG Basics
  • Online publication: 22 February 2024
  • Chapter DOI: https://doi.org/10.1017/9781009261159.018
Available formats
×