tailieunhanh - Handbook of EEG interpretation - part 6

óng ba pha được nhìn thấy trong các vụ nổ nonevolving song phương hoặc chạy 1-2 Hz thường xuyên với một ưu thế trước và trước tụt hậu sau, mặc dù họ cũng có thể sở hữu một ưu thế sau, hoặc ưu thế hỗn hợp. Họ có thể phản ứng để mở mắt hoặc chính quyền thậm chí benzodiazepine. | Patterns of Special Significance tive deflection sandwiched between a lower amplitude initial surface negative deflection and an aftergoing slower surface- negative potential. Triphasic waves are seen in bilateral nonevolving bursts or runs of 1 to 2 Hz frequently with an anterior predominance and an anterior to posterior lag although they may also possess a posterior predominance or mixed predominance. They may be reactive to eye opening or even benzodiazepine administration. When they occur in prolonged runs distinguishing triphasic waves from nonconvulsive status epilepticus can be difficult. 133 CHAPTER 5 FIGURE . Triphasic waves noted on the EEG of another patient with encephalopathy due to renal failure who is on hemodialysis. The EKG however demonstrates ventricular fibrillation. The patient had a cardiac arrest and died during long-term EEG monitoring. The electrocardiogram EKG is normally recorded on every EEG. Cardiac function has been inextricably related to brain function and while many channels are dedicated to recording the EEG the representation for cardiac function is based upon a single channel. The normal cardiac rhythm is usually represented by a bipolar derivation connecting the left to right chest. Various artifacts may appear in the EEG although cardiac rhythm disturbances may be detected that are important for cerebral function or even predicate discovery of malignant arrhythmias see above . 134 Patterns of Special Significance FIGURE . Burst-suppression following out-of-hospital cardiac arrest. The recording was obtained at 2 pV mm with single electrode distances. Burst suppression suggests a severe bilateral cerebral dysfunction and while nonspecific in etiology when associated with hypoxia this pattern suggests a poor prognosis. The burst-suppression pattern consists of stereotyped bursts usually consisting of mixed frequencies with or without intermixed epileptiform discharges. The bursts usually recur between 2 and 10 sec and are

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