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Alpha-Coma: Electroencephalographic, Clinical, Pathologic, and Etiologic Correlations

Alpha-Coma: Electroencephalographic, Clinical, Pathologic, and Etiologic Correlations Abstract • "Alpha-coma" denotes the conjunction of clinical coma with an electroencephalographic pattern resembling that of normal wakefulness and predominantly consisting of alpha activity. Clinical, EEG, and pathologic data from 13 patients with this syndrome were reviewed. The patients were divided into two groups, based on the pathogenesis of their conditions. The first group consisted of eight patients with brain stem strokes, and the second group consisted of five patients with diffuse hypoxic encephalopathy resulting from cardiac or pulmonary arrest. There were some differences between the EEGs of the two groups. In the first group, the alpha pattern was located more posteriorly, showed more variability and reactivity, and was more persistent in sequential recordings. In the second group, the alpha activity was transient and showed little reactivity. In both groups, this pattern indicated a poor prognosis for survival. References 1. Lundervold A, Hauge T, Löken AC: Unusual EEG in unconscious patient with brain stem atrophy . Electroencephalogr Clin Neurophysiol 8:665-670, 1956.Crossref 2. Loeb C, Poggio G: Electroencephalograms in a case with ponto-mesencephalic haemorrhage . Electroencephalogr Clin Neurophysiol 5:295-296, 1953.Crossref 3. Loeb C: Electroencephalographic changes during the state of coma . Electroencephalogr Clin Neurophysiol 10:589-606, 1958.Crossref 4. Chatrian GE, White LE Jr, Shaw C-M: EEG pattern resembling wakefulness in unresponsive decerebrate state following traumatic brain-stem infarct . Electroencephalogr Clin Neurophysiol 16:285-289, 1964.Crossref 5. Wilkus RJ, Harvey F, Ojemann LM, et al: Electroencephalogram and sensory evoked potentials: Findings in an unresponsive patient with pontine infarct . Arch Neurol 24:538-544, 1971.Crossref 6. Hughes JR, Cayaffa J, Leestma J, et al: Alternating "waking" and "sleep" EEG patterns in a deeply comatose patient . Clin Electroencephalogr 3:86-93, 1972. 7. Boonstra S, Notermans SLH: The EEG in 17 cases of lesions of the brain-stem, established post mortem, abstracted . Electroencephalogr Clin Neurophysiol 23:496, 1967.Crossref 8. Friedlander WJ: Electroencephalographic changes in acute brain stem vascular lesions . Neurology 9:24-34, 1959.Crossref 9. Watson CW, Adams RD: The electroencephalogram in its relation to consciousness and responsiveness in destructive lesions of the brain stem: A clinical pathological EEG study of brain stem disease particularly basilar artery occlusion, abstracted . Electroencephalogr Clin Neurophysiol 3:371, 1951.Crossref 10. Chase TN, Moretti L, Prensky AL: Clinical and electroencephalographic manifestations of vascular lesions of the pons . Neurology 18:357-368, 1968.Crossref 11. Radermecker J: Severe acute necrosis of the pons with long survival: Electro-clinical symptoms and absence of cerebral lesions, abstracted . Electroencephalogr Clin Neurophysiol 23:281, 1967.Crossref 12. Kaada BR, Harkmark W, Stokke O: Deep coma associated with desynchronization in EEG . Electroencephalogr Clin Neurophysiol 13:785-789, 1961.Crossref 13. Loeb C, Rosadini G, Poggio GF: Electroencephalograms during coma: Normal and borderline records in 5 patients . Neurology 9:610-618, 1959.Crossref 14. Marquardsen J, Harvald B: The electroencephalogram in acute vascular lesions of the brain stem and the cerebellum . Acta Neurol Scand 40:58-68, 1964.Crossref 15. Binnie CD, Prior PF, Lloyd DSL, et al: Electroencephalographic prediction of fatal anoxic brain damage after resuscitation from cardiac arrest . Br Med J 4:265-268, 1970.Crossref 16. Hockaday JM, Potts F, Epstein E, et al: Electroencephalographic changes in acute cerebral anoxia from cardiac or respiratory arrest . Electroencephalogr Clin Neurophysiol 18:575-586, 1965.Crossref 17. Lindgren S, Petersén I, Zwetnow N: Prediction of death in serious brain damage . Acta Chir Scand 134:405-416, 1968. 18. Brierley JB, Graham DI, Adams JH, et al: Neocortical death after cardiac arrest: A clinical, neurophysiological, and neuropathological report of two cases . Lancet 2:560-565, 1971. 19. Westmoreland B, Klass DW, Sharbrough FW, et al: "Alpha coma": EEG, clinical pathologic, and etiologic correlations, abstracted . Electroencephalogr Clin Neurophysiol 37:202, 1974. 20. Vignaendra V, Wilkus RJ, Copass MK, et al: Electroencephalographic rhythms of alpha frequency in comatose patients after cardiopulmonary arrest . Neurology 24:582-588, 1974.Crossref 21. Hauri P, Hawkins DR: Alpha-delta sleep . Electroencephalogr Clin Neurophysiol 34:233-237, 1973.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Alpha-Coma: Electroencephalographic, Clinical, Pathologic, and Etiologic Correlations

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Publisher
American Medical Association
Copyright
Copyright © 1975 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1975.00490530035001
Publisher site
See Article on Publisher Site

Abstract

Abstract • "Alpha-coma" denotes the conjunction of clinical coma with an electroencephalographic pattern resembling that of normal wakefulness and predominantly consisting of alpha activity. Clinical, EEG, and pathologic data from 13 patients with this syndrome were reviewed. The patients were divided into two groups, based on the pathogenesis of their conditions. The first group consisted of eight patients with brain stem strokes, and the second group consisted of five patients with diffuse hypoxic encephalopathy resulting from cardiac or pulmonary arrest. There were some differences between the EEGs of the two groups. In the first group, the alpha pattern was located more posteriorly, showed more variability and reactivity, and was more persistent in sequential recordings. In the second group, the alpha activity was transient and showed little reactivity. In both groups, this pattern indicated a poor prognosis for survival. References 1. Lundervold A, Hauge T, Löken AC: Unusual EEG in unconscious patient with brain stem atrophy . Electroencephalogr Clin Neurophysiol 8:665-670, 1956.Crossref 2. Loeb C, Poggio G: Electroencephalograms in a case with ponto-mesencephalic haemorrhage . Electroencephalogr Clin Neurophysiol 5:295-296, 1953.Crossref 3. Loeb C: Electroencephalographic changes during the state of coma . Electroencephalogr Clin Neurophysiol 10:589-606, 1958.Crossref 4. Chatrian GE, White LE Jr, Shaw C-M: EEG pattern resembling wakefulness in unresponsive decerebrate state following traumatic brain-stem infarct . Electroencephalogr Clin Neurophysiol 16:285-289, 1964.Crossref 5. Wilkus RJ, Harvey F, Ojemann LM, et al: Electroencephalogram and sensory evoked potentials: Findings in an unresponsive patient with pontine infarct . Arch Neurol 24:538-544, 1971.Crossref 6. Hughes JR, Cayaffa J, Leestma J, et al: Alternating "waking" and "sleep" EEG patterns in a deeply comatose patient . Clin Electroencephalogr 3:86-93, 1972. 7. Boonstra S, Notermans SLH: The EEG in 17 cases of lesions of the brain-stem, established post mortem, abstracted . Electroencephalogr Clin Neurophysiol 23:496, 1967.Crossref 8. Friedlander WJ: Electroencephalographic changes in acute brain stem vascular lesions . Neurology 9:24-34, 1959.Crossref 9. Watson CW, Adams RD: The electroencephalogram in its relation to consciousness and responsiveness in destructive lesions of the brain stem: A clinical pathological EEG study of brain stem disease particularly basilar artery occlusion, abstracted . Electroencephalogr Clin Neurophysiol 3:371, 1951.Crossref 10. Chase TN, Moretti L, Prensky AL: Clinical and electroencephalographic manifestations of vascular lesions of the pons . Neurology 18:357-368, 1968.Crossref 11. Radermecker J: Severe acute necrosis of the pons with long survival: Electro-clinical symptoms and absence of cerebral lesions, abstracted . Electroencephalogr Clin Neurophysiol 23:281, 1967.Crossref 12. Kaada BR, Harkmark W, Stokke O: Deep coma associated with desynchronization in EEG . Electroencephalogr Clin Neurophysiol 13:785-789, 1961.Crossref 13. Loeb C, Rosadini G, Poggio GF: Electroencephalograms during coma: Normal and borderline records in 5 patients . Neurology 9:610-618, 1959.Crossref 14. Marquardsen J, Harvald B: The electroencephalogram in acute vascular lesions of the brain stem and the cerebellum . Acta Neurol Scand 40:58-68, 1964.Crossref 15. Binnie CD, Prior PF, Lloyd DSL, et al: Electroencephalographic prediction of fatal anoxic brain damage after resuscitation from cardiac arrest . Br Med J 4:265-268, 1970.Crossref 16. Hockaday JM, Potts F, Epstein E, et al: Electroencephalographic changes in acute cerebral anoxia from cardiac or respiratory arrest . Electroencephalogr Clin Neurophysiol 18:575-586, 1965.Crossref 17. Lindgren S, Petersén I, Zwetnow N: Prediction of death in serious brain damage . Acta Chir Scand 134:405-416, 1968. 18. Brierley JB, Graham DI, Adams JH, et al: Neocortical death after cardiac arrest: A clinical, neurophysiological, and neuropathological report of two cases . Lancet 2:560-565, 1971. 19. Westmoreland B, Klass DW, Sharbrough FW, et al: "Alpha coma": EEG, clinical pathologic, and etiologic correlations, abstracted . Electroencephalogr Clin Neurophysiol 37:202, 1974. 20. Vignaendra V, Wilkus RJ, Copass MK, et al: Electroencephalographic rhythms of alpha frequency in comatose patients after cardiopulmonary arrest . Neurology 24:582-588, 1974.Crossref 21. Hauri P, Hawkins DR: Alpha-delta sleep . Electroencephalogr Clin Neurophysiol 34:233-237, 1973.Crossref

Journal

Archives of NeurologyAmerican Medical Association

Published: Nov 1, 1975

References