In this paper we reported a patient with multisystem failure, whose EEG immediately preceding death demonstrated a unique combination of suppression-burst pattern, generalized epileptiform discharges, and alpha-theta pattern coma. Post-mortem examination showed ischemic-anoxic lesions involving cortical and sub-cortical gray matter. The lack of white matter pathology in our patient indicates that white matter lesions may not be involved in the pathogenesis of the above EEG patterns in anoxic encephalopathy.
PampiglioneG., and HardenA., Resuscitation after cardio-circulatory arrest: Prognostic evaluation of early electroencephalographic findings, Lancet1:1261–1264,1968.
2.
LindgrenS., PetersonI., and ZwetnowN., Prediction of death in serious brain damage, Acta. Chir. Scand., 134:405–416, 1968.
3.
BinnieC.D., PriorP.F., LloydD.S.L., ScottD.F., and MargerisonJ.H., Electroencephalographic prediction of fatal anoxic brain damage after resuscitation from cardiac arrest, Brit. Med. J., 4:265–268, 1970.
4.
HockadayJ.M., PottsF., EpsteinE., BonazziA., and SchwabR.S., Electro-encephalographic changes in acute cerebral anoxia from cardiac or respiratory arrest, Electroenceph. clin. Neurophysiol., 18:575–586, 1965.
5.
VignaendraV., WilkinsR.J., CopassM.K., and ChatrianG., Electroencephalographic rhythms of alpha frequency in comatose patients after cardiopulmonary arrest, Neurology (Minneap.), 24:582–588, 1974.
6.
WestmorlandB.F., KlassD.W., Shar-BroughF.W., and ReaganT.J., Alpha-Coma: Electroencephalographic, clinical, pathologic, and etiologic considerations, Arch. Neurol., 32:713–718, 1975.
7.
ChokrovertyS., “Alpha-like” rhythms in electroencephalograms in coma after cardiac arrest, Neurology(Minneap.), 25:655–663, 1975.
8.
BennettD.R., HughesJ.R., KoreinJ., MerlisJ.K., and SuterC, Atlas of Electroencephalography in Coma and Cerebral Death, Raven Press, New York, 1976.
9.
GrindalA.B., SuterC., and MartinezA.J., Alpha-pattern coma: 24 cases with 9 survivors, Ann. Neurol., 1:371–377, 1977.
10.
AlvingJ., MollerM., SindrupE., and NielsenB.L., “Alpha pattern coma” following cerebral anoxia, Electroenceph. clin. Neurophysiol., 47:95–101, 1979.
11.
SynekV.M., and SynekB.J.L., Theta pattern coma, a variant of alpha pattern coma, Clin. Electroenceph., 15:116–121, 1984.
12.
KuroiwaY., and CelesiaG.G., Clinical significance of periodic EEG patterns, Arch. Neurol., 37:15–20, 1980.
13.
GibbsE.L, and GibbsF.A., Steady spiking in the electroencephalograms of acutely ill patients, Clin. Electroenceph., 6:191–200, 1975.
14.
AokiY., and LombrosoC.T., Prognostic value of electroencephalography in Reye's syndrome, Neurology (Minneap.), 23:333–343.
15.
JanatiA., and ErbaG., Electroencephalo-graphic correlates of near drowning encephalopathy in children, Electroenceph. clin. Neuro-physiol., 53:182–191, 1982.
16.
EchlinF.A., ArnettV., and ZollJ., Paroxysmal high voltage discharges from isolated and partially isolated human and animal cerebral cortex, Electroenceph. clin. Neuro-physiol., 4:147–164, 1952.
17.
HenryC.E., and ScovilleW.B., Suppression-burst activity from isolated cerebral cortex in man, Electroenceph. clin. Neurophysiol., 4:1–22, 1952.
18.
GloorP., KalabayG., and GiardN., The electroencephalogram in diffuse encephalopathies: Electroencephalographic correlates of gray and white matter lesions, Brain, 91:779–802, 1968.
19.
GoldmanJ.W., and AdamsA.H., “Alpha-coma” in association with generalized paroxysmal (spike-wave) activity: A case report, Clin. Electroenceph., 12:79–83, 1981.
