Journal List > Korean J Clin Neurophysiol > v.16(1) > 1084130

Park, Shin, Ha, Park, Kim, Kim, and Kim: Significance of Triphasic Waves in Metabolic Encephalopathy

Abstract

Background:

Triphasic waves are one of the electroencephalographic patterns that can be usually seen in metabolic encephalopathy. The aim of this study is to compare the clinical and electrophysiologic profiles between patients with and without triphasic waves in metabolic encephalopathy, and reassess the significance of triphasic waves in metabolic encephalopathy.

Methods:

We recruited 127 patients with metabolic encephalopathy, who were admitted to our hospital. We divided these admitted patients into two groups; those with and without triphasic waves. We analyzed the difference of duration of hospitalization, mortality rate during admission, Glasgow Coma Scale, severity of electroencephalographic alteration, and presence of acute symptomatic seizures between these two groups.

Results:

Of the 127 patients with metabolic encephalopathy, we excluded 67 patients who did not have EEG, and 60 patients finally met the inclusion criteria for this study. Patients with triphasic waves had more severe electroencephalographic alterations, lower Glasgow Coma Scale, and more acute symptomatic seizures than those without triphasic waves. After adjusting the clinical variables, Glasgow Coma Scale and acute symptomatic seizures were only significantly different between patients with and without triphasic waves.

Conclusions:

We demonstrated that patients with triphasic waves in metabolic encephalopathy had more significant impairment of the brain function. (Korean J Clin Neurophysiol 2014;16:15-20)

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Figure 1.
An electroencephalography of the 85-year-old woman with acute renal failure shows bilateral synchronous, frontally dominant runs with waveforms of phase: negative, positive, negative, and fronto-occipital lag.
kjcn-16-15f1.tif
Table 1.
A comparison of the clinical and electrophysiologic profiles between patients with and without triphasic waves in metabolic encephalopathy
Parameter* Metabolic encephalopathy with triphasic waves (n=13) Metabolic encephalopathy without triphasic waves (n=47) p-value
Median duration of the hospitalization (days) 24 (6-74) 20 (3-153) 0.8826
Mortality during the admission 4 (31) 14 (30) 0.1844
The severe EEG alteration 12 (92) 22 (47) 0.0038
Median GCS 9 (4-13) 12 (3-15) 0.0157
Acute symptomatic seizures 5 (39) 3 (6) 0.0326

CI; confidence interval, EEG; electroencephalography, GCS; Glasgow Coma Scale.

* Values are presented as number (range) or number (%).

Table 2.
Results of multivariate analysis of variables in patients with and without triphasic waves
Independent variable Adjusted odds ratio 95% confidence interval p-value
Severe EEG alteration 5.9 0.64-55.07 0.1175
GCS (≤10) 6.6 1.03-41.81 0.0463
Acute symptomatic seizures 7.6 1.06-54.68 0.0431

EEG; electroencephalography, GCS; Glasgow Coma Scale.

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