Elektroenzephalografie

Zusammenfassung

Die Elektroenzephalographie (EEG) ist trotz der Weiterentwicklung moderner bildgebender Verfahren auch heute noch in vielen Fällen eine unentbehrliche Untersuchungsmethode der neurologisch-psychiatrischen Diagnostik. Dabei spielt das EEG insbesondere bei der Diagnostik und Klassifikation von Epilepsien, der prächirurgischen Epilepsiediagnostik sowie in der Differentialdiagnose unklarer Bewusst seinsstörungen eine herausragende Rolle.

Neben den technischen und physiologischen Grundlagen des EEG wird in der folgenden Übersicht auf die Befundung der normalen und pathologischen EEG-Aktivität eingegangen. Aufgrund der hohen klinischen Relevanz werden insbesondere die spezifischen EEG-Muster im Rahmen des Status epilepticus und der Encephalopathien berücksichtigt.

Summary

In spite of the dominance of modern neuroimaging, the electroencephalography (EEG) is still an essential diagnostic test in many neurological patients. EEG plays an outstanding role particularly in diagnostic and classification of epilepsy syndromes, in presurgical evaluation of focal epilepsies and in differential diagnosis of obtunded patients.

Beside the technical and physiological basis of EEG, this review includes the interpretation of normal and pathological EEG activity. Because of the high clinical relevance, EEG patterns of status epilepticus and encephalopathies were particularly considered.

Schlüsselwörter

EEG - Epilepsie - Status epilepticus - Enzephalopathie

Keywords

EEG - epilepsy - status epilepticus - encephalopathy

• Literatur

• 1 Akhtari M, Bryant HC, Mamelak AN, Flynn ER, Heller L, Shih JJ, Mandelkern M, Matlachov A, Ranken DM, Best ED, DiMauro MA, Lee RR, Sutherling WW. Conductivities of three-layer live human skull. Brain Topogr 2002; 14: 151-67.
• 2 American Electroencephalographic Society.. Guideline thirteen: guidelines for standard electrode position nomenclature. J Clin Neurophysiol 1994; 11: 111-3.
• 3 Barkley GL, Baumgartner C. MEG and EEG in epilepsy. J Clin Neurophysiol 2003; 20: 163-78.
• 4 Blume WT. Current trends in electroencephalography. Curr Opin Neurol 2001; 14: 193-7.
• 5 Brenner RP. Is it status?. Epilepsia 2002; 43 Suppl 3: 103-13.
• 6 Chong DJ, Hirsch LJ. Which EEG patterns warrant treatment in the critically ill? Reviewing the evidence for treatment of periodic epileptiform discharges and related patterns. J Clin Neurophysiol 2005; 22: 79-91.
• 7 Cooper R, Winter AL, Crow HJ. Comparison of subcortical, cortical and scalp activity using chronically indwelling electrodes in man. Electroencephalogr Clin Neurophysiol 1965; 18: 217-28.
• 8 Daly DD, Pedley TA. Current practive of clinical electroencephalography. New York: Raven Press; 1990
• 9 de la Paz D, Brenner RP. Bilateral independent periodic lateralized epileptiform discharges. Clinical significance. Arch Neurol 1981; 38: 713-5.
• 10 Devinsky O, Kelley K, Porter RJ, Theodore WH. Clinical and electroencephalographic features of simple partial seizures. Neurology 1988; 38: 1347-52.
• 11 Duncan JS. Antiepileptic drugs and the electroencephalogram. Epilepsia 1987; 28: 259-66.
• 12 Fernandez Torre JL, Alarcon G, Binnie CD, Seoane JJ, Juler J, Guy CN, Polkey CE. Generation of scalp discharges in temporal lobe epilepsy as suggested by intraoperative electrocorticographic recordings. J Neurol Neurosurg Psychiatry 1999; 67: 51-8.
• 13 Fitzpatrick W, Lowry N. PLEDs: clinical correlates. Can J Neurol Sci 2007; 34: 443-50.
• 14 Goldman D. The clinical use of the „average“ electrode in monopolar recording. Electroencephalogr Clin Neurophysiol 1950; 2: 211-4.
• 15 Hamer HM, Lüders HO. Electrode montages and localization of potentials in clinical electroencephalography. In Levin KH, Lüders HO. editors. Comprehensive Clinical Neurophysiology. Philadelphia: W. Saunders; 2000: 358-86.
• 16 Hinrichs H. In: Ebner A, Deuschl G. (Hrsg.). EEG, 2. Aufl. Stuttgart: Thieme; 2010
• 17 Hirsch LJ, Brenner RP, Drislane FW, So E, Kaplan PW, Jordan KG, Herman ST, LaRoche SM, Young B, Bleck TP, Scheuer ML, Emerson RG. The ACNS subcommittee on research terminology for continuous EEG monitoring: proposed standardized terminology for rhythmic and periodic EEG patterns encountered in critically ill patients. J Clin Neurophysiol 2005; 22: 128-35.
• 18 Hirsch LJ, Claassen J, Mayer SA, Emerson RG. Stimulus-induced rhythmic, periodic, or ictal discharges (SIRPIDs): a common EEG phenomenon in the critically ill. Epilepsia 2004; 45: 109-23.
• 19 Hoekema R, Wieneke GH, Leijten FS, van Veelen CW, van Rijen PC, Huiskamp GJ, Ansems J, van Huffelen AC. Measurement of the conductivity of skull, temporarily removed during epilepsy surgery. Brain Topogr 2003; 16: 29-38.
• 20 Hoppe M, In: Ebner A, Deuschl G. (Hrsg) EEG, 2. Aufl. Stuttgart: Thieme; 2010: 18-27.
• 21 Kalamangalam GP, Diehl B, Burgess RC. Neuroimaging and neurophysiology of periodic lateralized epileptiform discharges: observations and hypotheses. Epilepsia 2007; 48: 1396-405.
• 22 Kaplan PW. Nonconvulsive status epilepticus in the emergency room. Epilepsia 1996; 37: 643-50.
• 23 Karnaze DS, Bickford RG. Triphasic waves: a reassessment of their significance. Electroencephalogr Clin Neurophysiol 1984; 57: 193-8.
• 24 Kuroiwa Y, Celesia GG. Clinical significance of periodic EEG patterns. Arch Neurol 1980; 37: 15-20.
• 25 Ludwig BI, Ajmone-Marsan C. EEG changes after witdrawal of medication in epileptic patients. Electroencephalogr Clin Neurophysiol 1975; 39: 173-81.
• 26 Marciani MG, Gotmann J, Andermann F, Olivier A. Patterns of seizure activation after withdrawal of antiepileptic medication. Neurology 1985; 35: 1537-43.
• 27 Nei M, Lee JM, Shanker VL, Sperling MR. The EEG and prognosis in status epilepticus. Epilepsia 1999; 40: 157-63.
• 28 Neufeld MY. Periodic triphasic waves in levodopa-induced encephalopathy. Neurology 1992; 42: 444-6.
• 29 Ogunyemi A. Triphasic waves during post-ictal stupor. Can J Neurol Sci 1996; 23: 208-12.
• 30 PeBenito R, Cracco JB. Periodic lateralized epileptiform discharges in infants and children. Ann Neurol 1979; 6: 47-50.
• 31 Rosenow F, Hamer HM, Klein KM. In Ebner A, Deuschl G. (Hrsg.) EEG, 2. Aufl. Stuttgart: Thieme; 2010: 52-66.
• 32 Schaul N, Lueders H, Sachdev K. Generalized, bilaterally synchronous bursts of slow waves in the EEG. Arch Neurol 1981; 38: 690-2.
• 33 Steriade M, Amzica F, Contreras D. Cortical and thalamic cellular correlates of electroencephalographic burst-suppression. Electroencephalogr Clin Neurophysiol 1994; 90: 1-16.
• 34 Sundaram MB, Blume WT. Triphasic waves: clinical correlates and morphology. Can J Neurol Sci 1987; 14: 136-40.
• 35 Theodore WH, Porter RJ, Raubertas RF. Seizures during barbiturate withdrawal: relation to drug levels. Ann Neurol 1987; 22: 644-7.
• 36 Towne AR, Waterhouse EJ, Boggs JG, Garnett LK, Brown AJ, Smith Jr. JR, DeLorenzo RJ. Prevalence of nonconvulsive status epilepticus in comatose patients. Neurology 2000; 54: 340-5.
• 37 Treiman DM. Electroclinical features of status epilepticus. J Clin Neurophysiol 1995; 12: 343-62.
• 38 Treiman DM, Walton NY, Kendrick C. A progressive sequence of electroencephalographic changes during generalized convulsive status epilepticus. Epilepsy Res 1990; 5: 49-60.
• 39 Walker MC. Diagnosis and treatment of nonconvulsive status epilepticus. CNS Drugs 2001; 15: 931-9.
• 40 Waltz S, Christen HJ, Doose H. The different patterns of photoparoxysmal respone – a genetic study. Electroencephalogr Clin Neurophysiol 1992; 83: 138-45.
• 41 Walsh JM, Brenner RP. Periodic lateralized epileptiform discharges – long-term outcome in adults. Epilepsia 1987; 28: 533-6.