Alpha coma on EEG

Unreactive alpha-frequency pattern in coma · Coma · ICU

Monotonous frontally predominant 9 Hz activity that does not change with a painful stimulus. Simulated trace, longitudinal bipolar channels. Open in the interactive viewer

What it looks like

Alpha-frequency activity in a comatose patient that is diffuse or frontally predominant, monotonous and unreactive. It is not a posterior dominant rhythm and does not block with eye opening or pain. ^3,11

What it means at the bedside

Prognosis follows the cause. After cardiac arrest it usually accompanies severe injury; after drug intoxication, recovery is common. A posterior, reactive alpha in an unresponsive patient is a different problem: think locked-in syndrome or a functional state.

ComaUnreactive

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Sources

Kane N, et al. A revised glossary of terms most commonly used by clinical electroencephalographers and updated proposal for the report format of the EEG findings (IFCN, 2017). Clin Neurophysiol Pract 2017;2:170–185. doi.org/10.1016/j.cnp.2017.07.002
Britton JW, et al. Electroencephalography (EEG): An Introductory Text and Atlas of Normal and Abnormal Findings in Adults, Children, and Infants. American Epilepsy Society, 2016 (free, NCBI Bookshelf). www.ncbi.nlm.nih.gov/books/NBK390354/

Alpha coma on EEG

What it looks like

What it means at the bedside

Sources

Related patterns