Diffuse slowing on EEG: encephalopathy

Generalized theta–delta background · Slowing · ICU

Generalized theta–delta without an alpha rhythm. The background changes with stimulation: reactive. Simulated trace, longitudinal bipolar channels. Open in the interactive viewer

What it looks like

No posterior dominant rhythm; the background is replaced by generalized, irregular theta and delta. This is the EEG signature of diffuse encephalopathy, and its degree follows the severity. 11

What it means at the bedside

The cause is not on the EEG: metabolic, septic, toxic, hypoxic, post-ictal, sedative. What the EEG adds is severity, reactivity to stimulation (preserved here, a favourable feature) and the exclusion of non-convulsive seizures.

EncephalopathyNon-specific

Sources

  1. 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/

Related patterns