82. EEG epileptiform abnormalities in patients with severe disorders of consciousness

Abstract

Although epileptiform abnormalities are a common electroencephalographic finding after a brain injury, not much is known about their prevalence and prognostic value in patients with severe disorders of consciousness. In this study, we evaluated the occurrence of epileptiform abnormalities in the electroencephalograms recorded at admission in 106 consecutive patients with unresponsive wakefulness syndrome (UWS, 59 patients), or in a minimally conscious state (MCS, 47 patients). Using the Coma Recovery Scale Revised (CRS-R), we compared the three-month outcome of patients with and without epileptiform abnormalities. Epileptiform abnormalities were found in 34 patients (32.1%), with a similar occurrence in patients with UWS (33.9%) or in a MCS (29.8%). The CRS-R score at admission was 7.5 ± 4.6 in patients with epileptiform abnormalities, and 7.4 ± 4.3 in patients without epileptiform abnormalities. After three months, the CRS-R score was 13.6 ± 8 in patients with epileptiform abnormalities, and 15.1 ± 7.7 3 in patients without epileptiform abnormalities. ANOVA showed no significant differences between groups in the three-months changes of the CRS-R score ( F 1,104 = 1.59; p = 0.2). In conclusion, epileptiform abnormalities are common in patients with UWS or MCS after a severe brain injury; yet, their occurrence does not seem to correlate with short term outcome.