The Electroencephalographic Diagnosis of Manifest and Latent `Delirium' With Particular Reference to That Complicating Hepatic Cirrhosis

Laidlaw, John; Read, A. E.

doi:10.1136/jnnp.24.1.58

Cited by 34 publications

(7 citation statements)

References 17 publications

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“…This is in accordance with other studies investigating hypoglycemia-associated EEG changes (11,22,23). Increased amplitude in the u band is not unique to hypoglycemia but is seen during a number of conditions including drowsiness, encephalopathy, or depression (24)(25)(26). However, in contrast, hypoglycemia-associated EEG changes are most pronounced in the parietotemporal area of the brain, whereas the perspective of the full EEG is needed in the other conditions.…”

Section: Discussionsupporting

confidence: 91%

Hypoglycemia-Associated Changes in the Electroencephalogram in Patients With Type 1 Diabetes and Normal Hypoglycemia Awareness or Unawareness

et al. 2014

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Hypoglycemia is associated with increased activity in the low-frequency bands in the electroencephalogram (EEG). We investigated whether hypoglycemia awareness and unawareness are associated with different hypoglycemia-associated EEG changes in patients with type 1 diabetes. Twenty-four patients participated in the study: 10 with normal hypoglycemia awareness and 14 with hypoglycemia unawareness. The patients were studied at normoglycemia (5–6 mmol/L) and hypoglycemia (2.0–2.5 mmol/L), and during recovery (5–6 mmol/L) by hyperinsulinemic glucose clamp. During each 1-h period, EEG, cognitive function, and hypoglycemia symptom scores were recorded, and the counterregulatory hormonal response was measured. Quantitative EEG analysis showed that the absolute amplitude of the θ band and α-θ band up to doubled during hypoglycemia with no difference between the two groups. In the recovery period, the θ amplitude remained increased. Cognitive function declined equally during hypoglycemia in both groups and during recovery reaction time was still prolonged in a subset of tests. The aware group reported higher hypoglycemia symptom scores and had higher epinephrine and cortisol responses compared with the unaware group. In patients with type 1 diabetes, EEG changes and cognitive performance during hypoglycemia are not affected by awareness status during a single insulin-induced episode with hypoglycemia.

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Section: Discussionsupporting

confidence: 91%

Hypoglycemia-Associated Changes in the Electroencephalogram in Patients With Type 1 Diabetes and Normal Hypoglycemia Awareness or Unawareness

et al. 2014

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“…Previous studies have noted that maximal changes in these parameters occur at the time of maximal sedation or coma (Laidlaw and Read, 1961) suggesting a causative role between EEG changes and sedation. It is of interest that diazepam induced a similar degree of sedation in normal subjects and patients with liver disease, yet there were marked differences in their EEGs.…”

Section: Discussionmentioning

confidence: 93%

Intravenous administration of diazepam in patients with chronic liver disease.

Branch¹,

Morgan²,

James³

et al. 1976

Gut

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SUMMARY The EEG response and drug kinetics after intravenous infusion of diazepam at 1.0 mg/ min until nystagmus, dysarthria, and moderate sedation developed, has been investigated in five normal subjects and 17 patients with chronic liver disease. Diazepam induced adequate premedication with a similar clinical response in all subjects with no adverse reactions. Maximal response was during or within five minutes of infusion. The dose of diazepam required in chronic liver disease was 17-9 + 1-4 mg (M ± SEM) compared with 27 ± 5-4 mg in controls (p < 0 01). Dose correlated significantly with serum albumin (p < 0-05). Baseline mean dominant frequency (MDF) and slow wave index (SWI) significantly correlated with albumin (p < 0 01). After diazepam, the MDF decreased and SWI increased. The change was greatest at the time of maximal clinical response.

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“…Two decadcs later, more sophisticated analyses were performed by Laidlaw and Read (1961), who used an "electronic waveform analyzer." This device consistcd of a series of resonant circuits whose output was stored in capacitors; the charge in the capacitors was used as an estimate of the relative EEG activity in a series of 1 Hz frequency bands.…”

Section: Semiquantitative Eeg Analysismentioning

confidence: 99%

Quantitative Measurement of Brain Electrical Activity in Delirium

Leuchter¹,

Jacobson

1991

Int. Psychogeriatr.

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It has long been known that the conventional electroencephalogram (EEG) is a useful tool in the evaluation of delirium. There are moderate correlations between the amount of slowing seen on EEG and the degree of confusion or level of arousal observed among delirious patients. The usefulness of the EEG for assessment and diagnosis in this area has been limited, however, by: (a) difficulties in assessing the significance of slow-wave activity, (b) problems in detecting changes in relative EEG power, and (c) the logistical problem of lengthy recording sessions with agitated patients. This article selectively reviews the development of quantitative EEG methods and presents preliminary data from an ongoing longitudinal study of the use of these methods among elderly delirious patients. There has been little work done in applying quantitative methods to the study of delirium, and no work done that has systematically compared conventional EEG analysis to quantitative analysis. Delirium shares electrophysiological characteristics with other organic mental syndromes, however, where quantitative EEG has been shown to be useful. Furthermore, analysis of digital EEG data is inherently superior to visual inspection in assessing the distribution of EEG power among different frequency bands. Previous studies, as well as data presented here, suggest that quantitative EEG is a clinically useful supplement to the conventional EEG for the assessment of elderly patients with delirium.

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The Electroencephalographic Diagnosis of Manifest and Latent `Delirium' With Particular Reference to That Complicating Hepatic Cirrhosis

Cited by 34 publications

References 17 publications

Hypoglycemia-Associated Changes in the Electroencephalogram in Patients With Type 1 Diabetes and Normal Hypoglycemia Awareness or Unawareness

Hypoglycemia-Associated Changes in the Electroencephalogram in Patients With Type 1 Diabetes and Normal Hypoglycemia Awareness or Unawareness

Intravenous administration of diazepam in patients with chronic liver disease.

Quantitative Measurement of Brain Electrical Activity in Delirium

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