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THE EFFECT OF GLYCEROL ON EEGABNORMALITY (POLYMORPHIC DELTA WAVE) IN PATIENTS WITH BRAIN TUMORS Tohru Soejima 1 , Shinya Okuda 1 , Tadahiro Ishikawa 1 , Shigeaki Matsuoka 1 1Department of Neurosurgery, University of Occupational and Environmental Health pp.553-560
Published Date 1987/6/1
DOI https://doi.org/10.11477/mf.1406205922
  • Abstract
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The effect of intravenous infusion of 10% glycerol on polymorphic delta waves of EEG was investigated in 13 patients (15 studies) with brain tumors in cerebral hemisphere. The delta waves were analyzed by two-dimentional EEG topography and power spectrum of delta waves (P (δ)) over the tumor, adjacent, and distant regions in the same hemisphere to the tumor, and ipsi- and contralateral hemispheres to the tumor. The delta focus of EEG topography was well corresponded to the tumor and surrounding brain edema which visualized byx-ray CT-scan. In the patient with brain tumors with marked brain edema (group A, 11 studies), EEG topography showed marked reduction of delta focus within 20 minutes from the end of in-travenous infusion of glycerol, and returned to preinfusion distribution within 60 miutes. In pa-tients with absent to minimum brain edema (group B, 4 studies), delta focus showed the tendency to enlarge and returned to preinfusion state at 60 minutes after the end of glycerol infusion.

In patients of group A, P (δ) of ipsilateral hemi-sphere to tumor decreased at the end of glycerol infusion, and showing maximal reduction ratio (30%, p<0.01) at 20 minutes, re-increased there-after. In group B, P (δ) of ipsilateral hemisphere showed no definite changes after the glycerol infusion. P (δ) of contralateral hemispheres in patients of both group A and B, showed similar reduction ratio and time course to those of ipsi-lateral hemisphere of group A. In the ipsilateral hemisphere to tumor in group A, P (δ) over the tumor showed lowest reduction ratio, and highest at the distant region to the tumor by glycerol infusion. Eventhough statistically significant changes was absent in group B, P (δ) over the tumor showed tendency to increase and to decrease over the distant part to the tumor. When the patients were grouped according to presence or absence of midline shift on x-ray CT-scan, there was no sta-tistical difference of reduction ratio of P (δ) after glycerol infusion between two groups.

These results suggest that polymorphic delta waves appearing in patients with brain tumor of cerebral hemisphere originates, at least partially, from the functional disturbance of brain due to edema. It is also likely that delta waves in some part are related to mechanical effect of brain edema to midline structure, and disruption of corticosubcortical fiber connection induced by tumor itself.

Also, similar reduction ratios of P (δ) over the ipsilateral hemisphere to tumor in group A and contralateral hemispheres of group A and B, may suggest that the temporary decrease of delta waves by glycerol infusion is not the direct result of dehydrating effect of glycerol upon abnormally accumulated brain water, but of improvement and activation of cerebral blood flow or some me-tabolism of edematous and normal brain.


Copyright © 1987, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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