The physiology of brain wave Satoshi EGAWA 1 1Neurointensive Care Unit, Department of Neurosurgery, and Stroke and Epilepsy Center TMG Asaka Medical Center pp.19-26
Published Date 2020/1/1
DOI https://doi.org/10.11477/mf.3102200705
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NCSE (nonconvulsive status epilepticus) is not a rare condition. If SE (status epilepticus) is untreated, resistance to anti-seizure medications increases, leading to high mortality. However, the pathophysiology of this problem has not been fully elucidated. IIC (Ictal-Interictal Continuum), are well known waveforms which may be related to NCSE. An increase in the occurrence of these waveforms may be associated with secondary brain injury. This can lead to a breakdown of the oxygen supply-demand balance in the brain. In addition, SE has a complex pathophysiology at the molecular cell level and at the level of the network in the brain. The concept of “burst suppression” is well known. Suppression means significant suppression of cerebral activities. Burst means a cluster of waveforms with various amplitudes, durations, and waveforms. This condition results from suppression of cortical activity via GABA-ergic mechanisms with breakthrough EEG activity due to intact glutaminergic transmission. At present, we have no clear evidence as to whether we should adjust sedative drugs for burst suppression based on EEG findings. The most recommended goal for EEG in the guideline is to suppress “nonconvulsive” seizure activity.

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