Title : Electrographic significance of periodic discharges and association with etiology and outcome in tertiary care hospital, a retrospective cohort study
Abstract:
Background: Periodic discharges in electroencephalograms (EEGs) represent rhythmic wave patterns and can signal acute or subacute brain damage. While they may predispose patients to seizures, not all are epileptiform. This study focuses on electrographical periodic discharges and aims to elucidate their frequency, etiological associations, and clinical outcomes within a tertiary care hospital setting.
Methodology: This retrospective observational cohort study spanned two years, from January 2021 to January 2023. It included patients aged 18 years and above with EEG-confirmed periodic discharges. Data, including demographics, symptoms, EEG findings, neuroimaging results, treatment, and outcomes, were collected and analyzed using SPSS version 22.
Results: Of the 41 patients analyzed, 51.2% were female, with an average age of approximately 58.5 years. Generalized tonic-clonic seizures were the most common clinical presentation (48.8%), with ischemic stroke being the leading etiological factor (31.7%). Lateralized periodic discharges (LPDs) were the most common EEG finding. Notably, 34% of patients exhibited chronic imaging changes, primarily encephalomalacia and gliosis. The majority (87.8%) were discharged home, with a minority (12.2%) experiencing mortality, often associated with status epilepticus or metabolic encephalopathy. A considerable portion (53.7%) had a modified Rankin Scale (mRS) score of 4 or higher, indicating significant post-discharge functional dependence.
Conclusion: This study highlights the importance of recognizing periodic discharges in EEGs within the context of a tertiary care hospital. The study’s findings emphasize the potential gravity of periodic discharges, as indicated by mortality rates and functional outcomes. Improved understanding of these periodic discharges and their associated conditions can guide clinical decision-making and enhance patient care within tertiary care hospital settings.
Keywords: Electroencephalogram, encephalopathy, lateralized, periodic discharges, seizures.
Audience Take Away Notes:
- The findings of our retrospective cohort study highlight the importance of comprehensively assessing and understanding periodic discharges in EEGs, particularly within a tertiary care hospital setting.
- The study also sheds light on the diverse etiologies and clinical presentations associated with periodic discharges, ranging from ischemic stroke to infections and metabolic encephalopathies.
- Furthermore, the study's exploration of clinical outcomes, including mortality and functional status, emphasizes the potential gravity of periodic discharges in patient care. The identification of these discharges and their subtypes and their correlation with specific etiologies provides valuable clinical insights that can guide treatment decisions and improve patient prognosis.
