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Alpha-coma. Electroencephalographic, clinical, pathologic, and etiologic correlations.

B F Westmoreland, D W Klass, F W Sharbrough

    Archives of Neurology
    |November 1, 1975
    PubMed
    Summary
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    Alpha-coma, a state of clinical coma with wakeful-appearing EEG alpha activity, indicates a poor prognosis. This pattern was observed in patients with brain stem strokes or hypoxic encephalopathy, with distinct EEG characteristics in each group.

    Area of Science:

    • Neurology
    • Neurophysiology
    • Clinical Neuroscience

    Background:

    • Alpha-coma is a rare clinical-EEG syndrome characterized by coma with a normal wakeful electroencephalogram (EEG) pattern.
    • This syndrome presents diagnostic and prognostic challenges in critical care settings.

    Purpose of the Study:

    • To investigate the clinical, electroencephalographic (EEG), and pathological features of alpha-coma.
    • To differentiate alpha-coma patterns based on underlying etiologies.
    • To assess the prognostic significance of alpha-coma.

    Main Methods:

    • Retrospective review of clinical, EEG, and pathological data from 13 patients diagnosed with alpha-coma.
    • Classification of patients into two groups based on etiology: brain stem stroke and hypoxic encephalopathy.

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  • Comparative analysis of EEG characteristics between the two groups.

    • Main Results:

    • Eight patients had brain stem strokes, and five had hypoxic encephalopathy.
    • EEG differences were noted: posterior, variable, reactive, and persistent alpha activity in stroke patients versus transient, less reactive alpha activity in hypoxic patients.
    • Alpha-coma pattern indicated a poor prognosis for survival in both etiological groups.

    Conclusions:

    • Alpha-coma is associated with severe brain injury, primarily from brain stem strokes or hypoxic encephalopathy.
    • Distinct EEG features may help differentiate etiologies within the alpha-coma syndrome.
    • The presence of alpha-coma is a grave prognostic indicator, irrespective of the cause.