Quantitative measurement of brain electrical activity in delirium

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.