Prolonged disturbance of consciousness with periodic EEG discharges after fulminant hepatitis

Prolonged disturbance of consciousness associated with periodic EEG discharges developed in a 57-year-old male after fulminant hepatitis. He had repeated episodes with mutism and depersonalization, each lasting for 1-2 days. There were periodic EEG discharges during each episode. The atypical triphasic wave was a constituent of periodic EEG discharges together with spike and sharp waves, which suggests that the atypical triphasic wave has an epileptogenic factor as do spike and sharp waves. The effectiveness of anticonvulsants on the disturbance also suggests that there was an epileptogenic factor in the causation of the disturbance of consciousness.