Disorders of Electrophysiology Following Severe Traumatic Brain Injury

Traumatic brain injury (TBI) produces electrophysiologic abnormalities that are critical to monitor. EEG is required to diagnose most seizures (Sz) that occur after severe TBI, provides information about background activity, and informs prognostic assessment. Non-invasive scalp EEG reflects large areas of the cortex, whereas direct recording of cortex, electrocorticography (ECOG), is invasive but provides more detailed information.The clinical management of electrophysiologic disorders has limited evidence and there is considerable equipoise about the prevention and management of Sz. Nonetheless, the use of scalp EEG, subdural strip ECOG, and depth electrode recordings in conjunction with other monitoring modalities form a complementary set of data that can be informative to bedside clinicians.