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Triphasic waves: To treat or not to treat?

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Triphasic waves (TWs) on EEG are linked to various conditions. This review clarifies their features, correlates, and the ongoing debate about their association with seizures, offering management guidance.

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Area of Science:

  • Neurophysiology
  • Clinical Neurology
  • EEG Interpretation

Background:

  • Generalized periodic discharges (GPDs) with triphasic morphology, known as triphasic waves (TWs), are significant EEG findings.
  • Research has focused on their causes, clinical associations, and implications for patient management, particularly concerning seizures.

Purpose of the Study:

  • To review the historical context and current understanding of triphasic waves (TWs).
  • To elucidate the clinical and radiographic correlates of TWs.
  • To discuss the controversial association between TWs and seizures and propose a management strategy.

Main Methods:

  • Literature review of studies on triphasic waves (TWs).
  • Analysis of typical and atypical EEG features of TWs.
  • Synthesis of evidence regarding the relationship between TWs and seizures.

Main Results:

  • Triphasic waves (TWs) have diverse clinical and radiographic associations.
  • Controversies persist regarding the direct link between TWs and seizures due to conflicting study findings.
  • A clear understanding of TWs' significance in seizure management remains debated.

Conclusions:

  • Triphasic waves (TWs) require careful interpretation considering their varied correlates.
  • Further research is needed to resolve the controversy surrounding TWs and seizures.
  • A structured approach to managing patients with TWs is proposed.