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Triphasic waves: To treat or not to treat?
Brin E Freund1, Khalil S Husari2, José L Fernández-Torre3,4,5
1Department of Neurology, Mayo Clinic Florida, Jacksonville, FL, USA.
Clinical Neurophysiology Practice
|July 21, 2025
Summary
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.
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.
Keywords:
EEGICU EEGNonconvulsive status epilepticusSeizuresTriphasic wavesgeneralized periodic dischargesMore Related Videos
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