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Alpha-pattern coma: 24 cases with 9 survivors.

A B Grindal, C Suter, A J Martinez

    Annals of Neurology
    |April 1, 1977
    PubMed
    Summary
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    Alpha-pattern coma, characterized by alpha-frequency activity on EEG, can arise from various neurological insults. Many patients survive with minimal deficits, especially when brainstem function is intact.

    Area of Science:

    • Neurology
    • Neurophysiology
    • Critical Care Medicine

    Background:

    • Alpha-pattern coma is a specific electroencephalogram (EEG) finding in comatose patients.
    • Its causes and prognostic indicators require further elucidation.

    Purpose of the Study:

    • To investigate the clinical characteristics, outcomes, and neuropathological findings in patients with alpha-pattern coma.
    • To determine factors associated with survival and neurological deficits.

    Main Methods:

    • Retrospective study of 24 patients with alpha-pattern coma over three years.
    • Analysis of patient history (etiology), clinical examination (brainstem function), EEG findings, and neuropathological data.
    • Correlation of clinical and EEG data with patient outcomes (survival and neurological deficit).

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    Main Results:

    • 24 cases studied: 14 post-cardiopulmonary arrest, 6 post-respiratory arrest, 3 with brainstem infarction.
    • 9 patients survived, with only 1 experiencing significant neurological deficit.
    • Clinical evidence of intact brainstem function correlated with favorable outcomes.
    • EEG patterns were similar in survivors and non-survivors, not differentiating diffuse cerebral from focal brainstem disease.
    • Neuropathology revealed both diffuse cortical and brainstem changes.

    Conclusions:

    • Alpha-pattern coma can stem from diverse neurological insults.
    • A substantial number of patients with alpha-pattern coma achieve survival with good neurological recovery.
    • Intact brainstem function is a key predictor of favorable outcomes.
    • EEG alone is insufficient to distinguish between diffuse cerebral dysfunction and focal brainstem disease in this context.
    • Neuropathological findings highlight the widespread nature of brain injury in alpha-pattern coma.