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Periodic EEG patterns in cerebral fat embolism
Clinical EEG (Electroencephalography)
|January 1, 1983
Summary
Fat embolism syndrome (FES) can cause varied EEG abnormalities, including periodic activity. These findings indicate a non-specific encephalopathy, not necessarily a poor prognosis for FES patients.
Area of Science:
- Neurology
- Neurophysiology
Background:
- Fat embolism syndrome (FES) is a rare but serious complication following long bone fractures.
- Cerebral involvement in FES can lead to significant neurological deficits.
Observation:
- A 24-year-old male with tibial and metatarsal fractures developed FES with coma, seizures, and respiratory distress.
- Prolonged electroencephalographic (EEG) monitoring revealed dynamic patterns: continuous high amplitude EEG rhythmical synchronous slowing (CHERSS), triphasic waves, bilateral independent periodic lateralized epileptiform discharges (BIPLEDs), and frontal intermittent delta activity (FIRDA).
Findings:
- Periodic EEG activities (CHERSS, triphasic waves, BIPLEDs, FIRDA) are observed in cerebral fat embolism.
- These EEG patterns represent a non-specific diffuse encephalopathy.
- Neurological recovery was complete after three months, with normalized EEG findings.
Implications:
- The presence of periodic EEG activity in FES does not predict a poor prognosis.
- Frequent, prolonged bedside EEG recordings are crucial for detecting fluctuating abnormalities in cerebral fat embolism.
- Previously unrecognized EEG patterns in FES may be due to evolving diagnostic criteria and techniques.