Prognostic utility of electroencephalogram in acute consciousness impairment

Abstract

The role of EEG in the context of prognostic assessment in patients with acute disorders of consciousness has expanded steadily over the last decades, paralleling technical developments and refinements; remarkably, recent collaborative efforts have led to a consensus proposal for the nomenclature of alterations commonly observed in this setting. This chapter will review the most common EEG patterns that are observed in this clinical context and outline their prognostic implications. Then, in a sort of “inverse solution approach,” several diagnostic categories will be analyzed regarding the role of EEG on outcome prediction. Finally, an overview of the most recent tools, such as intracranial EEG or automated EEG interpretations, will be critically discussed. While EEG is well established in the process of prognostication, its role is still that of a marker of the clinical evolution rather than representing a tool generating therapeutic implications. Hopefully, future work will lead to a change of paradigm that may not only improve and expand current knowledge but also, more importantly, allow better care of patients.