Lateralised Periodic Discharges — SCE Neurology MCQ

Correct answer: A — Generalised periodic discharges on the metabolic ictal-interictal continuum

The best answer is “Generalised periodic discharges on the metabolic ictal-interictal continuum”. Triphasic morphology is a descriptor rather than a diagnosis; generalised periodic discharges occur in toxic-metabolic encephalopathy but at faster frequencies can overlap with non-convulsive seizure activity, so causes, reactivity and treatment response must be assessed. “A physiological normal variant during quiet wakefulness” is less appropriate because periodic discharges are pathological rather than normal background “Definitive electrophysiological proof of functional unresponsiveness” is less appropriate because EEG morphology does not prove a functional disorder “Conclusive electrographic evidence of irreversible brain death” is less appropriate because brain death requires a distinct clinical and legal assessment “A pattern that cannot respond to antiseizure treatment” is less appropriate because selected patterns can improve with correction of the cause or antiseizure treatment

Reference: ACNS standardized critical-care EEG terminology 2021. https://pubmed.ncbi.nlm.nih.gov/33475321/