Purpose: Triphasic waves arising in patients with toxic metabolic encephalopathy (TME) are often considered different from generalized periodic discharges (GPDs) in patients with generalized nonconvulsive status epilepticus (GNCSE). The primary objective of this study was to investigate whether a common mechanism can explain key aspects of both triphasic waves in TME and GPDs in GNCSE.
Method: A neural mass model was used for the simulation of EEG patterns in patients with acute hepatic encephalopathy, a common etiology of TME. Increased neuronal excitability and impaired synaptic transmission because of elevated ammonia levels in acute hepatic encephalopathy patients were used to explain how triphasic waves and GNCSE arise. The effect of gamma-aminobutyric acid-ergic drugs on epileptiform activity, simulated with a prolonged duration of the inhibitory postsynaptic potential, was also studied.
Results: The simulations show that a model that includes increased neuronal excitability and impaired synaptic transmission can account for both the emergence of GPDs and GNCSE and their suppression by gamma-aminobutyric acid-ergic drugs.
Conclusions: The results of this study add to evidence from other studies calling into question the dichotomy between triphasic waves in TME and GPDs in GNCSE and support the hypothesis that all GPDs, including those arising in TME patients, occur via a common mechanism.
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http://dx.doi.org/10.1097/WNP.0000000000000719 | DOI Listing |
CEN Case Rep
December 2024
Department of Nephrology and Hypertension, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan.
Ceftriaxone is widely used clinically but it can potentially cause ceftriaxone encephalopathy in individuals who are on dialysis. We describe ceftriaxone encephalopathy in a dialysis patient. The 87-year-old Japanese woman had a 9-year dialysis history.
View Article and Find Full Text PDFActas Esp Psiquiatr
October 2024
Department of Pediatrics, West China Second University Hospital, Sichuan University, 610017 Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, 610017 Chengdu, Sichuan, China.
Background: Triphasic waves (TWs) on electroencephalograms (EEGs) have predominantly been observed in adults, often associated with Creutzfeldt‒Jakob disease and metabolic encephalopathy. However, TWs have also been linked to various nonmetabolic and structural abnormalities. Additionally, reports of TWs in children are rare.
View Article and Find Full Text PDFArq Neuropsiquiatr
November 2024
Universidade Federal do Paraná, Complexo Hospital de Clínicas, Departamento de Neurofisiologia, Curitiba PR, Brazil.
J Control Release
October 2024
Department of Radiology, University of Michigan, Ann Arbor, MI, USA; Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA; Applied Physics Program, University of Michigan, Ann Arbor, MI, USA. Electronic address:
Hydrogels can serve as local drug delivery depots that protect the biological activity of labile therapeutics. However, drug release from conventional hydrogels is typically rapid, which is not ideal for many therapeutic agents. We developed a composite hydrogel that enables sustained drug release in response to ultrasound.
View Article and Find Full Text PDFJ Investig Med High Impact Case Rep
July 2024
Joan Edwards School of Medicine, Huntington, WV, USA.
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