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Clinical and Electroencephalographic Correlates of Acute Encephalopathy

Sutter, Raoul*,†; Kaplan, Peter W.

Journal of Clinical Neurophysiology: October 2013 - Volume 30 - Issue 5 - p 443–453
doi: 10.1097/WNP.0b013e3182a73bc2
Invited Review

Summary: The term encephalopathy encompasses a wide variety of syndromes caused by a large number of different toxic, metabolic, and degenerative derangements. Despite advances in intensive medical care and new diagnostic procedures, encephalopathy remains a frequent and underrecognized critical medical condition with high morbidity and mortality. Electroencephalography (EEG) enables rapid bedside electrophysiological measurements of brain dysfunction and complements clinical and neuroimaging assessment of encephalopathic patients. Both progressive slowing of EEG background activity with increasing cerebral compromise and decreased EEG reactivity to external stimuli provide important diagnostic and prognostic information. The aim of this review was to provide an overview of the diagnostic and prognostic value of EEG in encephalopathic patients.

*Division of Neurosciences Critical Care, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A.; and

Department of Neurology, Johns Hopkins Bayview Medical Center, Baltimore, Maryland, U.S.A.

Address correspondence and reprint requests to Raoul Sutter, MD, Department of Neurology and Intensive Care Unit, University Hospital Basel, Petersgraben 4, Basel 4031, Switzerland, email:

R.S. is supported by the Research Funds of the University of Basel, the Scientific Society Basel, and the Gottfried Julia Bangerter-Rhyner Foundation. P.W.K. has no relevant conflicts of interest except authorship in several books on EEG.

© 2013 by the American Clinical Neurophysiology Society