What is the pathophysiology of EEG triphasic waves?

Updated: Sep 24, 2018
  • Author: Kalyani Korabathina, MD; Chief Editor: Tarakad S Ramachandran, MBBS, MBA, MPH, FAAN, FACP, FAHA, FRCP, FRCPC, FRS, LRCP, MRCP, MRCS  more...
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Regardless of the underlying etiology, TWs are associated with an impaired consciousness that may range from mild confusion to deep coma. The background may be slower in hepatic failure than in other conditions. Patients with metabolic abnormalities as a cause for TWE are more likely to be in coma than those with another etiology of TWE.

Early theories suggested that moving cortical positivity due to cortical irritation produced TWE. The cause now is believed to be a dysfunction of the thalamocortical relay neurons due to structural or metabolic disruption. Abnormalities in glutamate metabolism may be one of the mechanisms of TWE. Metabolic or structural abnormalities at the thalamocortical level, particularly dysfunction in the thalamocortical relay neurons, are hypothesized to be responsible for the EEG and clinical findings associated with TWE.

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