Should we treat patients with impaired consciousness and periodic patterns on EEG?  Kay Wei Ping Ng, Hung Chew Wong, Rahul Rathakrishnan  Seizure - European Journal of Epilepsy  Volume 23, Issue 8, Pages 622-628 (September 2014) DOI: 10.1016/j.seizure.2014.04.015 Copyright © 2014 British Epilepsy Association Terms and Conditions

Fig. 1 Patients receiving treatment in response to periodic EEG pattern. Seizure - European Journal of Epilepsy 2014 23, 622-628DOI: (10.1016/j.seizure.2014.04.015) Copyright © 2014 British Epilepsy Association Terms and Conditions

Fig. 2 (a and b) Distribution of functional status and death as graded by modified Rankin Scale (mRS) and assessed before admission and upon discharge in patients treated with abortive therapy in response to the EEG pattern, and in those who were not (numbers shown within bar graph are patient numbers). Seizure - European Journal of Epilepsy 2014 23, 622-628DOI: (10.1016/j.seizure.2014.04.015) Copyright © 2014 British Epilepsy Association Terms and Conditions

Supplementary Fig. S1 Case: This patient presented with altered mentation (GCS 5). She had a VP shunt in-situ for hydrocephalus secondary to multiple central nervous system tubers, and was already on carbamazepine and valproate prior to admission. Following the first EEG (A) which shows PLEDs, abortive therapy was given: IV midazolam infusion, levetiracetam, topiramate, and increased dosages of carbamazepine and valproate. The repeat EEG (B) shows resolution of the periodic pattern, with concomitant improvement in conscious level. Seizure - European Journal of Epilepsy 2014 23, 622-628DOI: (10.1016/j.seizure.2014.04.015) Copyright © 2014 British Epilepsy Association Terms and Conditions