Bricolo A, Faccioli F, Turazzi S
Rev Electroencephalogr Neurophysiol Clin. 1979 Apr-Jun;9(2):116-30. doi: 10.1016/s0370-4475(79)80066-0.
This study concerns 1600 post-traumatic acute comas, who underwent combined clinical and EEG examinations. The EEG has been recorded accurately bedside several times a day throughout the acute stage. The obtained EEG patterns, generally considered to be polimorphous and extremely variable, can be classified into five basic groups corresponding to progressive deterioration of the cerebral electrogenesis: borderline, changeable, sleep-like, monotonous and silent. Borderline, sleep-like and changeable patterns, even though they indicate a varying degree of impairment of cerebral electrogenesis, prove nevertheless that the brain is capable of elaborating physiological rhythms and of modifying its activity in a spontaneous or evoked manner. True slow monotonous activity indicates an extreme degree of cerebral impairment; flattening, up to EEG silence, indicates the onset of brain death. Focal slowing and/or flattening, which often lacks surgical significance, is not considered in this classification. Focal or generalized irritative activity in the early stages, however, indicates a more severe condition. EEG has often proved to be an useful means supporting the diagnostic and prognostic value of clinical examination.
本研究涉及1600例创伤后急性昏迷患者，这些患者均接受了临床和脑电图联合检查。在急性期，每天在床边多次准确记录脑电图。所获得的脑电图模式通常被认为是多形性的且极易变化，可分为五个基本组，分别对应于脑电发生的进行性恶化：边缘型、可变型、睡眠样、单调型和静息型。边缘型、睡眠样和可变型模式，尽管它们表明脑电发生存在不同程度的损害，但仍证明大脑能够产生生理节律并以自发或诱发的方式改变其活动。真正的慢波单调活动表明脑损伤程度极重；直至脑电图静息的平坦化表明脑死亡的开始。局灶性减慢和/或平坦化通常缺乏手术意义，本分类未予考虑。然而，早期的局灶性或全身性刺激性活动表明病情更严重。脑电图常常被证明是支持临床检查诊断和预后价值的有用手段。
