What are the etiologies of beta coma on electroencephalogram (EEG)?

From the Guidelines

Beta coma etiologies are most commonly associated with sedative drug intoxication, metabolic encephalopathy, post-anoxic coma, and certain structural brain injuries, as evidenced by recent guidelines 1. When considering the etiologies of EEG beta coma, several factors come into play, including the patient's medical history, current medications, and the presence of any underlying neurological conditions.

• Sedative drug intoxication, particularly with benzodiazepines, barbiturates, or propofol, is a common cause of beta coma, as these substances can alter brain activity patterns 1.
• Metabolic encephalopathy, such as hepatic encephalopathy, can also lead to beta activity on EEG, often with a characteristic triphasic wave pattern superimposed on the beta activity.
• Post-anoxic coma, resulting from cardiac arrest or other hypoxic events, may also present with beta activity, which can be indicative of a poorer prognosis, although individual patient outcomes may vary 1.
• Certain structural brain injuries, such as those resulting from trauma or stroke, can also cause beta coma, although this is less common. In terms of management, identifying and treating the underlying cause of the beta coma is crucial, while providing appropriate supportive care 1.
• This may involve discontinuing or adjusting sedative medications, addressing underlying metabolic disturbances, or providing targeted therapies for post-anoxic coma or structural brain injuries.
• The presence of beta activity in coma generally carries a more favorable prognosis than patterns showing severe slowing or suppression, although the underlying etiology remains the most important prognostic factor 1.

From the Research

EEG Beta Coma Etiologies

• Coma has many causes, including neurogenic, metabolic, and toxic factors 2
• EEG beta coma can be caused by various etiologies, such as:
  • Post-anoxic coma after cardiac arrest 3, 4
  • Status epilepticus, which can lead to neuronal injury, severe disability, coma, and death 5
  • Non-convulsive status epilepticus, which requires confirmation by electroencephalogram 5
• The prognosis and outcomes of comatose patients depend on various factors, including:
  • Age and comorbid diseases of the patient 2
  • Underlying cause of coma 2
  • Timely medical help and its quality 2
  • Intensive treatment and care of the patient in coma 2
• EEG patterns, such as non-evolving spike burst/isoelectric suppression pattern, can be indicative of poor neurological outcome, but may also reflect non-convulsive status epilepticus and should not dissuade physicians from intensifying treatment 4