Abstracts

RATIONALE: Triphasic waves (TWs) are typical findings of Metabolic Encephalopathy (ME) though TWs wave has been reported to have an epileptogenic origin, as well. In this study, we discussed differential diagnosis of TWs seen in patients who admitted with Acute Confusional State (ACS) with metabolic disease METHODS: In this study the patients who admitted with ACS as a result of metabolic disease are included. Triphasic waves were seen on EEG in 7 patients. Four patient had renal failure, 1 patient had renal failure and intracranial heamorhage, 1 patient had hepatic failure,1 patient had hepatic failure and hyponatremia. Suppression of TWs and recovery of slowing on EEG by diazepam ( DZP) are major criteria for nonconvulsive status epilepticus. RESULTS: After giving DZP, the TWs of 6 patients were suppresed. After the SE treatment, clinical presentation and EEG findings of 5 patients improved. The TWs of 1 patient with hyponatremia and hepatic failure weren t supressed by DZP until hyponatremia improved. One patient died from uncal herniation. CONCLUSIONS: Triphasic waves might be related with epileptiform activity even in patients with metabolic disorder and ACS. The differential diagnosis of TWs are important regarding to the treatment protocol and prognosis.