GPDs (generalized periodic discharges) on EEG

Generalized periodic discharges · Periodic · ICU

Synchronous generalized discharges at 1 Hz on a low-voltage background. Simulated trace, longitudinal bipolar channels. Open in the interactive viewer

What it looks like

Bilaterally synchronous, symmetric discharges recurring at nearly regular intervals, with a discernible background between them. Seen in toxic-metabolic and septic encephalopathy, after cardiac arrest, and during or after status epilepticus. 1

What it means at the bedside

Frequency drives the reading. Above 2.5 Hz for 10 seconds they meet the definition of an electrographic seizure; between 1 and 2.5 Hz they sit on the ictal–interictal continuum. 1 After cardiac arrest, GPDs on a suppressed background belong to the "highly malignant" patterns. 8

PeriodicGeneralized

Sources

  1. Hirsch LJ, et al. American Clinical Neurophysiology Society's Standardized Critical Care EEG Terminology: 2021 version. J Clin Neurophysiol 2021;38:1–29. doi.org/10.1097/WNP.0000000000000806
  2. Westhall E, et al. Standardized EEG interpretation accurately predicts prognosis after cardiac arrest. Neurology 2016;86:1482–1490. doi.org/10.1212/WNL.0000000000002462

Related patterns