Diffuse theta activity and spindle-like bursts during coma after cardiac arrest

An usual combination of diffuse theta activity with intermittent bursts of spindle-like activity, followed by 2-3 Hz rhythmic discharges and lasting about 7 seconds, was noted in a coma patient after cardiac arrest. We speculate that the theta pattern coma and spindle-like bursts originated in the pontine region, and that those bursts in turn triggered or recruited rhythmic slow-wave complexes similar to absence discharges.

Hypersomnia associated with a focal pontine lesion

A 50-year-old woman developed intractable excessive sleepiness after undergoing the surgical removal of a brainstem cholesteatoma. The 24-hour ambulatory monitoring revealed a normal architecture of sleep contents, with 62.7% of the time spent in sleep. Auditory and somatosensory evoked responses showed abnormal patterns. The MRI scan of her brain showed an extensive nonprogressive lesion in the brainstem. We speculate that the problem underlying the patient's hypersomnia is a defect in the ascending reticular activating system (ARAS) rather than in the REM and NREM sleep mechanisms.

Episodic coma due to acute basilar artery migraine: correlation of EEG and brainstem auditory evoked potential patterns

Our patient presented with three episodes of deep coma in 5 weeks, followed by a complete recovery. The neuroradiological tests and spinal fluid analysis excluded structural lesions, including subarachnoid hemorrhage, from the diagnosis. A nonconvulsive status was excluded by 24-hour EEG monitoring. The EEGs and brainstem auditory evoked responses were abnormal during ictus, but they reversed to normal with the clinical recovery. Timely neurophysiological tests helped in the diagnosis of basilar artery migraine.

Bilateral occipital lobe infarction in acute migraine: clinical, neurophysiological, and neuroradiological study

A woman having common migraine attacks coincident with an asymmetrical bilateral occipital lobe infarction that spared the brainstem and cerebellum underwent these studies: serial electroencephalography, brainstem auditory, visual and somatosensory evoked potentials, magnetic resonance imaging of the brain and cerebral arteriography. The patient's vision improved greatly during a one-year follow-up. The absence of risk factors for stroke suggested that migraine caused the infarction in the posterior circulation network. The pathophysiological mechanisms of stroke in migraine remains speculative.