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Spectral analysis of the electro encephalogram in hepatic encephalopathy treated with l dopa


, : Spectral analysis of the electro encephalogram in hepatic encephalopathy treated with l dopa. Electroencephalography & Clinical Neurophysiology 52(6): 617-625

A marked increase in low frequencies is the hallmark of the EEG changes in hepatic encephalopathy (HE). These changes are the best known correlates to the clinical state. In HE cases, dramatic clinical and EEG improvements were observed in response to L-dopa treatment. Frequency analysis was performed of EEG records that had been taken in acute HE and EEG power values before treatment were compared to power values during lactulose-neomycin-L-dopa treatment, when clinical and EEG improvement occurred. Nine cases were recorded both before and during treatment, 6 were recorded only before and 1 case only during treatment. The power-spectral calculations were performed on long time segments with overlaying and averaging, and a special data window (Blackman-Harris 4 sample window) was used, in order to increase resolution. There was a marked and significant decrease in the low-frequencies power in response to treatment, which also correlated well with clinical improvement. The .alpha. and .beta. frequencies power was not affected either by the HE dysmetabolic state, or by the treatment and did not correlate at all with the clinical improvement. The slow-wave generating processes may in fact be activated by the HE dysmetabolic states, and that this phenomenon may not be due to slowing of the .alpha. and the .beta. generating processes. These last processes did not respond to the dysmetabolic state, nor did they respond to the treatment with high doses of L-dopa. The .alpha. and .beta. generating processes are probably neither dopaminergic nor serotoninergic. It seems that the slow-wave generating processes are L-dopa responders. All cases were treated with lactulose and neomycin as well as L-dopa, and reduction of slow-waves may be attributed to the metabolic improvement and not to the direct effect of L-dopa.

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