Standard EEG and the difficult-to-assess mental status

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BACKGROUNDDelirium commonly appears on the differential diagnostic list of psychiatric patients in acute care settings. When a patient is unable or unwilling to answer questions about orientation, determination of possible delirium or other probable etiologies becomes difficult. The role of the standard electroencephalogram (SEEG) in evaluating such patients is not known.METHODSExhaustive MEDLINE and PsycInfo searches were performed for the period 1950-2007 for all articles cross-referenced for “delirium” and “EEG.” The focus was on method, comorbid conditions, demographics, and prevalence and nature of reported abnormalities.RESULTSWe reviewed a total of 45 articles, of which 12 met criteria for more stringent review. All findings are presented in chronological order. Our analysis focuses on SEEG, although we also allude to quantitative EEG when described.CONCLUSIONSDiffuse slowing of the EEG is considered one of the hallmarks of an encephalopathic process and is commonly reported in psychiatric patients. The EEG may be helpful in the diagnostic evaluation of patients with a difficult-to-assess mental status.

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