In EEG type of wave seen in metabolic encephalophathv -

Ans. is 'd' i.e., Delta E.E.G changes in metabolic encephalopathyIn metabolic encephalopathy chances are typically nonfocalo E.E.G. has been widely used to evaluate metabolic encephalopathy. o The E.E.G. findings are abnormal in acute encephalopathic stages.o It is difficult to establish a diagnosis of metabolic encephalopathy with certainity through E.E.G."There is generalized slowing of the E.E.G with an excess of the delta and theta waves with suppression of normal alpha and beta wave activity and occasionally bilateral spikes and waves complexes occurring in absence of seizure activity".o In metabolic encephalopathies, the E.E. G evolution correlates well with the severity of encephalopathy,o However EEG has little specificity in differentiating etiologies in metabolic encephalopathy.# For example, though triphasic waves are most frequently mentioned in hepatic encephalopathy, they can also he seen in uremic encephalopathy or even in aged psychiatric patients treated with lithium,o Spikes and waves may appear in hypo or hyperglycemia uremic encephalopathy or vitamin deficiencies.Common principles of EEG changes in metabolic encephalopathy are : -i) Varied degrees of slowingii)Associated mixtures of epileptic dischargeHigh incidence of triphasic wavesReversibility after treatment of underlying causesMetabolic encephalopathyEEG rythmGrade I (almost normal)Dominant activity is alpha rhythm with minimal teta activityGrade II (mildly abnormal)Dominant teta background with some alpha and delta activities.Grade II (moderately abnormal)Continuous delta activity predominates, little activity of faster frequenciesGrade IV (severely abnormal)Low-amplitude delta activity or suppression-burst patternGrade V (extremely abnormal)Nearly"flat" tracing or electrocerebral inactivity.