Comments, Opinions, and Reviews Current Role of Electroencephalography in Cerebral Ischemia

Background: The electroencephalogram has been largely supplanted by neuroimaging techniques for the diagnosis and localization of ischemic stroke. However, because of its close correlation with cerebral metabolism and its ability to detect brief transient alterations in cortical function, the electroencephalogram may still be useful for certain diagnostic applications in stroke. Summary of Review: The relation of electroencephalographic phenomena to cerebral blood flow and metabolism is reviewed. Ten clinical questions that can be addressed by the electroencephalogram in patients with stroke are posed. The presence of seizures, confirmation of diagnosis, intraoperative monitoring, and level of consciousness are areas of proven usefulness. The electroencephalogram provides less worthwhile information about the time course, prognosis, and localization of strokes. Computerized techniques are of potential but unproven value. Conclusions: The electroencephalogram retains a worthwhile place in the evaluation of patients with cerebral ischemia when it is used to answer specific questions. All patients with strokes do not need electroencephalograms, but the test can provide uniquely useful data in some. (Stroke 1993;24:609-613)