**4.3 GPDs and seizures**

GPDs are associated with seizures [32]; one study found NCSs in 27% vs. 8% of patients with/without GPDs and NCSE in 22% vs. 7% only [26]. GPDs with "plus

*Periodic EEG Patterns in the Intensive Care Unit (ICU): Definition, Recognition and Clinical… DOI: http://dx.doi.org/10.5772/intechopen.95503*

#### **Figure 9.**

*Association of NCSs, NCSE with GDPs. Generalized periodic discharges and NCSs, NCSE. (A) Seizure occurrence at any time in patients with GPDs vs. controls (%) and (B) during cEEG in patients with GPDs vs. controls (%). (C) Timing of first recorded seizure in patients with GPDs vs. controls. CSE convulsive status epilepticus; CSz convulsive seizure; NCSE nonconvulsive status epilepticus; NCSz nonconvulsive seizure.*

#### **Figure 10.**

*GPDs with Triphasic morphology (GDPs TM) in a 59 ys old patient following cardiac arrest. GDPs show frequency change and qualify probably for "evolving GPDs". Patient given 10 mg diazepam IV.*

#### **Figure 11.**

*Same patient in Figure 10 following 10 mg of diazepam. Note the EEG improvement 6 mn following diazepam IV; however, there was no clinical improvement (patient remained comatose): "Possible NCSE in coma" ("comatose NCSE"?).*

features", sharper morphology, and high frequency increase the possibility of seizures on EEG [23]. Sutter R et al. have shown that GDPs are strongly associated with NCSs, NCSE [33] (**Figure 9**). GDPs may reflect an ictal rhythm; they may manifest with a triphasic morphology [31]; in addition there is a clear GDPs response (triphasic morphology) to Benzodiazepines (BDZs) (**Figures 10** and **11**).
