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Etiology and prognosis of alpha coma

From the Department of Medicine, Division of Neurology (Drs. Austin, Wilkus, and Longstreth), and Department of Laboratory Medicine, Division of Electroencephalography and Clinical Neurophysiology (Drs. Austin and Wilkus), University of Washington School of Medicine, Seattle, WA.

We reviewed our experience with alpha coma, the finding of predominantly alpha-frequency rhythms in the EEGs of unconscious patients, and identified 50 patients. Cardiac arrest, either inside (n = 25) or outside (n = 24) the hospital, was the cause of unconsciousness in all except one patient who had hyperglycemic, hyperosmolar coma. After out-of-hospital cardiac arrest, the risk of never regaining consciousness or dying during hospitalization did not differ significantly between unconscious patients with (n = 24) and without (n = 69) alpha frequencies in their EEGs. A review of the literature supports our findings that alpha coma most commonly follows cardiac arrest and does not preclude the possibility of neurologic recovery. We conclude that alpha coma is a descriptive term and lacks prognostic significance in itself.

Address correspondence and reprint requests to Dr. Austin, Neurology Service, Veterans Administration Medical Center, 113 Holland Avenue, Albany, NY 12208.

Received July 28, 1986. Accepted for publication in final form August 31, 1987.

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