Generalized periodic spike discharges

Interpretation: Severe encephalopathy of non specific etiology indicating diffuse cortical irritability and potential epileptogenic dysfunction

Semiology: 05.-1.5 hz GPD with discontinuous low amp delta background.

Hx: geriatric patient with h/o non occulsive thrombus pt suddenly started bleeding from nose and mouth, s/p L TKA c/b non healing wound stent. Code blue called (PEA arrest), ROSC but remained comatose due to cerebral edema resulting in anoxic brain injury. Concerned of SE due to increase in GPD, increased AED and weaning sedation

Meds:

Keppra, onfi, vimpat, proprofol