PMID- 22940145
OWN - NLM
STAT- MEDLINE
DCOM- 20160423
LR  - 20181201
IS  - 1294-9361 (Print)
IS  - 1294-9361 (Linking)
VI  - 14
IP  - 3
DP  - 2012 Sep
TI  - Falsely pessimistic prognosis by EEG in post-anoxic coma after cardiac arrest: 
      the borderland of nonconvulsive status epilepticus.
PG  - 340-4
LID - 10.1684/epd.2012.0519 [doi]
AB  - BACKGROUND: Prognostication following anoxic coma relies on clinical assessment 
      and is assisted by neurophysiology. A non-evolving EEG spike burst/isoelectric 
      suppression pattern after the first 24 hours almost invariably indicates poor 
      outcome, while an evolving pattern implies nonconvulsive status epilepticus 
      (NCSE) that may "hide" surviving brain activity and is amenable to treatment. 
      CASE STUDY: We present the case of a 53-year-old woman who had a witnessed 
      out-of-hospital ventricular fibrillation cardiac arrest, was resuscitated by 
      paramedics, but remained comatose. An EEG, performed 36 hours post-insult, showed 
      an unremitting, non-evolving, unresponsive 2-6 Hz high-voltage spike 
      burst/isoelectric suppression pattern, which remained unchanged at 96 hours 
      post-insult, following therapeutic hypothermia. During this period, she was 
      completely off sedation and taking triple antiepileptic treatment, without 
      systemic confounding disorders. Although the initial pattern was indicative of 
      poor neurological outcome, she eventually made meaningful functional recovery; 
      the last EEG showed satisfactory background rhythms and stimulus-induced 
      epileptiform discharges without seizures. CONCLUSION: In post-anoxic coma, 
      non-evolving >2 Hz spike burst/isoelectric suppression pattern may still reflect 
      NCSE and therefore should be considered in the diagnostic EEG criteria for NCSE. 
      Such borderline patterns should not dissuade physicians from intensifying 
      treatment until more confident prognostication can be made.
FAU - Sreedharan, Jemeen
AU  - Sreedharan J
AD  - Department of Neurology.
FAU - Gourlay, Elizabeth
AU  - Gourlay E
FAU - Evans, Matthew R
AU  - Evans MR
FAU - Koutroumanidis, Michalis
AU  - Koutroumanidis M
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Epileptic Disord
JT  - Epileptic disorders : international epilepsy journal with videotape
JID - 100891853
SB  - IM
MH  - *Coma/diagnosis
MH  - *Electroencephalography
MH  - Heart Arrest
MH  - Humans
MH  - Prognosis
MH  - Status Epilepticus/diagnosis
EDAT- 2012/09/04 06:00
MHDA- 2016/04/24 06:00
CRDT- 2012/09/04 06:00
PHST- 2012/09/04 06:00 [entrez]
PHST- 2012/09/04 06:00 [pubmed]
PHST- 2016/04/24 06:00 [medline]
AID - epd.2012.0519 [pii]
AID - 10.1684/epd.2012.0519 [doi]
PST - ppublish
SO  - Epileptic Disord. 2012 Sep;14(3):340-4. doi: 10.1684/epd.2012.0519.