PMID- 26004321
OWN - NLM
STAT- MEDLINE
DCOM- 20160307
LR  - 20181202
IS  - 1525-5069 (Electronic)
IS  - 1525-5050 (Linking)
VI  - 49
DP  - 2015 Aug
TI  - Low frequency nonevolving generalized periodic epileptiform discharges and the 
      borderland of hypoxic nonconvulsive status epilepticus in comatose patients after 
      cardiac arrest.
PG  - 255-62
LID - S1525-5050(15)00239-5 [pii]
LID - 10.1016/j.yebeh.2015.04.060 [doi]
AB  - To explore the EEG boundary of nonconvulsive status epilepticus (NCSE) and the 
      concept of "possible NCSE", we studied 14 consecutive patients with </= 2-Hz 
      nonevolving periodic generalized epileptiform discharges (GPDs) in their first 
      EEG after out of hospital cardiac arrest (OHCA). The pattern was associated with 
      myoclonus in 11 patients. EG reactivity to antiseizure drugs (benzodiazepines and 
      propofol), but without clinical improvement, was noted in 8 patients, satisfying 
      the diagnostic criteria of "possible NCSE". Resolution of GPDs and emergence of 
      physiological rhythms in follow-up EEGs and/or subsequent clinical improvement 
      were noted in 6 of them, strongly suggesting that the initial slow nonevolving 
      GPD pattern reflected NCSE significantly contributing to their coma. Background 
      rhythms from 10 to 90% of the periods between GPDs were noted in 9 patients and 
      appeared to correlate with reactivity of the GPD pattern to antiseizure drugs 
      when 20% or more. Ten patients died, and four were discharged to longer care 
      rehabilitation centers. Although based on few observations, preliminary evidence 
      appears to indicate that in this context, nonevolving GPD frequencies as low as 
      0.8 Hz can reflect clinically significant NCSE and, therefore, warrant 
      appropriate testing for possible reactivity. There is also some preliminary 
      indication that background rhythms may be another important diagnostic and, 
      perhaps, prognostic indicator, but this needs to be tested in large prospective 
      studies. This article is part of a Special Issue entitled "Status Epilepticus".
CI  - Copyright (c) 2015 Elsevier Inc. All rights reserved.
FAU - Koutroumanidis, Michalis
AU  - Koutroumanidis M
AD  - Department of Clinical Neurophysiology and Epilepsy, Guys and St. Thomas' NHS 
      Foundation Trust, UK; Department of Academic Neurosciences, Kings College London, 
      UK. Electronic address: michael.koutroumanidis@gstt.nhs.uk.
FAU - Sakellariou, Dimitris
AU  - Sakellariou D
AD  - Department of Clinical Neurophysiology and Epilepsy, Guys and St. Thomas' NHS 
      Foundation Trust, UK; Department of Academic Neurosciences, Kings College London, 
      UK. Electronic address: dimitris.sakellariou@gstt.nhs.uk.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20150523
PL  - United States
TA  - Epilepsy Behav
JT  - Epilepsy & behavior : E&B
JID - 100892858
RN  - 0 (Anticonvulsants)
RN  - 12794-10-4 (Benzodiazepines)
RN  - YI7VU623SF (Propofol)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anticonvulsants/therapeutic use
MH  - Benzodiazepines/therapeutic use
MH  - Coma/complications/mortality/*physiopathology
MH  - Electroencephalography/drug effects
MH  - Epilepsy/etiology/mortality/*physiopathology
MH  - Female
MH  - Heart Arrest/complications/mortality/*physiopathology
MH  - Humans
MH  - Hypoxia/mortality/*physiopathology
MH  - Male
MH  - Middle Aged
MH  - Myoclonus/etiology/physiopathology
MH  - Prognosis
MH  - Propofol/therapeutic use
MH  - Prospective Studies
MH  - Status Epilepticus/etiology/mortality/*physiopathology
OTO - NOTNLM
OT  - Background activity
OT  - EEG
OT  - NCSE
OT  - Propofol
OT  - Reactivity
OT  - Window of sedation
EDAT- 2015/05/26 06:00
MHDA- 2016/03/08 06:00
CRDT- 2015/05/26 06:00
PHST- 2015/04/15 00:00 [received]
PHST- 2015/04/18 00:00 [accepted]
PHST- 2015/05/26 06:00 [entrez]
PHST- 2015/05/26 06:00 [pubmed]
PHST- 2016/03/08 06:00 [medline]
AID - S1525-5050(15)00239-5 [pii]
AID - 10.1016/j.yebeh.2015.04.060 [doi]
PST - ppublish
SO  - Epilepsy Behav. 2015 Aug;49:255-62. doi: 10.1016/j.yebeh.2015.04.060. Epub 2015 
      May 23.