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Electroencephalographic characteristics of status epilepticus after cardiac arrest

Backman, Sofia LU ; Westhall, Erik LU ; Dragancea, Irina LU ; Friberg, Hans LU ; Rundgren, Malin LU ; Ullén, Susann and Cronberg, Tobias LU (2017) In Clinical Neurophysiology 128(4). p.681-688
Abstract

Objective: To describe the electrophysiological characteristics and pathophysiological significance of electrographic status epilepticus (ESE) after cardiac arrest and specifically compare patients with unequivocal ESE to patients with rhythmic or periodic borderline patterns defined as possible ESE. Methods: Retrospective cohort study of consecutive patients treated with targeted temperature management and monitored with simplified continuous EEG. Patients with ESE were identified and electrographically characterised until 72. h after ESE start using the standardised terminology of the American Clinical Neurophysiology Society. Results: ESE occurred in 41 of 127 patients and 22 fulfilled the criteria for unequivocal ESE, which... (More)

Objective: To describe the electrophysiological characteristics and pathophysiological significance of electrographic status epilepticus (ESE) after cardiac arrest and specifically compare patients with unequivocal ESE to patients with rhythmic or periodic borderline patterns defined as possible ESE. Methods: Retrospective cohort study of consecutive patients treated with targeted temperature management and monitored with simplified continuous EEG. Patients with ESE were identified and electrographically characterised until 72. h after ESE start using the standardised terminology of the American Clinical Neurophysiology Society. Results: ESE occurred in 41 of 127 patients and 22 fulfilled the criteria for unequivocal ESE, which typically appeared early and transiently. Three of the four survivors had unequivocal ESE, starting after rewarming from a continuous background. There were no differences between the groups of unequivocal ESE and possible ESE regarding outcome, neuron-specific enolase levels or prevalence of reported clinical convulsions. Conclusion: ESE is common after cardiac arrest. The distinction between unequivocal and possible ESE patterns was not reflected by differences in clinical features or survival. Significance: A favourable outcome is seen infrequently in patients with ESE, regardless of using strict or liberal ESE definitions.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cardiac arrest, Coma, Continuous EEG monitoring, EEG, Electrographic status epilepticus, Hypoxic-ischemic encephalopathy, Outcome prediction, Therapeutic hypothermia
in
Clinical Neurophysiology
volume
128
issue
4
pages
8 pages
publisher
Elsevier
external identifiers
  • scopus:85011371480
  • pmid:28169132
  • wos:000397963400022
ISSN
1388-2457
DOI
10.1016/j.clinph.2017.01.002
language
English
LU publication?
yes
id
ac4cf246-795d-4282-b928-58d3b10bb3df
date added to LUP
2017-02-16 15:32:07
date last changed
2018-01-07 11:50:33
@article{ac4cf246-795d-4282-b928-58d3b10bb3df,
  abstract     = {<p>Objective: To describe the electrophysiological characteristics and pathophysiological significance of electrographic status epilepticus (ESE) after cardiac arrest and specifically compare patients with unequivocal ESE to patients with rhythmic or periodic borderline patterns defined as possible ESE. Methods: Retrospective cohort study of consecutive patients treated with targeted temperature management and monitored with simplified continuous EEG. Patients with ESE were identified and electrographically characterised until 72. h after ESE start using the standardised terminology of the American Clinical Neurophysiology Society. Results: ESE occurred in 41 of 127 patients and 22 fulfilled the criteria for unequivocal ESE, which typically appeared early and transiently. Three of the four survivors had unequivocal ESE, starting after rewarming from a continuous background. There were no differences between the groups of unequivocal ESE and possible ESE regarding outcome, neuron-specific enolase levels or prevalence of reported clinical convulsions. Conclusion: ESE is common after cardiac arrest. The distinction between unequivocal and possible ESE patterns was not reflected by differences in clinical features or survival. Significance: A favourable outcome is seen infrequently in patients with ESE, regardless of using strict or liberal ESE definitions.</p>},
  author       = {Backman, Sofia and Westhall, Erik and Dragancea, Irina and Friberg, Hans and Rundgren, Malin and Ullén, Susann and Cronberg, Tobias},
  issn         = {1388-2457},
  keyword      = {Cardiac arrest,Coma,Continuous EEG monitoring,EEG,Electrographic status epilepticus,Hypoxic-ischemic encephalopathy,Outcome prediction,Therapeutic hypothermia},
  language     = {eng},
  number       = {4},
  pages        = {681--688},
  publisher    = {Elsevier},
  series       = {Clinical Neurophysiology},
  title        = {Electroencephalographic characteristics of status epilepticus after cardiac arrest},
  url          = {http://dx.doi.org/10.1016/j.clinph.2017.01.002},
  volume       = {128},
  year         = {2017},
}