This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
Objectives: To determine the prognostic value of an EEG grading scale and clinical outcome of treated seizures detected with continuous EEG (cEEG) during therapeutic hypothermia (TH) and rewarming post cardiac arrest (CA).
Methods: Our cohort study retrospectively reviewed the electronic medical records and cEEGs of all patients undergoing TH after CA under protocol over 2 years. cEEG was initiated during TH and continued until restoration of normothermia (NT). EEGs were graded 1–3 (3 = most severe) using a departmentally developed EEG severity grading scale by 2 authors blinded to clinical outcome. Outcome was measured using the Cerebral Performance Category scale; grades 1–2 were considered a “good” outcome, 3–5 “poor.”
Results: Fifty-four patients were included; 51 remained on cEEG through NT. Nineteen died. EEG severity grading during both TH and NT statistically correlated with outcome (grade 1 = good, grade 3 = poor). Other EEG features correlating with poor outcome included seizures, nonreactive background, and epileptiform discharges. Changes in EEG grade during monitoring did not statistically correlate with outcome. Five patients had seizures; all occurred in patients with grade 3 EEG backgrounds and all had a poor outcome.
Conclusion: Grades 1 and 3 on our EEG severity grading scale during TH and NT correlated with outcome. Treating seizures did not improve outcome in our cohort.
GLOSSARY
- CA=
- cardiac arrest;
- cEEG=
- continuous EEG;
- CPC=
- Cerebral Performance Category;
- ELAE=
- episodic low-amplitude events;
- GPED=
- generalized epileptiform discharges;
- IED=
- interictal epileptiform discharges;
- NCSE=
- nonconvulsive status epilepticus;
- NT=
- normothermia;
- TH=
- therapeutic hypothermia
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
- Received June 7, 2012.
- Accepted September 13, 2012.
- © 2013 American Academy of Neurology
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
- Early EEG Prognostication after Cardiac Arrest
- Prognostication of cardiac arrest patients undergoing therapeutic hypothermia-making the right call
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
More Online
Topics Discussed
Alert Me
Recommended articles
Electroencephalographic monitoring during hypothermia after pediatric cardiac arrest
Neurologic outcome of postanoxic refractory status epilepticus after aggressive treatment
Early EEG correlates of neuronal injury after brain anoxia
Electrographic seizures and periodic discharges after intracerebral hemorrhage