期刊
CLINICAL NEUROPHYSIOLOGY
卷 129, 期 8, 页码 1660-1668出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.clinph.2018.05.016
关键词
EEG; Continuous EEG monitoring; Prognosis; Status epilepticus; Coma; Cardiac arrest
资金
- Swedish Heart and Lung Association in Sweden
- Skane University Hospital Foundations in Sweden
- Gyllenstierna-Krapperup Foundation in Sweden
- Segerfalk foundation in Sweden
- Swedish National Health System (ALF) in Sweden
- County Council of Skane in Sweden
- Swedish Society of Medicine in Sweden
- Koch Foundation in Sweden
- Swedish Heart-Lung Foundation in Sweden
- AFA Insurance in Sweden
- Swedish Research Council in Sweden
- Hans-Gabriel and Alice Trolle-Wachtmeister Foundation in Sweden
- Tryg Foundation
- Denmark
- Care Fusion Inc
- EU programme Interreg IV A
Objective: Investigate the temporal development of EEG and prognosis. Methods: Prospective observational substudy of the Target Temperature Management trial. Six sites performed simplified continuous EEG-monitoring (cEEG) on comatose patients after cardiac arrest, blinded to treating physicians. We determined time-points of recovery of a normal-voltage continuous background activity and the appearance of an epileptiform EEG, defined as abundant epileptiform discharges, periodic/rhythmic discharges or electrographic seizure activity. Results: 134 patients were included, 65 had a good outcome. Early recovery of continuous background activity (within 24 h) occurred in 72 patients and predicted good outcome since 55 (76%) had good outcome, increasing the odds for a good outcome seven times compared to a late background recovery. Early appearance of an epileptiform EEG occurred in 38 patients and 34 (89%) had a poor outcome, increasing the odds for a poor outcome six times compared to a late debut. The time to background recovery and the time to epileptiform activity were highly associated with outcome and levels of neuron-specific enolase. Multiple regression analysis showed that both variables were independent predictors. Conclusions: Time to epileptiform activity and background recovery are independent prognostic indicators. Significance: Patients with early background recovery combined with late appearance of epileptiform activity may have a good outcome. (C) 2018 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.
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