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Time to epileptiform activity and EEG background recovery are independent predictors after cardiac arrest
Lund Univ, Sweden.
Lund Univ, Sweden.
Lund Univ, Sweden.
Rigshosp, Denmark; Univ Copenhagen, Denmark.
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2018 (English)In: Clinical Neurophysiology, ISSN 1388-2457, E-ISSN 1872-8952, Vol. 129, no 8, p. 1660-1668Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
ELSEVIER IRELAND LTD , 2018. Vol. 129, no 8, p. 1660-1668
Keywords [en]
EEG; Continuous EEG monitoring; Prognosis; Status epilepticus; Coma; Cardiac arrest
National Category
Neurology
Identifiers
URN: urn:nbn:se:liu:diva-149833DOI: 10.1016/j.clinph.2018.05.016ISI: 000438140900025PubMedID: 29933239OAI: oai:DiVA.org:liu-149833DiVA, id: diva2:1236463
Note

Funding Agencies|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

Available from: 2018-08-02 Created: 2018-08-02 Last updated: 2018-08-02

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Lindehammar, Hans
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Division of Neuro and Inflammation ScienceFaculty of Medicine and Health SciencesDepartment of Clinical Neurophysiology
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