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A Single-Center Study on Nonconvulsive Status Epilepticus After Cardiac Arrest

  • Kazuhiro Sugiyama
  • Yuichi Hamabe
Chapter

Abstract

The prognostication of post-cardiac-arrest patients remains a challenge. Electroencephalography (EEG) is a promising modality; however, conventional EEG is difficult for non-neurologists to interpret. Amplitude-integrated EEG (aEEG) is quantitative EEG that is easy to interpret. aEEG is derived from continuous EEG with reduced electrode montage, with an easy setup. aEEG patterns have been useful in the prognostication of comatose post-cardiac-arrest patients. EEG is important in monitoring seizure activity in post-cardiac-arrest care. At the 44th Annual Meeting of the Japanese Society of Critical Care Medicine, we reported the incidence and characteristics of status epilepticus among patients treated with target temperature management and monitored with aEEG using a single bipolar frontal hairline lead. Seven of 61 patients (11%) revealed status epileptics, and 1 patient with continuous normal voltage before status epilepticus showed a good neurological outcome. aEEG monitoring with reduced leads has limited, but substantial, utility for detecting generalized seizure. Status epilepticus during post-cardiac-arrest care is not uniform: patients with status epilepticus are categorized into two groups based on the background pattern of aEEG before status epilepticus. Status epilepticus from continuous normal voltage is not always associated with poor outcomes. Knowledge of the background pattern can be gained, via aEEG monitoring, from the early phase after return of spontaneous circulation (ROSC). This could help identify targets of aggressive anticonvulsant therapy. Furthermore, aEEG monitoring is a useful tool for intensive and emergency physicians who treat post-cardiac-arrest patients at the bedside.

Keywords

Amplitude-integrated electroencephalography Post-cardiac-arrest care Hypoxic encephalopathy Prognosis Status epilepticus 

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Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • Kazuhiro Sugiyama
    • 1
  • Yuichi Hamabe
    • 1
  1. 1.Tertiary Emergency Medical CenterTokyo Metropolitan Bokutoh HospitalTokyoJapan

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