Neurologic prognosis after cardiopulmonary arrest

Abstract

Nineteen (30%) of 63 adult survivors of cardiopulmonary arrest had seizures after admission to the hospital. Eleven of 19 had more than one type of seizure. Myoclonic seizures began within 12 hours of the arrest in eight patients, and after 3 or more days in four patients. Only two (17%) patients with myoclonic seizures survived. Partial seizures usually began within 12 hours of the arrest and were controllable with anticonvulsants; 4 of 12 patients survived. Two of four patients with generalized tonic-clonic seizures survived; one of four with "shivering" lived. Overall, patients with seizures had a survival rate of 32% (6 of 19), compared with 43% for patients without seizures. None of the survivors had recurrent seizures within 6 months after hospital admission.

Prognosis following Postanoxic Myoclonus Status epilepticus

“…Postanoxic MSE is estimated to occur in 30–37% of comatose adult survivors of cardiopulmonary resuscitation [20, 21]. This condition should be distinguished from chronic postanoxic myoclonus or the Lance-Adams syndrome occurring in survivors of hypoxia and referring to myoclonic jerks in isolation, which are triggered by movement, startle and tactile stimulation [22].…”

Calcium Overload in Selectively Vulnerable Neurons of the Hippocampus during and after Ischemia: An Electron Microscopy Study in the Rat

“…Epileptic activity is observed in humans and an imals during the early recovery period after an ep isode of cerebral ischemia (Levy and Duffy, 1977;Snyder et al, 1980). Enhanced neuronal activity is recorded in the CA I region 7 -10 h after a 5-min episode of ischemia in the gerbil (Suzuki et aI., 1983a).…”

Post–Cardiac Arrest Syndrome

“…75,76,210,211 Seizures increase cerebral metabolism by up to 3-fold. 212 No studies directly address the use of prophylactic anticonvulsant drugs after cardiac arrest in adults.…”