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Long‐term electro‐clinical profile of sudden cardiac arrest survivors

OBJECTIVE: Recent research has explored the use of continuous EEG (cEEG) monitoring for prognostication of spontaneous cardiac arrest (SCA). However, there is limited literature on the long‐term (post‐hospital discharge) electrographic findings among SCA survivors and their clinical correlates. Our...

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Autores principales: Shaker, Hussam, Milan, Anna, Alsallom, Faisal, Newey, Christopher, Hantus, Stephen, Punia, Vineet
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8408603/
https://www.ncbi.nlm.nih.gov/pubmed/34181820
http://dx.doi.org/10.1002/epi4.12516
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author Shaker, Hussam
Milan, Anna
Alsallom, Faisal
Newey, Christopher
Hantus, Stephen
Punia, Vineet
author_facet Shaker, Hussam
Milan, Anna
Alsallom, Faisal
Newey, Christopher
Hantus, Stephen
Punia, Vineet
author_sort Shaker, Hussam
collection PubMed
description OBJECTIVE: Recent research has explored the use of continuous EEG (cEEG) monitoring for prognostication of spontaneous cardiac arrest (SCA). However, there is limited literature on the long‐term (post‐hospital discharge) electrographic findings among SCA survivors and their clinical correlates. Our study aims to fill this critical knowledge gap. METHODS: We retrospectively used our EEG database to identify adults (≥18 years) with SCA history who underwent an outpatient laboratory‐based EEG between 01/01/2011 and 12/31/2018. After electronic medical records (EMR) review, patients with epilepsy history and unclear/poorly documented SCA history were excluded. Outpatient EEGs were reviewed by authors. Acute EEG findings were extracted from the EEG database and EMR. In addition, we extracted data on acute and long‐term neuroimaging findings (CT/MRI), post‐SCA seizures, and anti‐seizure medications (ASM) status. Descriptive analysis and Fisher's exact test were performed. RESULTS: We included 32 SCA survivors (50% women; mean age = 52.1 ± 13.6 years) in the study. During a median clinical follow‐up of 28.2 months, 3 patients suffered only clinical seizures, 3 only chronic post‐hypoxic myoclonus, and 5 had both [11 (34.4%) in total]. Interictal epileptiform discharges (IEDs) were noted in one‐third of the patients, which localized to vertex and frontocentral regions in all but one patient. Five (15.6%) of them did not suffer a clinical seizure despite the presence of EAs. Patients who developed epilepsy were significantly more likely to have abnormal neuroimaging findings [10/11 (90.9%)] during the follow‐up compared to the rest of the patients [OR = 25 (95% CI 2.6–>100, P = .002)]. Half of the study cohort was taking ASM at the last follow‐up. SIGNIFICANCE: Our small study reveals a signature location of IEDs in SCA survivors. Neuroimaging abnormalities seem to be a better indicator of epilepsy development, while EEG may reveal markers of potential epileptogenicity in the absence of clinical seizures. Future, larger studies are needed to confirm our findings.
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spelling pubmed-84086032021-09-03 Long‐term electro‐clinical profile of sudden cardiac arrest survivors Shaker, Hussam Milan, Anna Alsallom, Faisal Newey, Christopher Hantus, Stephen Punia, Vineet Epilepsia Open Full‐length Original Research OBJECTIVE: Recent research has explored the use of continuous EEG (cEEG) monitoring for prognostication of spontaneous cardiac arrest (SCA). However, there is limited literature on the long‐term (post‐hospital discharge) electrographic findings among SCA survivors and their clinical correlates. Our study aims to fill this critical knowledge gap. METHODS: We retrospectively used our EEG database to identify adults (≥18 years) with SCA history who underwent an outpatient laboratory‐based EEG between 01/01/2011 and 12/31/2018. After electronic medical records (EMR) review, patients with epilepsy history and unclear/poorly documented SCA history were excluded. Outpatient EEGs were reviewed by authors. Acute EEG findings were extracted from the EEG database and EMR. In addition, we extracted data on acute and long‐term neuroimaging findings (CT/MRI), post‐SCA seizures, and anti‐seizure medications (ASM) status. Descriptive analysis and Fisher's exact test were performed. RESULTS: We included 32 SCA survivors (50% women; mean age = 52.1 ± 13.6 years) in the study. During a median clinical follow‐up of 28.2 months, 3 patients suffered only clinical seizures, 3 only chronic post‐hypoxic myoclonus, and 5 had both [11 (34.4%) in total]. Interictal epileptiform discharges (IEDs) were noted in one‐third of the patients, which localized to vertex and frontocentral regions in all but one patient. Five (15.6%) of them did not suffer a clinical seizure despite the presence of EAs. Patients who developed epilepsy were significantly more likely to have abnormal neuroimaging findings [10/11 (90.9%)] during the follow‐up compared to the rest of the patients [OR = 25 (95% CI 2.6–>100, P = .002)]. Half of the study cohort was taking ASM at the last follow‐up. SIGNIFICANCE: Our small study reveals a signature location of IEDs in SCA survivors. Neuroimaging abnormalities seem to be a better indicator of epilepsy development, while EEG may reveal markers of potential epileptogenicity in the absence of clinical seizures. Future, larger studies are needed to confirm our findings. John Wiley and Sons Inc. 2021-07-13 /pmc/articles/PMC8408603/ /pubmed/34181820 http://dx.doi.org/10.1002/epi4.12516 Text en © 2021 The Authors. Epilepsia Open published by Wiley Periodicals LLC on behalf of International League Against Epilepsy. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Full‐length Original Research
Shaker, Hussam
Milan, Anna
Alsallom, Faisal
Newey, Christopher
Hantus, Stephen
Punia, Vineet
Long‐term electro‐clinical profile of sudden cardiac arrest survivors
title Long‐term electro‐clinical profile of sudden cardiac arrest survivors
title_full Long‐term electro‐clinical profile of sudden cardiac arrest survivors
title_fullStr Long‐term electro‐clinical profile of sudden cardiac arrest survivors
title_full_unstemmed Long‐term electro‐clinical profile of sudden cardiac arrest survivors
title_short Long‐term electro‐clinical profile of sudden cardiac arrest survivors
title_sort long‐term electro‐clinical profile of sudden cardiac arrest survivors
topic Full‐length Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8408603/
https://www.ncbi.nlm.nih.gov/pubmed/34181820
http://dx.doi.org/10.1002/epi4.12516
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