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The Impact of Nonconvulsive Status Epilepticus after Cardiac Surgery on Outcome

Neurological complications after heart surgery are associated with tremendous morbidity and mortality. Nonconvulsive status epilepticus (NCSE), which can only be verified by EEG, may cause secondary brain damage. Its frequency and its impact on outcomes after cardiac surgery is still unclear. We col...

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Autores principales: Skhirtladze-Dworschak, Keso, Felli, Alessia, Aull-Watschinger, Susanne, Jung, Rebekka, Mouhieddine, Mohamed, Zuckermann, Andreas, Tschernko, Edda, Dworschak, Martin, Pataraia, Ekaterina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9572147/
https://www.ncbi.nlm.nih.gov/pubmed/36233535
http://dx.doi.org/10.3390/jcm11195668
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author Skhirtladze-Dworschak, Keso
Felli, Alessia
Aull-Watschinger, Susanne
Jung, Rebekka
Mouhieddine, Mohamed
Zuckermann, Andreas
Tschernko, Edda
Dworschak, Martin
Pataraia, Ekaterina
author_facet Skhirtladze-Dworschak, Keso
Felli, Alessia
Aull-Watschinger, Susanne
Jung, Rebekka
Mouhieddine, Mohamed
Zuckermann, Andreas
Tschernko, Edda
Dworschak, Martin
Pataraia, Ekaterina
author_sort Skhirtladze-Dworschak, Keso
collection PubMed
description Neurological complications after heart surgery are associated with tremendous morbidity and mortality. Nonconvulsive status epilepticus (NCSE), which can only be verified by EEG, may cause secondary brain damage. Its frequency and its impact on outcomes after cardiac surgery is still unclear. We collected the neurological files and clinical data of all our patients after heart surgery who, in the course of their ICU stay, had been seen by a neurologist who ordered an EEG. Within 18 months, 1457 patients had cardiac surgery on cardiopulmonary bypass. EEG was requested for 89 patients. Seizures were detected in 39 patients and NCSE was detected in 11 patients. Open heart surgery was performed in all 11 NSCE patients, of whom eight showed concomitant brain insults. None had a history of epilepsy. Despite the inhibition of seizure activity with antiseizure medication, clinical improvement was only noted in seven NCSE patients, three of whom were in cerebral performance category 2 and four in category 3 at hospital discharge. The four patients without neurological benefit subsequently died in the ICU. The occurrence of NCSE after open cardiac surgery is significant and frequently associated with brain injury. It seems prudent to perform EEG studies early to interrupt seizure activity and mitigate secondary cerebral injury.
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spelling pubmed-95721472022-10-17 The Impact of Nonconvulsive Status Epilepticus after Cardiac Surgery on Outcome Skhirtladze-Dworschak, Keso Felli, Alessia Aull-Watschinger, Susanne Jung, Rebekka Mouhieddine, Mohamed Zuckermann, Andreas Tschernko, Edda Dworschak, Martin Pataraia, Ekaterina J Clin Med Article Neurological complications after heart surgery are associated with tremendous morbidity and mortality. Nonconvulsive status epilepticus (NCSE), which can only be verified by EEG, may cause secondary brain damage. Its frequency and its impact on outcomes after cardiac surgery is still unclear. We collected the neurological files and clinical data of all our patients after heart surgery who, in the course of their ICU stay, had been seen by a neurologist who ordered an EEG. Within 18 months, 1457 patients had cardiac surgery on cardiopulmonary bypass. EEG was requested for 89 patients. Seizures were detected in 39 patients and NCSE was detected in 11 patients. Open heart surgery was performed in all 11 NSCE patients, of whom eight showed concomitant brain insults. None had a history of epilepsy. Despite the inhibition of seizure activity with antiseizure medication, clinical improvement was only noted in seven NCSE patients, three of whom were in cerebral performance category 2 and four in category 3 at hospital discharge. The four patients without neurological benefit subsequently died in the ICU. The occurrence of NCSE after open cardiac surgery is significant and frequently associated with brain injury. It seems prudent to perform EEG studies early to interrupt seizure activity and mitigate secondary cerebral injury. MDPI 2022-09-26 /pmc/articles/PMC9572147/ /pubmed/36233535 http://dx.doi.org/10.3390/jcm11195668 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Skhirtladze-Dworschak, Keso
Felli, Alessia
Aull-Watschinger, Susanne
Jung, Rebekka
Mouhieddine, Mohamed
Zuckermann, Andreas
Tschernko, Edda
Dworschak, Martin
Pataraia, Ekaterina
The Impact of Nonconvulsive Status Epilepticus after Cardiac Surgery on Outcome
title The Impact of Nonconvulsive Status Epilepticus after Cardiac Surgery on Outcome
title_full The Impact of Nonconvulsive Status Epilepticus after Cardiac Surgery on Outcome
title_fullStr The Impact of Nonconvulsive Status Epilepticus after Cardiac Surgery on Outcome
title_full_unstemmed The Impact of Nonconvulsive Status Epilepticus after Cardiac Surgery on Outcome
title_short The Impact of Nonconvulsive Status Epilepticus after Cardiac Surgery on Outcome
title_sort impact of nonconvulsive status epilepticus after cardiac surgery on outcome
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9572147/
https://www.ncbi.nlm.nih.gov/pubmed/36233535
http://dx.doi.org/10.3390/jcm11195668
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