en
Scientific article
Review
Open access
English

Nonconvulsive status epilepticus following cardiac arrest: overlooked, untreated and misjudged

Published inJournal of neurology, vol. 270, no. 1, p. 130-138
Publication date2022-09-08
First online date2022-09-08
Abstract

Aims

Seizures and status epilepticus (SE) are detected in almost a third of the comatose cardiac arrest survivors. As the literature is quite exhaustive regarding SE with motor symptoms in those patients, little is known about nonconvulsive SE (NCSE). Our aim was to compile the evidence from the literature of the frequency and outcome of NCSE in adult patients remaining in coma after resuscitation.

Methods

The medical search PubMed was screened for most relevant articles reporting the emergence and outcome of NCSE in comatose post-resuscitated adult patients.

Results

We identified 11 cohort studies (four prospective observational, seven retrospective) including 1092 patients with SE in 29–96% and NCSE reported in 1–20%. EEG evaluation started at a median of 9.5 h (range 7.5–14.8) after cardiac arrest, during sedation and targeted temperature management (TTM). Favorable outcome after NCSE occurred in 24.5%. We found no study reporting EEG to detect or exclude NCSE in patients remaining in coma prior to the initiation of TTM and without sedation withing the first hours after ROSC.

Discussion

Studies on NCSE after ROSC are scarce and unsystematic, reporting favorable outcome in every fourth patient experiencing NCSE after ROSC. This suggests that NCSE is often overlooked and outcome after NCSE is not always poor. The low data quality does not allow firm conclusions regarding the effects of NCSE on outcome calling for further investigation. In the meantime, clinicians should avoid equating NCSE after ROSC with poor prognosis.

eng
Keywords
  • Cardiac arrest
  • Ischemic-hypoxic encephalopathy
  • NCSE
  • Non-convulsive status epilepticus
  • Status epilepticus
Citation (ISO format)
DE STEFANO, Pia et al. Nonconvulsive status epilepticus following cardiac arrest: overlooked, untreated and misjudged. In: Journal of neurology, 2022, vol. 270, n° 1, p. 130–138. doi: 10.1007/s00415-022-11368-5
Main files (1)
Article (Published version)
Identifiers
ISSN of the journal0340-5354
37views
28downloads

Technical informations

Creation12/04/2023 2:32:49 PM
First validation03/06/2024 9:34:02 AM
Update time03/06/2024 9:34:02 AM
Status update03/06/2024 9:34:02 AM
Last indexation05/06/2024 6:06:32 PM
All rights reserved by Archive ouverte UNIGE and the University of GenevaunigeBlack