Post-anoxic status epilepticus: which variable could modify prognosis? A single-center experience

Minerva Anestesiol. 2017 Dec;83(12):1255-1264. doi: 10.23736/S0375-9393.17.11629-9. Epub 2017 Jul 5.

Abstract

Background: Status epilepticus (SE) is associated with high mortality in post-anoxic coma despite antiepileptic treatment. The aim of our study was to assess the percentage of awakening in a consecutive series of post-anoxic comatose patients with an EEG pattern consistent with SE and to verify any correlation with clinical, neurophysiological or pharmacological parameters.

Methods: We retrospectively analyzed data collected from seventeen patients affected by post-anoxic SE matching them with outcome scores by means of univariate statistical analysis.

Results: Four patients were not pharmacologically treated while thirteen patients were treated with a combination of benzodiazepines, antiepileptic or anesthetic drugs: seven patients awakened even if they showed a moderate-severe disability A statistically significant correlation with preserved median nerve cortical somatosensory evoked potentials (SSEP), with the use of anesthetics and with the duration of SE was found.

Conclusions: In post-anoxic coma, SE does not always correlate with poor outcome. In patients with favorable patterns on multimodal prognostication approach, pharmacologic treatment, even aggressive, could be attempted.

MeSH terms

  • Coma / complications*
  • Female
  • Humans
  • Hypoxia, Brain / complications*
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Status Epilepticus / diagnosis
  • Status Epilepticus / etiology*
  • Status Epilepticus / therapy