title: Neurologic recovery after therapeutic hypothermia in patients with post-cardiac arrest myoclonus.
abstract: Early myoclonus in comatose survivors of cardiac arrest, even when it is not myoclonic status epilepticus (MSE), is considered a sign of severe global brain ischemia and has been associated with high rates of mortality and poor neurologic outcomes. We report on three survivors of primary circulatory cardiac arrests who had good neurologic outcomes (two patients with a CPC score=1 and one patient with a CPC score=2) after mild therapeutic hypothermia, despite exhibiting massive myoclonus within the first 4h after return of spontaneous circulation. The concept that early myoclonus heralds a uniformly poor prognosis may need to be reconsidered in the era of post-cardiac arrest mild therapeutic hypothermia.
authors.affiliation: Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, United States.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Lucas
authors.forename: Michael N
authors.initials: MN
authors.lastname: Cocchi
authors.forename: Justin
authors.initials: J
authors.lastname: Salciccioli
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Stanbridge
authors.forename: Romergryko G
authors.initials: RG
authors.lastname: Geocadin
authors.forename: Susan T
authors.initials: ST
authors.lastname: Herman
authors.forename: Michael W
authors.initials: MW
authors.lastname: Donnino
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000150:complications* / Q000209:etiology / Q000503:physiopathology; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000150:complications* / Q000628:therapy; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009207:Myoclonus / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D020127:Recovery of Function