title: Prognostic EEG patterns in patients resuscitated from cardiac arrest with particular focus on Generalized Periodic Epileptiform Discharges (GPEDs).
abstract: OBJECTIVE
  We assessed clinical and early electrophysiological characteristics, in particular Generalized Periodic Epileptiform Discharges (GPEDs) patterns, of consecutive patients during a 1-year period, hospitalized in the Intensive Care Unit (ICU) after resuscitation following cardiac arrest (CA).
  
  
  METHODS
  Consecutive patients resuscitated from cardiac arrest (CA) with first EEG recordings within 48hours were included. Clinical data were collected from hospital records, in particular therapeutic hypothermia. Electroencephalograms (EEGs) were re-analyzed retrospectively.
  
  
  RESULTS
  Sixty-two patients were included. Forty-two patients (68%) were treated with therapeutic hypothermia according to international guidelines. Global mortality was 74% but not significantly different between patients who benefited from therapeutic hypothermia compared to those who did not. All the patients who did not have an initial background activity (36/62; 58%) died. By contrast, initial background activity was present in 26/62 (42%) and among these patients, 16/26 (61%) survived. Electroencephalography demonstrated GPEDs patterns in 5 patients, all treated by therapeutic hypothermia and antiepileptic drugs. One of these survived and showed persistent background activity with responsiveness to benzodiazepine intravenous injection.
  
  
  CONCLUSIONS
  Patients presenting suppressed background activity, even when treated by hypothermia, have a high probability of poor outcome. Thorough analysis of EEG patterns might help to identify patients with a better chance of survival.
authors.affiliation: Université Paris Diderot, Sorbonne Paris Cité, 75013 Paris, France; Service de physiologie clinique, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Milani
authors.affiliation: Service de réanimation médicale et toxicologique, hôpital Lariboisière, AP-HP, 75010 Paris, France.
authors.forename: I
authors.initials: I
authors.lastname: Malissin
authors.affiliation: Université Paris Diderot, Sorbonne Paris Cité, 75013 Paris, France; Service de physiologie clinique, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France.
authors.forename: Y R
authors.initials: YR
authors.lastname: Tran-Dinh
authors.affiliation: Service de réanimation médicale et toxicologique, hôpital Lariboisière, AP-HP, 75010 Paris, France; Inserm U942, hôpital Lariboisière, 75010 Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Deye
authors.affiliation: Université Paris Diderot, Sorbonne Paris Cité, 75013 Paris, France; Service de réanimation médicale et toxicologique, hôpital Lariboisière, AP-HP, 75010 Paris, France; Inserm U942, hôpital Lariboisière, 75010 Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Baud
authors.affiliation: Université Paris Diderot, Sorbonne Paris Cité, 75013 Paris, France; Service de physiologie clinique, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France; Inserm U965, hôpital Lariboisière, 75010 Paris, France.
authors.forename: B I
authors.initials: BI
authors.lastname: Lévy
authors.affiliation: Université Paris Diderot, Sorbonne Paris Cité, 75013 Paris, France; Service de physiologie clinique, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France; Inserm U965, hôpital Lariboisière, 75010 Paris, France. Electronic address: nathalie.kubis@lrb.aphp.fr.
authors.forename: N
authors.initials: N
authors.lastname: Kubis
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000503:physiopathology; D016887:Cardiopulmonary Resuscitation; D004569:Electroencephalography; D004829:Epilepsy, Generalized / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006323:Heart Arrest / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D006801:Humans; D007036:Hypothermia, Induced; D008297:Male; D008875:Middle Aged; D011379:Prognosis
keywords: Anoxic encephalopathy; Arrêt cardiaque; Cardiac arrest; Décharges généralisées épileptiformes périodiques; Encéphalopathie anoxique; Generalized Periodic Epileptiform Discharges; Hypothermie thérapeutique; Myoclonus status epilepticus; Therapeutic hypothermia; État de mal épileptique myoclonique