Prediction of outcome after cardiac arrest has important ethical and socioeconomic implications. In general, delay in recovery of neurological function is associated with a worse prognosis. The presence of myoclonic seizures early after anoxia has been identified as a poor prognostic factor. We report a series of patients who developed postanoxic myoclonus status epilepticus (MSE), which was defined as continuous myoclonic seizure activity lasting 30 min or more. The results from 18 patients were retrieved, 11 men and 7 women, age ranging from 29 to 90 years. Myoclonus developed a mean of 11.7 h after cardiac arrest, persisting for a mean of 60.5 h. Sixteen (89%) died following MSE and the 2 survivors were highly dependent or remained in a persistent vegetative state, supporting the view that prognosis is poor in this condition.
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http://dx.doi.org/10.1159/000086755 | DOI Listing |
Clin Neurophysiol
January 2025
Epilepsy Center, Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, OH, USA. Electronic address:
Objective: To report a novel phenotype of negative myoclonus in acute post-anoxic brain injury (PABI).
Methods: We performed a retrospective analysis of 18-channel video-EEG and surface-EMG (sEMG) recordings of three patients with PABI. sEMG electrodes were placed on the neck, bulbar and arm muscles.
J Intensive Care Med
September 2024
Department of Neurology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Purpose: Myoclonus after anoxic brain injury is a marker of significant cerebral injury. Absent cortical signal (N20) on somatosensory evoked potentials (SSEPs) after cardiac arrest is a reliable predictor of poor neurological recovery when combined with an overall clinical picture consistent with severe widespread neurological injury. We evaluated a clinical question of if SSEP result could be predicted from other clinical and neurodiagnostic testing results in patients with post-anoxic myoclonus.
View Article and Find Full Text PDFResuscitation
May 2023
Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA. Electronic address:
Arch Clin Cases
December 2022
Department of Interventional Neurology, Bellevue Clinic, Kolkata, India.
Thromboembolic event is an important and widely regarded risk factor, influencing the outcome and overall survival in post-operative cases with second highest association with gynaecological surgeries. Here we report a 52 years old female who underwent total laparoscopic hysterectomy with bilateral salpingo-oophorectomy (TLH+BSO) presented to our emergency in unconscious and intubated state on her post-operative day-1 with cardiorespiratory failure. Based on the immediate investigations after successful resuscitation, an initial diagnosis of massive pulmonary thromboembolism was made following supportive and conservative management.
View Article and Find Full Text PDFNeurol Clin Pract
August 2021
Division of Clinical Neurophysiology (FA), Epilepsy, Beth Israel Deaconess Medical Center, Boston, MA; Harvard Medical School (FA), Boston, MA; Epilepsy Center (HS, CN, SH, VP), Cerebrovascular Center (CN), Neurological Institute, and Center for Clinical Artificial Intelligence (CN), Cleveland Clinic, OH.
Background: Postanoxic myoclonus is a known poor prognostic sign, and other postanoxic spontaneous movements have been reported but poorly described. We aim to describe the electroclinical phenomenon of postanoxic eyelid openings in context of its possible prognostic value.
Methods: We collected clinical data on postcardiac arrest patients with suspicious eyelid movements noted on continuous EEG monitoring.
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