The EEGs of 26 patients who remained at least 6 hours in coma after cardiovascular arrest were analyzed. The first EEG was recorded within few days after reanimation, classified in a 5-grade scale of increasingly severe impairment and compared with the final clinical outcome. On the basis of the present study and of a review of 408 EEG findings reported in similar investigations in the literature we conclude that the EEG can be useful in predicting the outcome of patients in postanoxic coma states: the EEG should be recorded at earliest 8-12 hours but within 2 days after reanimation, a barbiturate intoxication and hypothermia should be excluded. The classification of the recordings in a 5-grade scale has proven to be helpful and accurate in predicting the outcome: Grade I EEG findings imply a very good prognosis, a complete remission can be expected in most cases. Grade II and III findings have no definite prognosis: the EEG should be repeated one or two days later, a favorable outcome is to be expected only with rapid improvement of the tracing. Grade IV and Grade V findings have a very serious prognosis: complete recovery has been described episodically, most in the pediatric population and with findings of alpha-coma.
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