Global hypoxia-ischemia and critical care seizures

Lauren Koffman, Matthew A. Koenig, Romergryko Geocadin

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Seizures after cardiopulmonary arrest are a common problem in the intensive care unit, occurring in as many as one-third of these patients during the hospitalization. The etiology, treatment, and prognostic importance of seizures in this setting have been the focus of research in post-cardiac arrest care within the past several years. Historically post-cardiac arrest status epilepticus has carried an ominous prognosis. As studies have examined the occurrence of seizures in this patient population, the outcome may not be as poor as initially thought. Additional consideration should be given to the “self-fulfilling prophecy” that has burdened patients, their families, and practitioners. When the prognosis remains uncertain, generalized tonic-clonic (GTC) status epilepticus should be treated in the conventional manner described elsewhere in this book. Targeted temperature management (TTM), which includes therapeutic hypothermia (TH) and avoidance of fever, has become a standard part of post-cardiac arrest care and raises new considerations for this patient population. These patients often have seizures earlier, and their neurologic exam may be obscured by paralytics, sedation, and altered metabolism of medications. Finally, the role of electroencephalography should not be overlooked, as it can be used not only to diagnose seizure activity but also prognosticate neurologic outcome.

Original languageEnglish (US)
Title of host publicationCurrent Clinical Neurology
PublisherHumana Press Inc.
Pages227-242
Number of pages16
Edition9783319495552
DOIs
StatePublished - Jan 1 2017

Publication series

NameCurrent Clinical Neurology
Number9783319495552
ISSN (Print)1559-0585

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Keywords

  • Cardiac arrest
  • Hypothermia
  • Hypoxic ischemic injury
  • Intensive care unit
  • Myoclonic status epilepticus
  • Myoclonus
  • Seizures
  • Status myoclonus

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Koffman, L., Koenig, M. A., & Geocadin, R. (2017). Global hypoxia-ischemia and critical care seizures. In Current Clinical Neurology (9783319495552 ed., pp. 227-242). (Current Clinical Neurology; No. 9783319495552). Humana Press Inc.. https://doi.org/10.1007/978-3-319-49557-6_13