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Minerva Anestesiologica 2017 December;83(12):1255-64

DOI: 10.23736/S0375-9393.17.11629-9

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Post-anoxic status epilepticus: which variable could modify prognosis? A single-center experience

Christian LETTIERI 1 , Grazia DEVIGILI 1, Giada PAULETTO 1, Miriam ISOLA 2, Sara RINALDO 1, Riccardo BUDAI 1, Roberto ELEOPRA 1

1 Unit of Neurology, Department of Neurosciences, S. Maria della Misericordia University Hospital, Udine, Italy; 2 Division of Medical Statistics, Department of Medical and Biological Sciences, University of Udine, Udine, Italy


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BACKGROUND: Status epilepticus (SE) is associated with high mortality in post-anoxic coma despite antiepileptic treatment. The aim of our study was to assess the percentage of awakening in a consecutive series of post-anoxic comatose patients with an EEG pattern consistent with SE and to verify any correlation with clinical, neurophysiological or pharmacological parameters.
METHODS: We retrospectively analyzed data collected from seventeen patients affected by post-anoxic SE matching them with outcome scores by means of univariate statistical analysis.
RESULTS: Four patients were not pharmacologically treated while thirteen patients were treated with a combination of benzodiazepines, antiepileptic or anesthetic drugs: seven patients awakened even if they showed a moderate-severe disability A statistically significant correlation with preserved median nerve cortical somatosensory evoked potentials (SSEP), with the use of anesthetics and with the duration of SE was found.
CONCLUSIONS: In post-anoxic coma, SE does not always correlate with poor outcome. In patients with favorable patterns on multimodal prognostication approach, pharmacologic treatment, even aggressive, could be attempted.


KEY WORDS: Status epilepticus - Multimodal imaging - Somatosensory evoked potentials - Anesthetics

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