Hovland Anders, Nielsen Erik Waage, Klüver Jens, Salvesen Rolf
Coronary Care Unit, Medical Department, NLSH Bodo, 8092 Bodo, Norway.
Resuscitation. 2006 Jan;68(1):143-6. doi: 10.1016/j.resuscitation.2005.05.019. Epub 2005 Dec 1.
Induced hypothermia has improved neurological outcome after cardiac arrest. Even though anoxic insults to the brain often provoke epileptic activity, it is unclear whether EEG monitoring is necessary in these patients. We report the case of a 53-year-old female who suffered cardiac arrest. During induced hypothermia extensive shivering was managed by sedation and curare. After their discontinuation convulsions appeared and status epilepticus was disclosed on EEG recording, and was treated by thiopental infusion for 10 days. The patient recovered slowly and has now regained independent living (CPC 1). In induced hypothermia several factors including the use of curare, may conceal clinical signs of epileptic activity. We therefore suggest a broader use of EEG in these patients.
诱导性低温改善了心脏骤停后的神经学转归。尽管大脑的缺氧性损伤常引发癫痫活动,但这些患者是否需要脑电图(EEG)监测尚不清楚。我们报告一例53岁女性心脏骤停的病例。在诱导性低温期间,通过镇静和使用箭毒控制了广泛的寒战。停用后出现惊厥,EEG记录显示为癫痫持续状态,通过静脉输注硫喷妥钠治疗10天。患者恢复缓慢,现已恢复独立生活能力(脑功能分级1级)。在诱导性低温过程中,包括使用箭毒在内的多种因素可能掩盖癫痫活动的临床体征。因此,我们建议对这些患者更广泛地使用EEG。