Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, United States.
Resuscitation. 2012 Feb;83(2):265-9. doi: 10.1016/j.resuscitation.2011.09.017. Epub 2011 Oct 1.
Early myoclonus in comatose survivors of cardiac arrest, even when it is not myoclonic status epilepticus (MSE), is considered a sign of severe global brain ischemia and has been associated with high rates of mortality and poor neurologic outcomes. We report on three survivors of primary circulatory cardiac arrests who had good neurologic outcomes (two patients with a CPC score=1 and one patient with a CPC score=2) after mild therapeutic hypothermia, despite exhibiting massive myoclonus within the first 4h after return of spontaneous circulation. The concept that early myoclonus heralds a uniformly poor prognosis may need to be reconsidered in the era of post-cardiac arrest mild therapeutic hypothermia.
心脏停搏后昏迷幸存者的早期肌阵挛，即使不是肌阵挛性癫痫持续状态（MSE），也被认为是严重全脑缺血的标志，与高死亡率和不良神经结局相关。我们报告了 3 例原发性循环性心脏骤停幸存者，尽管在自主循环恢复后 4 小时内出现了大量肌阵挛，但在接受亚低温治疗后，他们的神经结局良好（2 例患者 CPC 评分为 1，1 例患者 CPC 评分为 2）。在心脏停搏后亚低温治疗时代，早期肌阵挛预示着预后普遍不良的概念可能需要重新考虑。
