Department of Neurology, Mayo Clinic, Rochester, MN, USA.
Neurology. 2013 Jan 22;80(4):339-44. doi: 10.1212/WNL.0b013e31827f089d. Epub 2013 Jan 2.
To determine the prognostic value of an EEG grading scale and clinical outcome of treated seizures detected with continuous EEG (cEEG) during therapeutic hypothermia (TH) and rewarming post cardiac arrest (CA).
Our cohort study retrospectively reviewed the electronic medical records and cEEGs of all patients undergoing TH after CA under protocol over 2 years. cEEG was initiated during TH and continued until restoration of normothermia (NT). EEGs were graded 1-3 (3 = most severe) using a departmentally developed EEG severity grading scale by 2 authors blinded to clinical outcome. Outcome was measured using the Cerebral Performance Category scale; grades 1-2 were considered a "good" outcome, 3-5 "poor."
Fifty-four patients were included; 51 remained on cEEG through NT. Nineteen died. EEG severity grading during both TH and NT statistically correlated with outcome (grade 1 = good, grade 3 = poor). Other EEG features correlating with poor outcome included seizures, nonreactive background, and epileptiform discharges. Changes in EEG grade during monitoring did not statistically correlate with outcome. Five patients had seizures; all occurred in patients with grade 3 EEG backgrounds and all had a poor outcome.
Grades 1 and 3 on our EEG severity grading scale during TH and NT correlated with outcome. Treating seizures did not improve outcome in our cohort.
确定在心脏骤停后治疗性低体温和复温期间连续脑电图（cEEG）检测到的脑电图分级量表和治疗性发作的预后价值。
我们的队列研究回顾性地审查了在 2 年多的协议下接受心脏骤停后治疗性低体温的所有患者的电子病历和 cEEG。cEEG 在低体温期间开始，并持续到体温正常恢复（NT）。由 2 位作者使用部门开发的脑电图严重程度分级量表对脑电图进行 1-3 级（3=最严重）分级，他们对临床结果不知情。使用脑功能分类量表测量结果；1-2 级被认为是“良好”的结果，3-5 级为“差”。
54 例患者入选；51 例患者在 NT 期间仍继续进行 cEEG。19 人死亡。TH 和 NT 期间的脑电图严重程度分级与结果具有统计学相关性（1 级=良好，3 级=不良）。与不良结果相关的其他脑电图特征包括癫痫发作、无反应性背景和癫痫样放电。监测期间脑电图分级的变化与结果无统计学相关性。5 例患者出现癫痫发作；所有发生在脑电图背景为 3 级的患者中，且均预后不良。
在 TH 和 NT 期间，我们的脑电图严重程度分级量表的 1 级和 3 级与结果相关。在我们的队列中，治疗癫痫发作并未改善预后。
