Accardo Jennifer, De Lisi Domenico, Lazzerini Paola, Primavera Alberto
Centro di Fisiopatologia del Sonno, DINOGMI, Università di Genova, Largo Rosanna Benzi, 10 16132 Genova, Italy.
U.O. Anestesia e Rianimazione, DIPEA, IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Largo Rosanna Benzi, 10 16132 Genova, Italy.
Case Rep Neurol Med. 2013;2013:872127. doi: 10.1155/2013/872127. Epub 2013 Dec 3.
In anoxic coma, myoclonic status epilepticus and other nonreactive epileptiform patterns are considered as signs of poor prognosis. We report the case of a good recovery in a prolonged comatose myoclonic status epilepticus (MSE) after a cardiac arrest (CA) treated with mild therapeutic hypothermia (TH) in a patient who had undergone a bone marrow transplantation for Hodgkin's lymphoma. This case emphasizes the opportunity of performing an electroencephalogram (EEG) in the acute period after an hypoxic-ischemic insult and underlines the diagnostic difficulties between MSE and Lance-Adams syndrome, which classically occurs after the patient has regained consciousness, but can also begin while the patient is still comatose or sedated. Major problems in prognostication for postarrest comatose patients will also be pointed out.
在缺氧性昏迷中，肌阵挛性癫痫持续状态及其他无反应性癫痫样模式被视为预后不良的征象。我们报告了1例因霍奇金淋巴瘤接受骨髓移植的患者，在心脏骤停（CA）后出现长时间昏迷性肌阵挛性癫痫持续状态（MSE），经轻度治疗性低温（TH）治疗后恢复良好的病例。该病例强调了在缺氧缺血性损伤急性期进行脑电图（EEG）检查的必要性，并突出了MSE与兰斯-亚当斯综合征之间的诊断困难，后者通常在患者意识恢复后出现，但也可在患者仍处于昏迷或镇静状态时开始。同时还将指出心脏骤停后昏迷患者预后评估中的主要问题。
