• P Milani, I Malissin, Y R Tran-Dinh, N Deye, F Baud, B I Lévy, and N Kubis.
• Université Paris Diderot, Sorbonne Paris Cité, 75013 Paris, France; Service de physiologie clinique, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France.
• Neurophysiol Clin. 2014 Apr 1;44(2):153-64.

Study AimsWe assessed clinical and early electrophysiological characteristics, in particular Generalized Periodic Epileptiform Discharges (GPEDs) patterns, of consecutive patients during a 1-year period, hospitalized in the Intensive Care Unit (ICU) after resuscitation following cardiac arrest (CA).Patients And MethodsConsecutive patients resuscitated from cardiac arrest (CA) with first EEG recordings within 48hours were included. Clinical data were collected from hospital records, in particular therapeutic hypothermia. Electroencephalograms (EEGs) were re-analyzed retrospectively.ResultsSixty-two patients were included. Forty-two patients (68%) were treated with therapeutic hypothermia according to international guidelines. Global mortality was 74% but not significantly different between patients who benefited from therapeutic hypothermia compared to those who did not. All the patients who did not have an initial background activity (36/62; 58%) died. By contrast, initial background activity was present in 26/62 (42%) and among these patients, 16/26 (61%) survived. Electroencephalography demonstrated GPEDs patterns in 5 patients, all treated by therapeutic hypothermia and antiepileptic drugs. One of these survived and showed persistent background activity with responsiveness to benzodiazepine intravenous injection.ConclusionPatients presenting suppressed background activity, even when treated by hypothermia, have a high probability of poor outcome. Thorough analysis of EEG patterns might help to identify patients with a better chance of survival.Copyright © 2014 Elsevier Masson SAS. All rights reserved.

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