• Sang-Bae Ko, Santiago Ortega-Gutierrez, H Alex Choi, Jan Claassen, Mary Presciutti, J Michael Schmidt, Neeraj Badjatia, Kiwon Lee, and Stephan A Mayer.
• Neurological Intensive Care Unit, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA.
• Arch. Neurol. 2011 Oct 1;68(10):1323-6.

ObjectiveTo report changes of cerebral blood flow and metabolism associated with status epilepticus after cardiac arrest.DesignCase report.SettingNeurological intensive care unit in a university hospital.PatientAn 85-year-old man resuscitated from out-of-hospital cardiac arrest underwent brain multimodality monitoring and treatment with therapeutic hypothermia.Main Outcome MeasuresChanges of cerebral blood flow and metabolism.ResultsRepetitive electrographic seizure activity detected at the start of monitoring was associated with dramatic reductions in brain tissue oxygen tension and striking surges in cerebral blood flow and brain temperature. Intravenous lorazepam and levetiracetam administration resulted in immediate cessation of the seizures and these associated derangements. The lactate to pyruvate ratio was initially elevated and trended down after administration of anticonvulsants.ConclusionBrain multimodality monitoring is a feasible method for evaluating secondary brain injury associated with seizure activity after cardiac arrest.

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