The Benefit of Neuromuscular Blockade in Patients with Postanoxic Myoclonus Otherwise Obscuring Continuous Electroencephalography (CEEG)
Joint Authors
Newey, C. R.
Hornik, Alejandro
Guerch, Meziane
Veripuram, Anantha
Yerram, Sushma
Ardelt, Agnieszka
Source
Critical Care Research and Practice
Issue
Vol. 2017, Issue 2017 (31 Dec. 2017), pp.1-7, 7 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2017-02-06
Country of Publication
Egypt
No. of Pages
7
Main Subjects
Abstract EN
Introduction.
Myoclonus status epilepticus is independently associated with poor outcome in coma patients after cardiac arrest.
Determining if myoclonus is of cortical origin on continuous electroencephalography (CEEG) can be difficult secondary to the muscle artifact obscuring the underlying CEEG.
The use of a neuromuscular blocker can be useful in these cases.
Methods.
Retrospective review of CEEG in patients with postanoxic myoclonus who received cisatracurium while being monitored.
Results.
Twelve patients (mean age: 53.3 years; 58.3% male) met inclusion criteria of clinical postanoxic myoclonus.
The initial CEEG patterns immediately prior to neuromuscular blockade showed myoclonic artifact with continuous slowing (50%), burst suppression with myoclonic artifact (41.7%), and continuous myogenic artifact obscuring CEEG (8.3%).
After intravenous administration of cisatracurium (0.1 mg–2 mg), reduction in artifact improved quality of CEEG recordings in 9/12 (75%), revealing previously unrecognized patterns: continuous EEG seizures (33.3%), lateralizing slowing (16.7%), burst suppression (16.7%), generalized periodic discharges (8.3%), and, in the patient who had an initially uninterpretable CEEG from myogenic artifact, continuous slowing.
Conclusion.
Short-acting neuromuscular blockade is useful in determining background cerebral activity on CEEG otherwise partially or completely obscured by muscle artifact in patients with postanoxic myoclonus.
Fully understanding background cerebral activity is important in prognostication and treatment, particularly when there are underlying EEG seizures.
American Psychological Association (APA)
Newey, C. R.& Hornik, Alejandro& Guerch, Meziane& Veripuram, Anantha& Yerram, Sushma& Ardelt, Agnieszka. 2017. The Benefit of Neuromuscular Blockade in Patients with Postanoxic Myoclonus Otherwise Obscuring Continuous Electroencephalography (CEEG). Critical Care Research and Practice،Vol. 2017, no. 2017, pp.1-7.
https://search.emarefa.net/detail/BIM-1139807
Modern Language Association (MLA)
Newey, C. R.…[et al.]. The Benefit of Neuromuscular Blockade in Patients with Postanoxic Myoclonus Otherwise Obscuring Continuous Electroencephalography (CEEG). Critical Care Research and Practice No. 2017 (2017), pp.1-7.
https://search.emarefa.net/detail/BIM-1139807
American Medical Association (AMA)
Newey, C. R.& Hornik, Alejandro& Guerch, Meziane& Veripuram, Anantha& Yerram, Sushma& Ardelt, Agnieszka. The Benefit of Neuromuscular Blockade in Patients with Postanoxic Myoclonus Otherwise Obscuring Continuous Electroencephalography (CEEG). Critical Care Research and Practice. 2017. Vol. 2017, no. 2017, pp.1-7.
https://search.emarefa.net/detail/BIM-1139807
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1139807