The predictive value for poor outcome of the presence of myoclonic status epilepticus, which was defined as spontaneous, repetitive, unrelenting, generalized multifocal myoclonus involving the face, limbs, and axial musculature in comatose patients,[sup] was reaffirmed in a 2013 meta-analysis (6 studies, 764 patients), and at 24 h after CPR, the presence of myoclonic status epilepticus had an FPR of 0 (95% CI : 0.
For the prediction of poor prognosis in comatose patients, appropriate predictors for clinical examination include the presence of myoclonic status epilepticus 24 h after CPR, absent pupillary light reflexes 72 h after CPR, and a GCS motor ≤2 score 72 h after CPR (Recommendation Level A, Evidence Class I).
07), respectively, for poor outcomes associated with the presence of myoclonic status epilepticus.
After rewarming from hypothermia only, predictors of poor prognosis in comatose patients with hypothermia treatment include the clinical examination (absent pupillary light reflexes, absent corneal reflexes, or presence of myoclonic status epilepticus), EEG (generalized suppression, burst suppression, status epilepticus on EEG, or the absence of EEG reactivity), and neurological biomarkers (48 h NSE ≥81.
bFDA approved for monotherapy and adjunctive therapy for partial seizures, simple and complex absence seizures and as adjunctive therapy for multiple seizures types including absence, photosensitive and generalized tonic-clonic, absence and myoclonic status
epilepticus, status epilepticus
When pharmacological paralysis and hypothermia were discontinued and sedation decreased a day later, a myoclonic status began despite treatment with midazolam and phenobarbitone.
Acute PHM typically begins within 24 hours from the hypoxic insult, occurs in patients who are deeply comatose and, by some authors, it is also called myoclonic status epilepticus, despite the lack of definitive evidence that these movements represent epileptic activity (3).