Abstracts

Rationale: Postanoxic status epilepticus is considered a poor prognostic sign. Hypothermic protocols have been implemented with some success. There is no consensus regarding management of postanoxic posthypothermic status epilepticus. It is important to know if treating these patients aggressively is beneficial. To this end we are reporting some results from our ongoing prospective observational study. Methods: Five consecutive patients were included thus far from January 2009. They were treated for post-anoxic status epilepticus, if they had an anoxic event after cardiac arrest, underwent hypothermic protocol and had evidence of status epilepticus on EEG. Treatment included an initial loading dose of antiepileptic medication and if there was status epilepticus on continuous EEG, they were started on propofol (3-5 mg/kg IV bolus, 2-10mg/kg/hr infusion) or pentobarbital (5mg/kg IV load, 0.5-10mg/kg/hr infusion) to target 24 hours of complete EEG suppression followed by tapering over 12 hours. Medical records and outcomes were reviewed. Results: Patients age range was 59-72 years. The initial EKG showed either ventricular fibrillation, PEA arrest or asystole. Time to return of perfusing rhythm ranged from 5-20 minutes. The initial EEG showed rhythmic frequent periodic spikes, and polyspike discharges meeting criteria for non-convulsive status epilepticus. After treatment as above, none of the patients recovered from their status epilepticus and all of them died. Conclusions: Although the sample size is very small, we have not had significant success in reverting post-anoxic status-epilepticus by aggressive treatment in patients after hypothermia protocol. We are continuing to add more patients.