Neurophysiological Findings in a Patient with Posthypoxic Myoclonus after Cardio-Respiratory Arrest
Ruiz Navarrete PA1* and Galdón Castillo A1
1Video-EEG Unit. Clinical Neurophysiology Service. Virgen de las Nieves University Hospital. Granada, Spain.
*Corresponding Author: Ruiz Navarrete PA, Video-EEG Unit. Clinical Neurophysiology Service. Virgen de las Nieves University Hospital. Granada, Spain.
Received: May 04, 2022 Published: June 03, 2022
Abstract
Introduction: Post-hypoxic myoclonus (PHM) are involuntary movements that occur after cardio-respiratory arrest (CRA). They are classified into myoclonic status epilepticus (MSE) that occurs in the first 12 hours and Lance-Adams syndrome that occurs later. The practical application of this division lies in the poor prognosis associated with MSE. To differentiate, it is useful to perform electroencephalogram (EEG) and somatosensory evoked potentials (SSEPs).
Objective: To assess the findings of the neurophysiological tests in a patient in a coma with PHM after CRA.
Method: Study of a patient admitted to Intensive Care at the Virgen de las Nieves University Hospital in Granada, with a bibliographic review in PubMed. Case: 56-year-old patient with a history of hypertension who suffers from CRA, after which an examination is compatible with coma of unknown etiology and associated spasms.
Results: EEG is performed 6 hours after CRA, which records isoelectric periods interspersed with cortical activity. It presents spontaneously, to tactile and sound stimulation, axial myoclonic response with spasms without epileptiform correlation. At 24 hours, an EEG is performed with tracing compatible with alpha-coma. Bilateral median nerve SSEPs without cortical response (N20). At 96 hours, SSEPs is repeated with the same results, and EEG showing tracing without cortical differentiation. After the findings, the life support measures that cause the death of the patient are limited Conclusion: Neurophysiological tests can help determine the PHM subtype that allows establishing a prognosis.
Keywords: Post-hypoxic Myoclonus, Cardio-respiratory Arrest, Myoclonic Status Epilepticus, Lance-Adams.
Citation: Ruiz Navarrete PA, Galdo n Castillo A “Neurophysiological Findings in a Patient with Posthypoxic Myoclonus after Cardio-Respiratory Arrest”. SVOA Neurology 2022, 3:3, 131-136.
