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EEG patterns associated with present cortical SSEP after cardiac arrest
Author(s) -
Beuchat Isabelle,
Novy Jan,
Barbella Giuseppina,
Oddo Mauro,
Rossetti Andrea O.
Publication year - 2020
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.13264
Subject(s) - electroencephalography , somatosensory evoked potential , medicine , anesthesia , cardiology , audiology , psychology , psychiatry
Background After cardiac arrest (CA), present cortical somatosensory evoked potentials (N20 response of SSEPs) have low predictive value for good outcome and might be redundant with EEG. Aims To determine whether specific features, or rather global, standardized EEG assessments, are reliably associated with cortical SSEP occurrence after cardiac arrest (CA). Methods In a prospective CA registry, EEGs recorded within 72 hours were scored according to the ACNS nomenclature, and also categorized into “benign,” “malignant,” and “highly malignant.” Correlations between EEGs and SSEPs (bilaterally absent vs present), and between EEGs/SSEPs and outcome (good: CPC 1‐2) were assessed. Results Among 709 CA episodes, 532 had present N20 and 366 “benign EEGs.” While EEG categories as well as background, epileptiform features, and reactivity differed significantly between patients with and without N20 (each P < .001), only “benign EEG” was almost universally associated with present N20: 99.5% (95%CI: 97.9%‐99.9%) PPV. The combination of “benign EEG” and present N20 showed similar PPV for good outcome as “benign” EEG alone: 69.0% (95% CI: 65.2‐72.4) vs 68.6% (95% CI: 64.9‐72.0). Conclusion Global EEG (“benign”) assessment, rather than single EEG features, can reliably predict cortical SSEP occurrence. SSEP adjunction does not increase EEG prognostic performance toward good outcome. SSEP could therefore be omitted in patients with “benign EEG.”