A major miss in prognostication after cardiac arrest: Burst suppression and brain healing

Danielle A. Becker, Nicholas D. Schiff, Lance B. Becker, Manisha G. Holmes, Joseph J. Fins, James M. Horowitz, Orrin Devinsky

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

We report a case with therapeutic hypothermia after cardiac arrest where meaningful recovery far exceeded anticipated negative endpoints following cardiac arrest with loss of brainstem reflexes and subsequent status epilepticus. This man survived and recovered after an out-of-hospital cardiac arrest followed by a 6-week coma with absent motor responses and 5 weeks of burst suppression. Standard criteria suggested no chance of recovery. His recovery may relate to the effect of burst-suppression on EEG to rescue neurons near neuronal cell death. Further research to understand the mechanisms of therapeutic hypothermia and late restoration of neuronal functional capacity may improve prediction and aid end-of-life decisions after cardiac arrest.

Original languageEnglish (US)
Pages (from-to)1-5
Number of pages5
JournalEpilepsy and Behavior Case Reports
Volume7
DOIs
StatePublished - 2017

Keywords

  • Burst suppression
  • Cardiac arrest
  • Hypothermia
  • Prognostication
  • Status epilepticus

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Behavioral Neuroscience

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