Abstracts

Rationale: The rationale of our study is to build electro-clinical phenotypes of spontaneous cardiac arrest (SCA) survivor and to correlate acute EEG findings to long-term seizure risk and electrographic findings. Methods: After IRB approval, we used our prospectively maintained EEG database to identify adults (≥18 years) who underwent a out-patient lab based electroencephalogram (EEG) and had history of SCA in their history section of the EEG report. Electronic medical records (EMR) along with EEG reports and raw tracings were reviewed to extract data on demographical, clinical and EEG variables. We excluded patients with: - history of epilepsy prior to SCA - no details available about the SCA in EMRAcute (≤7 days)EEG was divided into following categories: - Malignant pattern: background suppression or burst suppression - Epileptogenic: seizures, interictal epileptiform discharges - Continuous: EEG findings excluding above (includes periodic pattern)Out-patient, follow-up EEG was divided into following categories: normal, non-epileptic, and epileptogenic.Descriptive statistical analysis was performed. Results: A total of 32 patients (16 females), with mean age of 50.8 (±13.9) years, were included. The median ROSC was 13.5 (6.5 – 21.5) minutes which was available in 24/32 (75%).The duration between the time of SCA and follow up EEG was 13.2 (4.9 - 26.2) months. Follow-up EEG follow up was:Normal: 13 (40.6%) Non-epileptic: 8 (25%)Epileptogenic: 11(34.3%). Acute EEG data was as available for 22 patients (Table 1).Clinical outcomes:Post-anoxic myoclonus: 8 (25%)Clinical seizures: 8 (25%)Both: 5 (15.6%)AEDs at last follow-up: 19 (59.4%) patients Conclusions: In this small but first of its kind study, we report that slight more than a third of SCA survivors have epileptogenic findings on EEG.These are not found in patients lacking malignant or epileptiform activity on acute EEG.While one-third of patients develop clinical epilepsy or post-anoxic myoclonus, more than half of the patients in our study were on long term AEDs. Future studies with larger, unbiased sampling are required to confirm our findings. Funding: No funding