The Impact of Nonconvulsive Status Epilepticus after Cardiac Surgery on Outcome
Neurological complications after heart surgery are associated with tremendous morbidity and mortality. Nonconvulsive status epilepticus (NCSE), which can only be verified by EEG, may cause secondary brain damage. Its frequency and its impact on outcomes after cardiac surgery is still unclear. We col...
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| Format: | Article |
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MDPI AG
2022-09-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/19/5668 |
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| author | Keso Skhirtladze-Dworschak Alessia Felli Susanne Aull-Watschinger Rebekka Jung Mohamed Mouhieddine Andreas Zuckermann Edda Tschernko Martin Dworschak Ekaterina Pataraia |
| author_facet | Keso Skhirtladze-Dworschak Alessia Felli Susanne Aull-Watschinger Rebekka Jung Mohamed Mouhieddine Andreas Zuckermann Edda Tschernko Martin Dworschak Ekaterina Pataraia |
| author_sort | Keso Skhirtladze-Dworschak |
| collection | DOAJ |
| description | Neurological complications after heart surgery are associated with tremendous morbidity and mortality. Nonconvulsive status epilepticus (NCSE), which can only be verified by EEG, may cause secondary brain damage. Its frequency and its impact on outcomes after cardiac surgery is still unclear. We collected the neurological files and clinical data of all our patients after heart surgery who, in the course of their ICU stay, had been seen by a neurologist who ordered an EEG. Within 18 months, 1457 patients had cardiac surgery on cardiopulmonary bypass. EEG was requested for 89 patients. Seizures were detected in 39 patients and NCSE was detected in 11 patients. Open heart surgery was performed in all 11 NSCE patients, of whom eight showed concomitant brain insults. None had a history of epilepsy. Despite the inhibition of seizure activity with antiseizure medication, clinical improvement was only noted in seven NCSE patients, three of whom were in cerebral performance category 2 and four in category 3 at hospital discharge. The four patients without neurological benefit subsequently died in the ICU. The occurrence of NCSE after open cardiac surgery is significant and frequently associated with brain injury. It seems prudent to perform EEG studies early to interrupt seizure activity and mitigate secondary cerebral injury. |
| first_indexed | 2024-03-09T21:34:19Z |
| format | Article |
| id | doaj.art-68429225595f4d84a0dcb591530b919d |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T21:34:19Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-68429225595f4d84a0dcb591530b919d2023-11-23T20:46:49ZengMDPI AGJournal of Clinical Medicine2077-03832022-09-011119566810.3390/jcm11195668The Impact of Nonconvulsive Status Epilepticus after Cardiac Surgery on OutcomeKeso Skhirtladze-Dworschak0Alessia Felli1Susanne Aull-Watschinger2Rebekka Jung3Mohamed Mouhieddine4Andreas Zuckermann5Edda Tschernko6Martin Dworschak7Ekaterina Pataraia8Department of Anesthesia, Intensive Care Medicine and Pain Medicine, Division of Cardiac Thoracic Vascular Anesthesia and Intensive Care Medicine, General Hospital Vienna, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, AustriaDepartment of Anesthesia, Intensive Care Medicine and Pain Medicine, Division of General Anesthesia and Intensive Care Medicine, Medical University of Vienna, A-1090 Vienna, AustriaDepartment of Neurology, Medical University of Vienna, A-1090 Vienna, AustriaDepartment of Neurology, Medical University of Vienna, A-1090 Vienna, AustriaDepartment of Anesthesia, Intensive Care Medicine and Pain Medicine, Division of Cardiac Thoracic Vascular Anesthesia and Intensive Care Medicine, General Hospital Vienna, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, AustriaDepartment of Cardiac Surgery, Medical University of Vienna, A-1090 Vienna, AustriaDepartment of Anesthesia, Intensive Care Medicine and Pain Medicine, Division of Cardiac Thoracic Vascular Anesthesia and Intensive Care Medicine, General Hospital Vienna, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, AustriaDepartment of Anesthesia, Intensive Care Medicine and Pain Medicine, Division of Cardiac Thoracic Vascular Anesthesia and Intensive Care Medicine, General Hospital Vienna, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, AustriaDepartment of Neurology, Medical University of Vienna, A-1090 Vienna, AustriaNeurological complications after heart surgery are associated with tremendous morbidity and mortality. Nonconvulsive status epilepticus (NCSE), which can only be verified by EEG, may cause secondary brain damage. Its frequency and its impact on outcomes after cardiac surgery is still unclear. We collected the neurological files and clinical data of all our patients after heart surgery who, in the course of their ICU stay, had been seen by a neurologist who ordered an EEG. Within 18 months, 1457 patients had cardiac surgery on cardiopulmonary bypass. EEG was requested for 89 patients. Seizures were detected in 39 patients and NCSE was detected in 11 patients. Open heart surgery was performed in all 11 NSCE patients, of whom eight showed concomitant brain insults. None had a history of epilepsy. Despite the inhibition of seizure activity with antiseizure medication, clinical improvement was only noted in seven NCSE patients, three of whom were in cerebral performance category 2 and four in category 3 at hospital discharge. The four patients without neurological benefit subsequently died in the ICU. The occurrence of NCSE after open cardiac surgery is significant and frequently associated with brain injury. It seems prudent to perform EEG studies early to interrupt seizure activity and mitigate secondary cerebral injury.https://www.mdpi.com/2077-0383/11/19/5668cardiac surgerycardiopulmonary bypassbrain insultnonconvulsive status epilepticusconventional electroencephalographyseizures |
| spellingShingle | Keso Skhirtladze-Dworschak Alessia Felli Susanne Aull-Watschinger Rebekka Jung Mohamed Mouhieddine Andreas Zuckermann Edda Tschernko Martin Dworschak Ekaterina Pataraia The Impact of Nonconvulsive Status Epilepticus after Cardiac Surgery on Outcome Journal of Clinical Medicine cardiac surgery cardiopulmonary bypass brain insult nonconvulsive status epilepticus conventional electroencephalography seizures |
| title | The Impact of Nonconvulsive Status Epilepticus after Cardiac Surgery on Outcome |
| title_full | The Impact of Nonconvulsive Status Epilepticus after Cardiac Surgery on Outcome |
| title_fullStr | The Impact of Nonconvulsive Status Epilepticus after Cardiac Surgery on Outcome |
| title_full_unstemmed | The Impact of Nonconvulsive Status Epilepticus after Cardiac Surgery on Outcome |
| title_short | The Impact of Nonconvulsive Status Epilepticus after Cardiac Surgery on Outcome |
| title_sort | impact of nonconvulsive status epilepticus after cardiac surgery on outcome |
| topic | cardiac surgery cardiopulmonary bypass brain insult nonconvulsive status epilepticus conventional electroencephalography seizures |
| url | https://www.mdpi.com/2077-0383/11/19/5668 |
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