41. Epileptiform activity and epileptic seizures in brain injured patients with prolonged disorders of consciousness. Issue 12 (December 2016)

• Record Type: Journal Article
• Authors: Estraneo, A.; Pascarella, A.; Loreto, V.
• Is Part Of: Clinical neurophysiology. Volume 127:Issue 12(2016:Dec.)
• Page Start: e333
• Publication Date: 2016-12
• Subjects: Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2016.10.053
• Languages: English
• ISSNs: 1388-2457

Abstract

Abstract : Brain injured patients might show "late" seizures beyond one week from injury. In the present observational study we analyzed occurrence of epileptiform activity (EA) and late Epileptic Seizures (ES) during neurorehabilitation stay in 130 traumatic, vascular and anoxic DOC patients (77 males, mean age: 55.8 ± 17.33), with a clinical diagnosis of vegetative state ( n = 97) or minimally conscious state ( n = 33). We also investigated impact of EA and ES on patients' long-term (30 months post-onset) clinical outcome. EA resulted to be present in 61/130 (46.9%) DOC patients and ES occurred in 35/130 (26.9%) DOC without significant differences in the clinical diagnosis or etiology. Among patients with EA, only 26/61 (42.6%) develop clinically evident ES. Mortality at 30 months did not significantly differ in DOC patients with or without ES and in DOC patients with of without EA (37.5% vs. 35.8%; p = .86). The proportion of "recovered" patients was higher in patients without ES than in patients with ES (70.5% vs. 48.0%; p = .064), whereas the proportion of recovered patients did not differ between patients without or with EA (64.7% vs. 60.0%; chi-square < 1). Presence of ES, but not of EA, significantly impact on recovery of consciousness and level of responsiveness at long-term outcome.