ArticleAnnals of neurology2016
Clinically distinct electroencephalographic phenotypes of early myoclonus after cardiac arrest.
Article in Annals of neurology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 75 papers, 5 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
75 citing papers in PubMed, 5 syntheses or guidelines pooled it, 197 citations in OpenAlex.
- 2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 6. Post-cardiac arrest care.Clinical and experimental emergency medicine · 2026Guideline
- European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2025: post-resuscitation care.Intensive care medicine · 2025Guideline
- Myoclonus After Cardiac Arrest: Need for Standardization-A Systematic Review and Research Proposal on Terminology.Critical care medicine · 2025Pooled it
- Guidelines for Neuroprognostication in Comatose Adult Survivors of Cardiac Arrest.Neurocritical care · 2023Guideline
- Prediction of poor neurological outcome in comatose survivors of cardiac arrest: a systematic review.Intensive care medicine · 2020Pooled it
- Sedation and analgesia in post-cardiac arrest care: a post hoc analysis of the TTM2 trial.Critical care (London, England) · 2025Trial
- Cardiac Arrest Treatment Center Differences in Sedation and Analgesia Dosing During Targeted Temperature Management.Neurocritical care · 2023Trial
- Neurotoxicity in Neuroprognostication: The Importance of Differential Diagnostic Clarity.Neurocritical care · 2026Article
- Seminar in Epileptology: Normal awake and sleep patterns, interictal abnormalities, and ictal patterns on scalp EEG.Epileptic disorders : international epilepsy journal with videotape · 2025Review
- Electrographic and Clinical Determinants of Good Outcome After Postanoxic Status Epilepticus.Neurology · 2025Observational
- Lance-Adams syndrome or chronic post-hypoxic myoclonus in adults: a systematic literature review.Brain communications · 2025Review
- Lance-Adams Syndrome: An Updated Review of a Rare Post-Hypoxic Complication.Tremor and other hyperkinetic movements (New York, N.Y.) · 2025Review
- Optimizing brain protection after cardiac arrest: advanced strategies and best practices.Interface focus · 2024Review
- Looking Back at the Lance-Adams Syndrome: Uncommon and Unalike.Neurocritical care · 2024Article
- Utility and rationale for continuous EEG monitoring: a primer for the general intensivist.Critical care (London, England) · 2024Review
- Article
- Neuromonitoring after Pediatric Cardiac Arrest: Cerebral Physiology and Injury Stratification.Neurocritical care · 2024Review
- Review
- Critical Care Management of Patients After Cardiac Arrest: A Scientific Statement from the American Heart Association and Neurocritical Care Society.Neurocritical care · 2024Article
- Critical Care Management of Patients After Cardiac Arrest: A Scientific Statement From the American Heart Association and Neurocritical Care Society.Circulation · 2024Review
15 more citing papers are in PubMed but not listed here.
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveWe tested the hypothesis that there are readily classifiable electroencephalographic (EEG) phenotypes of early postanoxic multifocal myoclonus (PAMM) that develop after cardiac arrest.
methodsWe studied a cohort of consecutive comatose patients treated after cardiac arrest from January 2012 to February 2015. For patients with clinically evident myoclonus before awakening, 2 expert physicians reviewed and classified all EEG recordings. Major categories included: Pattern 1, suppression-burst background with high-amplitude polyspikes in lockstep with myoclonic jerks; and Pattern 2, continuous background with narrow, vertex spike-wave discharges in lockstep with myoclonic jerks. Other patterns were subcortical myoclonus and unclassifiable. We compared population characteristics and outcomes across these EEG subtypes.
resultsOverall, 401 patients were included, of whom 69 (16%) had early myoclonus. Among these patients, Pattern 1 was the most common, occurring in 48 patients (74%), whereas Pattern 2 occurred in 8 patients (12%). The remaining patients had subcortical myoclonus (n = 2, 3%) or other patterns (n = 7, 11%). No patients with Pattern 1, subcortical myoclonus, or other patterns survived with favorable outcome. By contrast, 4 of 8 patients (50%) with Pattern 2 on EEG survived, and 4 of 4 (100%) survivors had favorable outcomes despite remaining comatose for 1 to 2 weeks postarrest.
interpretationEarly PAMM is common after cardiac arrest. We describe 2 distinct patterns with distinct prognostic significances. For patients with Pattern 1 EEGs, it may be appropriate to abandon our current clinical standard of aggressive therapy with conventional antiepileptic therapy in favor of early limitation of care or novel neuroprotective strategies. Ann Neurol 2016;80:175-184.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.