Evidence map›Paper›PMID 34484940›Full record

ArticleNeurology. Clinical practice2021

Characterization of Postanoxic Tonic Eyelid Opening: A Poorly Recognized Prognostic Sign.

Faisal Alsallom, Hussam Shaker, Christopher Newey, Stephen Hantus, Vineet Punia

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology. Clinical practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Faisal AlsallomDivision of Clinical Neurophysiology (FA), Epilepsy, Beth Israel Deaconess Medical Center, Boston, MA; Harvard Medical School (FA), Boston, MA; Epilepsy Center (HS, CN, SH, VP), Cerebrovascular Center (CN), Neurological Institute, and Center for Clinical Artificial Intelligence (CN), Cleveland Clinic, OH.
Hussam ShakerDivision of Clinical Neurophysiology (FA), Epilepsy, Beth Israel Deaconess Medical Center, Boston, MA; Harvard Medical School (FA), Boston, MA; Epilepsy Center (HS, CN, SH, VP), Cerebrovascular Center (CN), Neurological Institute, and Center for Clinical Artificial Intelligence (CN), Cleveland Clinic, OH.
Christopher NeweyDivision of Clinical Neurophysiology (FA), Epilepsy, Beth Israel Deaconess Medical Center, Boston, MA; Harvard Medical School (FA), Boston, MA; Epilepsy Center (HS, CN, SH, VP), Cerebrovascular Center (CN), Neurological Institute, and Center for Clinical Artificial Intelligence (CN), Cleveland Clinic, OH.
Stephen HantusDivision of Clinical Neurophysiology (FA), Epilepsy, Beth Israel Deaconess Medical Center, Boston, MA; Harvard Medical School (FA), Boston, MA; Epilepsy Center (HS, CN, SH, VP), Cerebrovascular Center (CN), Neurological Institute, and Center for Clinical Artificial Intelligence (CN), Cleveland Clinic, OH.
Vineet PuniaDivision of Clinical Neurophysiology (FA), Epilepsy, Beth Israel Deaconess Medical Center, Boston, MA; Harvard Medical School (FA), Boston, MA; Epilepsy Center (HS, CN, SH, VP), Cerebrovascular Center (CN), Neurological Institute, and Center for Clinical Artificial Intelligence (CN), Cleveland Clinic, OH.
Harvard University · USBeth Israel Deaconess Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPostanoxic myoclonus is a known poor prognostic sign, and other postanoxic spontaneous movements have been reported but poorly described. We aim to describe the electroclinical phenomenon of postanoxic eyelid openings in context of its possible prognostic value.

methodsWe collected clinical data on postcardiac arrest patients with suspicious eyelid movements noted on continuous EEG monitoring. The eyelid movements captured on the video were correlated with the EEG findings and final clinical outcome. Neuroimaging data were reviewed when available. We also conducted a thorough literature review on this topic.

resultsA total of 10 patients (5 females) with average age of 56.1 (±14.4) years were included. The mean cardiopulmonary resuscitation duration was 18.9 (±11.3) minutes. Postanoxic eyelid-opening movements occurred at variable intervals (0.5-570 seconds) in each individual. Close examination of eyelid opening (available in 6 patients) revealed them to be tonic movements, lasting an average of 3 (±0.8) seconds and always succeeded the onset of burst of EEG activity in a burst-suppression background. This is a transient phenomenon, lasting a median duration of 30 (interquartile range 7.75-36) hours. MRI findings in 3 patients demonstrated diffuse cortical ischemic injury with relative sparing of the brainstem. All patients died within 2-7 days following cardiac arrest.

conclusionsContrary to previous descriptions, the postanoxic tonic eyelid openings (PATEO) are repetitive but nonperiodic, nonmyoclonic movements. Their close and specific temporal correlation with the burst of EEG activity suggests that this could be considered an ictal phenomenon requiring an intact midbrain based on MRI findings.

Identifiers

PMID34484940
PMCPMC8382422
OpenAlexW3094321272

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.