CLINICAL CHARACTERISTICS AND EEG FEATURES OF NON-CONVULSIVE STATUS EPILEPTICUS (NCSE) AFTER CARDIOVASCULAR SURGERY

Abstract

One of the most frequent complications after cardiovascular surgery are different types of epilepsy seizures during coma (GCS <8). Manifestation of coma might be result of hypoxic brain injury. It is very important to make early diagnose of exact type of complications and immediately start appropriate treatment. There are several difficulties in identification of non-convulsive status epilepticus (NCSE) during coma that is why in all of these cases we are using Specific clinical and Electrophysiological examinations. Materials And Methods: There were 42 patients with persistent coma after cardiac surgery under our clinical observation. Aged between 36-82. Patients underwent one of the following surgeries: coronary artery bypass graft surgery (CABG) in 27 patients, valve surgery - in 9 cases. In 6 cases there were used Surgery of ascending aorta and aortal arch. 40 patients have been undergone cardiopulmonary bypass (CPB) during cardiac surgery. Following methods were used: Ÿ Clinical neurological status evaluation Ÿ Computer tomography (CT scan) Ÿ Long-term EEG Results: Non-convulsive status was discovered in 9 cases. Patients with the NCSE were separated into three groups: First, 3 patients with nystagmoid eye jerking and facial muscles twitching. Second: in 4 cases there were twitching of the limb. Third: 2 patients didn't have any movement clinical symptoms. Conclusion: As we see Cardiovascular surgery might cause neurological especially epileptiform type of complications during coma. These types of complications include non-convulsive epileptic status. Each patient needs immediate EEG examination for early diagnose and correct treatment of this condition.