Anoxie cérébrale par noyade chez l'enfant. Intérêt de l'EEG dans le pronostic

A Review of Long-term EEG Monitoring in Critically Ill Children With Hypoxic–Ischemic Encephalopathy, Congenital Heart Disease, ECMO, and Stroke

“…Certain EEG background features are known to have prognostic significance in adults (Wijdicks, et al 2006, Young 2000) and children (Nishisaki, Sullivan, Steger, et al 2007, Pampiglione and Harden 1968, Tasker, et al 1988, Cheliout-Heraut, et al 1991, Ramachandrannair, et al 2005, Mandel, et al 2002, Pampiglione, et al 1978, Evans and Bartlett 1995). Patients with more severely abnormal EEG backgrounds tend to have a worse short-term outcome than patients with only mild/moderate background abnormalities.…”

“…Pediatric studies have reported that burst suppression (Pampiglione and Harden 1968), excessive discontinuity (Mandel, Martinot, Delepoulle, et al 2002), severe attenuation (Tasker, Boyd, Harden, et al 1988), lack of reactivity (Ramachandrannair, Sharma, Weiss, et al 2005, Mandel, Martinot, Delepoulle, et al 2002), and generalized epileptiform discharges (Mandel, Martinot, Delepoulle, et al 2002) are associated with unfavorable prognosis. Conversely, rapid EEG improvement (Pampiglione, Chaloner, Harden, et al 1978), reactivity (Cheliout-Heraut, Sale-Franque, Hubert, et al 1991) and normal sleep patterns (Cheliout-Heraut, Sale-Franque, Hubert, et al 1991, Evans and Bartlett 1995) are associated with good prognosis. While alpha coma is often considered in relation to anoxic encephalopathy and unfavorable prognosis, it is a non-specific pattern that can occur with a wide variety of etiologies and outcome is probably mostly dependent on etiology.…”

Electroencephalographic Monitoring in the Pediatric Intensive Care Unit

“…Pediatric studies have reported that burst suppression [15, 16], excessive discontinuity [20], severe attenuation [15, 17], lack of reactivity [19, 20], and periodic or multifocal epileptiform discharges [15] are associated with unfavorable prognosis. Conversely, rapid EEG improvement over hours [21], reactivity [18] and normal sleep patterns [18, 22] are associated with favorable prognosis. A study of children treated with therapeutic hypothermia after cardiac arrest resuscitation found that EEG backgrounds categorized as unreactive, discontinuous, burst-suppression, or lacking cerebral activity during the hypothermic or normothermic time periods were associated with unfavorable outcome, although not with perfect predictive value.…”

EEG Monitoring during Therapeutic Hypothermia in Neonates, Children, and Adults

“…Some EEG background features are known to have prognostic significance in children when TH is not utilized (Nishisaki et al 2007, Pampiglione and Harden 1968, Tasker et al 1988, Cheliout-Heraut et al 1991, Ramachandrannair et al 2005, Mandel et al 2002, Pampiglione et al 1978, Evans and Bartlett 1995). Patients with more severely abnormal EEG backgrounds tend to have a worse short-term outcome than patients with only mild/moderate background abnormalities.…”

“…Pediatric studies have reported that burst suppression (Pampiglione and Harden 1968), excessive discontinuity (Mandel et al 2002), severe attenuation (Tasker et al 1988), lack of reactivity (Ramachandrannair et al 2005, Mandel et al 2002), and generalized epileptiform discharges (Mandel et al 2002) are associated with unfavorable prognosis. Conversely, rapid EEG improvement (Pampiglione et al 1978), reactivity (Cheliout-Heraut et al 1991), and normal sleep patterns (Cheliout-Heraut et al 1991, Evans and Bartlett 1995) are associated with good prognosis. A retrospective study of 34 children resuscitated from cardiac arrest who had EEGs performed during the initial seven days after cardiac arrest reported that a more severely abnormal EEG score was associated with poor neurologic outcome.…”