الفهرس 
Acknowledgements
Electroencephalography (EEG)Only 14 pages are availabe for public view
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Abstract
Cardiac arrest is a major health problem and a leading cause of coma, survivors of the cardiac arrest may develop neurological complications, such as post hypoxic myoclonus (PHM). Two types of myoclonus can occur in patients with hypoxic injury of the brain:
1) Early or acute post anoxic multifocal myoclonus (PAMM).
2) chronic PAMM or Lance Adams Syndrome (LAS).
Early post-anoxic multifocal myoclonus (PAMM) traditionally has been considered a grave prognostic feature in patients who remain comatosed after cardiac arrest.
Electroencephalography (EEG) can distinguish types of post hypoxic multifocal myoclonus (PHMM). Three predefined EEG categories {based on the recent American Clinical Neurophysiology Society (ACNS) standardized critical care terminology} show good correlation with poor and good outcome.
1- “Highly malignant”: suppressed background with or without continuous periodic discharges; burst-suppression.
2- “Malignant”: abundant periodic discharges, or rhythmic epileptiform transients; electrographic seizure; discontinuous or low-voltage background; reversed anterior–posterior gradient; unreactive EEG to stimuli.
3- “Benign” EEG (absence of all malignant features stated above).
This study aimed to assess prognostic value of Electro-encephalography pattern in prediction of survival and early myoclonus after cardiac arrest.
It was performed at Department of Neurology and Psychiatry in the period from October 1st 2016 to May 31th 2017. The study included 40 patients who were resuscitated after cardiac arrest.
Out of the 40 studied patients, 29 (72.5%) patients were alive while 11 (27.5%) patients were dead. There were some criteria regarding study outcomes:
• About (63.6%) of dead patients were males while (72.4%) of alive patients were females.
• Alive patients had higher frequency of IHD (93.1%), shockable rhythm (82.8%) in comparison to dead patients.
• Mean time to return to spontaneous circulation was significantly lower in alive (5.95 ± 2.5) vs. (22 ± 5.72) minute in dead patients; P< 0.001.
• While GCS was significantly higher in alive patients (12.6 ± 2.16) vs. (4.7 ± 2.64) in dead patients; P< 0.001.
• Regarding patterns of EEG; 86.2% of lived patients had benign pattern, while 63.6% of dead patients had highly malignant pattern.
Experts in coma prognostication defined outcome by cerebral performance categories CPCs; we refer to good (CPC 1 or 2) or poor (CPC 3-5) outcome.
• Regarding CPC, 79.3% of lived patients had cerebral performance grade 1(CPC1) while 54.5% of dead patients had CPC 4.
• Frequency of seizures after resuscitation was significantly higher in dead patients (45.5%) vs. (17.2%) in alive patients; P= 0.03.
• Most of the patients with post- arrest seizures (40%) and those without seizures (70%) had benign EEG’s pattern while 30% of those with seizures had highly malignant pattern and only 13.3% of those without seizure had such pattern, also 66.7% of those without post-arrest seizures had CPC1 while 30% of those with seizures had CPC1.