Stimulus-sensitive seizures in postanoxic coma.

PURPOSE: To describe four patients with stimulus-sensitive seizures and myoclonus following severe hypoxic-ischemic injury.

METHODS

In 22 months, four adult patients with myoclonus, generalized tonic-clonic, and clonic seizures following tactile stimulation were identified. EEG and hospital records were reviewed.

RESULTS

EEGs showed bursts of generalized spike and polyspike activity following tactile stimulation associated with the clinical seizures. No cerebral activity was present between the epileptiform bursts. At times, prolonged periods of suppression were recorded. All patients failed to respond to antiepileptic drugs and died.

CONCLUSIONS

Stimulus-sensitive seizures and myoclonus following anoxia are associated with poor clinical outcome. The presence of seizures and myoclonus in conjunction with epileptiform discharges on EEG confirms that post-anoxic myoclonus is an epileptic state.