In:
Neurology, Ovid Technologies (Wolters Kluwer Health), Vol. 92, No. 3 ( 2019-01-15), p. e183-e193
Abstract:
To analyze the factors that determine the occurrence or severity of postictal hypoxemia in the immediate aftermath of a generalized convulsive seizure (GCS). Methods We reviewed the video-EEG recordings of 1,006 patients with drug-resistant focal epilepsy included in the REPO 2 MSE study to identify those with ≥1 GCS and pulse oximetry (SpO 2 ) measurement. Factors determining recovery of SpO 2 ≥ 90% were investigated using Cox proportional hazards models. Association between SpO 2 nadir and person- or seizure-specific variables was analyzed after correction for individual effects and the varying number of seizures. Results A total of 107 GCS in 73 patients were analyzed. A transient hypoxemia was observed in 92 GCS (86%). Rate of GCS with SpO 2 〈 70% dropped from 40% to 21% when oxygen was administered early ( p = 0.046). Early recovery of SpO 2 ≥90% was associated with early administration of oxygen ( p = 0.004), absence of postictal generalized EEG suppression (PGES) ( p = 0.014), and extratemporal lobe epilepsy ( p = 0.001). Lack of early administration of O 2 ( p = 0.003), occurrence of PGES ( p = 0.018), and occurrence of ictal hypoxemia during the focal phase ( p = 0.022) were associated with lower SpO 2 nadir. Conclusion Postictal hypoxemia was observed in the immediate aftermath of nearly all GCS but administration of oxygen had a strong preventive effect. Severity of postictal hypoxemia was greater in temporal lobe epilepsy and when hypoxemia was already observed before the onset of secondary GCS.
Type of Medium:
Online Resource
ISSN:
0028-3878
,
1526-632X
DOI:
10.1212/WNL.0000000000006777
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2019
