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J Neurol Neurosurg Psychiatry 73:94-95 doi:10.1136/jnnp.73.1.94
  • Letter

Propofol in myoclonus status epilepticus in comatose patients following cardiac resuscitation

  1. E F M Wijdicks
  1. Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA Competing interests: none declared
  1. Correspondence to:
 Dr E F M Wijdicks, Department of Neurology, Mayo Clinic–W8B, 200 First Street SW, Rochester, MN 55905, USA;
 wijde{at}mayo.edu

    Myoclonus status epilepticus has been identified as a poor prognosticating sign in comatose patients following cardiopulmonary resuscitation.1 These vigorous generalised jerks are considered to be the penultimate phenomenon in a severly damaged brain that is difficult to manage and that may cause difficulty in ventilating the patient. Antiepileptic drugs such as phenytoin or benzodiazepines have not been very successful. When the jerks are particularly severe, neuromuscular junction blockers have been recommended.1 I report on two comatose patients with myoclonus status epilepticus. Propofol in a subanaesthetic dose muted these movements considerably.

    A 77 year old patient with a prior history of rheumatoid arthritis was resuscitated at home after sudden …