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Post-ischemic Myoclonic Status Following Cardiac Arrest in Young Drug Users
Sherri A Braksick1, Alejandro A Rabinstein2, Eelco F M Wijdicks2
1Division of Critical Care Neurology, Department of Neurology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA. braksick.sherri@mayo.edu.
Background:
Myoclonic status may be observed following cardiac arrest and has previously been identified as a poor prognostic indicator in regard to return of neurologic function. We describe a unique situation in post-cardiac arrest patients with myoclonic status and hypothesize possible predictors of a good neurologic outcome.
Methods:
Case series.
Results:
We illustrate two cases of cardiac arrest due to a respiratory cause in young patients with evidence of illicit drug use at the time of hospital admission that suffered post-ischemic myoclonic status. These patients subsequently recovered with good neurologic outcomes.
Conclusions:
On rare occasions, myoclonic status does not imply a poor functional outcome following cardiac arrest. Other clinical and demographic characteristics including young age, presence of illicit substances, and primary respiratory causes of arrest may contribute to a severe clinical presentation, with a subsequent good neurologic outcome in a small subset of patients.