Pulseless Electrical Activity Arrest Presenting as Tonic Arm Stiffening and a Flat Electroencephalogram

Area of Science:

• Neurology
• Cardiology
• Critical Care Medicine

Background:

• Pulseless electrical activity (PEA) is a critical condition characterized by organized electrical activity on electrocardiogram without a palpable pulse.
• PEA arrest can present with diverse clinical manifestations, sometimes mimicking other neurological emergencies.
• Differentiating PEA from conditions like seizures is vital for timely and appropriate intervention.

Purpose of the Study:

• To report a unique case of PEA arrest that clinically mimicked a tonic seizure.
• To emphasize the diagnostic utility of electroencephalogram (EEG) in identifying PEA in such presentations.
• To highlight the importance of considering cardiac causes in seizure-like events.

Main Methods:

• A case report detailing a patient presenting with seizure-like activity.
• Electroencephalogram (EEG) monitoring was performed to evaluate the neurological event.
• Correlation of EEG findings with cardiac rhythm and clinical presentation.

Main Results:

• EEG recordings revealed findings inconsistent with a typical tonic seizure.
• Simultaneously, pulseless electrical activity was identified on cardiac monitoring.
• The patient's condition was ultimately diagnosed as PEA arrest mimicking a seizure.

Conclusions:

• Electroencephalogram is an invaluable tool in the differential diagnosis of seizure-like events, especially when cardiac etiologies are suspected.
• This case underscores the importance of a comprehensive diagnostic approach, integrating neurological and cardiac assessments.
• Prompt recognition of PEA, even when masked by seizure-like symptoms, is essential for improving patient outcomes.