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Postanoxic Myoclonic Seizures After Pediatric Cardiac Arrest: Characteristics and Outcomes in a Single-Center Cohort,

Ashley M Bach1,2, Kathleen Walsh1, Dominique D Cooper1,2

  • 1Department of Pediatrics, Division of Neurology, Children's Hospital of Philadelphia, PA.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|July 10, 2026
PubMed

Insights

Postanoxic myoclonic seizures (PAMS) in children after cardiac arrest (CA) often lead to severe disability or death. Continuous EEG background and limited MRI diffusion restriction may indicate better outcomes in PAMS patients.

Area of Science:

  • Pediatric Neurology
  • Critical Care Medicine
  • Neurophysiology

Background:

  • Postanoxic myoclonic seizures (PAMS) are a challenging complication in children following cardiac arrest (CA).
  • Understanding the clinical features and outcomes of PAMS is crucial for improving patient management.

Purpose of the Study:

  • To describe the clinical characteristics and outcomes of pediatric patients experiencing postanoxic myoclonic seizures (PAMS) after cardiac arrest (CA).

Main Methods:

  • Retrospective cohort study at a single children's hospital.
  • Identified pediatric patients (<18 years) with PAMS on video continuous electroencephalography (CEEG) within 24 hours of CA.
  • Analyzed clinical seizure manifestations, electroencephalography (EEG) patterns, treatments, and neurological outcomes.

Main Results:

  • Twenty-six children with PAMS were identified; median age was 6.3 years.
  • PAMS commonly presented as limb jerking and rhythmic eye opening, with burst-suppressed/burst-attenuated EEG background in most.
  • Seventeen of 26 patients died before hospital discharge; survivors experienced severe disability (PCPC 3-5).
  • Brain MRI revealed restricted diffusion in cortical areas supplied by the posterior cerebral artery in all evaluated patients.

Conclusions:

  • Pediatric PAMS exhibit diverse EEG characteristics and are associated with high rates of mortality and severe disability.
  • A continuous EEG background and limited MRI diffusion restriction may correlate with a less severe outcome, as seen in one survivor with moderate disability.
Abstract

Keywords:
electroencephalographymagnetic resonance imagingmyoclonuspediatric cardiac arrestseizure

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