1.Unreactive alpha or alpha-theta coma electroencephalogram patterns with favorable neurologic outcomes: a report of three cases and literature review
Marvic Joseph S. AMORANTO ; Marc Laurence L. FERNANDEZ
Journal of Neurocritical Care 2024;17(2):67-74
Background:
Alpha coma and its variants theta coma and alpha-theta coma (ATC) are clinical coma states characterized by electroencephalographic patterns resembling those of wakefulness. The complete (unreactive) form of these states is invariably associated with poor outcomes among post-anoxic comatose patients.Case Report: Herein, we present three adult comatose patients (aged 21, 45, and 51 years) with unreactive ATC patterns, who exhibited remarkable neurological improvement. Two patients experienced post-cardiopulmonary arrest (due to electrocution and viral myocarditis, respectively), while the third had severe septic encephalopathy. Electroencephalograms (EEGs) taken at least 24 hours after coma onset revealed unreactive ATC patterns. All patients survived, achieving significant neurological improvement. Remarkably, in one patient, the only symptom was minor incoordination during ambulation upon discharge.
Conclusion
These cases challenge the grave prognosis associated with this EEG pattern, particularly in post-anoxic comatose patients. Factors such as younger age, presence of shockable rhythms, and cause of arrest may have contributed to these favorable outcomes.
2.Unreactive alpha or alpha-theta coma electroencephalogram patterns with favorable neurologic outcomes: a report of three cases and literature review
Marvic Joseph S. AMORANTO ; Marc Laurence L. FERNANDEZ
Journal of Neurocritical Care 2024;17(2):67-74
Background:
Alpha coma and its variants theta coma and alpha-theta coma (ATC) are clinical coma states characterized by electroencephalographic patterns resembling those of wakefulness. The complete (unreactive) form of these states is invariably associated with poor outcomes among post-anoxic comatose patients.Case Report: Herein, we present three adult comatose patients (aged 21, 45, and 51 years) with unreactive ATC patterns, who exhibited remarkable neurological improvement. Two patients experienced post-cardiopulmonary arrest (due to electrocution and viral myocarditis, respectively), while the third had severe septic encephalopathy. Electroencephalograms (EEGs) taken at least 24 hours after coma onset revealed unreactive ATC patterns. All patients survived, achieving significant neurological improvement. Remarkably, in one patient, the only symptom was minor incoordination during ambulation upon discharge.
Conclusion
These cases challenge the grave prognosis associated with this EEG pattern, particularly in post-anoxic comatose patients. Factors such as younger age, presence of shockable rhythms, and cause of arrest may have contributed to these favorable outcomes.
3.Unreactive alpha or alpha-theta coma electroencephalogram patterns with favorable neurologic outcomes: a report of three cases and literature review
Marvic Joseph S. AMORANTO ; Marc Laurence L. FERNANDEZ
Journal of Neurocritical Care 2024;17(2):67-74
Background:
Alpha coma and its variants theta coma and alpha-theta coma (ATC) are clinical coma states characterized by electroencephalographic patterns resembling those of wakefulness. The complete (unreactive) form of these states is invariably associated with poor outcomes among post-anoxic comatose patients.Case Report: Herein, we present three adult comatose patients (aged 21, 45, and 51 years) with unreactive ATC patterns, who exhibited remarkable neurological improvement. Two patients experienced post-cardiopulmonary arrest (due to electrocution and viral myocarditis, respectively), while the third had severe septic encephalopathy. Electroencephalograms (EEGs) taken at least 24 hours after coma onset revealed unreactive ATC patterns. All patients survived, achieving significant neurological improvement. Remarkably, in one patient, the only symptom was minor incoordination during ambulation upon discharge.
Conclusion
These cases challenge the grave prognosis associated with this EEG pattern, particularly in post-anoxic comatose patients. Factors such as younger age, presence of shockable rhythms, and cause of arrest may have contributed to these favorable outcomes.
4.The effect of smoking in the development of stroke in young patients 19 to 45 years old: A case-control study
Cherie Ann A. Bautista, MD ; Ken Manongas, MD ; Marc Laurence L. Fernandez, MD ; Fritz Rinaldi De Asis Bernardo, MD
Philippine Journal of Internal Medicine 2023;61(1):1-5
Introduction:
The increasing incidence of stroke in young adults has been a growing concern, which is why research studies were generated to find out the risk factors contributing to the development of this disease. This study investigated the dose-dependent effect of smoking in the development of stroke in the young ages (19-45 years).
Methods:
A case-control retrospective study was conducted using electronic and printed records of the patients admitted to Amang Rodriguez Memorial Medical Center last 2017-2018. There were 275 patients included in the study. The smoking status and pack-years cigarette smoking of the subjects were recorded and were correlated with the duration of hospitalization and the Modified Rankin Scale (MRS). Results were analyzed using student’s t-test, ANOVA, and Pearson’s Correlation.
Result:
The prevalence of stroke was higher in men than in women. The ORs (95% CI) of stroke were significant in current cigarette smoking at 2.71 (CI: 1.6398 to 4.4943). Compared with non-smokers and those who smoked 1 to 9 pack years, the OR of stroke was significantly increased for those who smoked 10 to 19, and ≥ 20 cigarettes per day with OR of 14.0765 (4.10 to 48.35), and 31.5854 (1.82 to 548.97), respectively (p= 0.032 for linear trends). There was a weak positive linear correlation between pack years of cigarette smoking (1-9, 10-19, >20 pack years) and days of hospitalization (r= 0.28; p for trend = 0.0168). There was also a strong positive linear correlation between stroke outcome using the Modified Rankin Scale and pack years of cigarette smoking (r = 0.72; P for trend = 0.001). This study shows an increase in the odds of stroke in current cigarette smokers with a dose-dependent relationship in its outcome.
Conclusion
Smoking is a significant risk factor for stroke with a dose-dependent effect on its outcome. Furthermore, quitting smoking significantly decreases the risk of developing stroke.
Stroke
;
Case-Control
;
Retrospective