Neurophysiologie clinique = Clinical neurophysiology
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The retrospective electroclinical evaluation of anoxia by near-drowning in 23 children observed between 1985 and 1989 revealed 2 groups, each with a distinct evolution: the first group, with good prognosis of 17 children, which recovered consciousness without neurological complications between 2 d and 1 wk after the accident. The second group of 6 children with a poor outcome--either i), death; or ii), state of permanent injury; or iii), a high level of clinical deficits. The gravity of the early clinical state, the estimated duration of cardiorespiratory arrest, the severity of the hypothermia, the seizures and the paroxysmic activity, do not determine the severity of near-drowning encephalopathy. ⋯ A bad outcome was defined by: high voltage, rhythmic delta waves; biphasic sharp waves; monotonous EEG, "burst-suppression" pattern, absence of beta rhythms. The importance of EEG recordings is emphasized performed as early as possible and until 3 or 7 d after the near-drowning. Any modification in the EEG, with attenuation or disappearance of fast frequencies and painful reactivity, appearance or enhancement of slow and biphasic sharp waves, are ominous signs and may be accompanied by the appearance of cerebral oedema and decerebration.