A major negative outcome of cardiac arrest is neurologic deficits. In the immediate ROSC period, this may manifest as coma, neurocognitive decline, myoclonus, seizures, or brain death. 

Managing Seizures

Up to 1/5 of all patients will have a seizure following cardiac arrest. This may be an underestimation as some seizures may not be clinically evident. Additionally, seizures after arrest may be more resistant to medications than others. EEGs are necessary to diagnose seizure activity and should be evaluated rapidly. Continuous or at least frequent monitoring is necessary for patients in a coma. (Class I, Evidence level C-LD). Management is with antiseizure medications used in status epilepticus due to non-arrest etiologies. (Class IIb, Evidence level C-LD).