Author Response: Prediction of Regaining Consciousness Despite an Early Epileptiform EEG After Cardiac Arrest

We thank Dr. Sethi for his interesting comment on our study.1 The exact nature of stimulus-induced rhythmic, periodic, or ictal discharges (SIRPIDs) has been indeed unclear since their first description,2 and a retrospective multicenter study did not find any independent association between SIRPIDs and mortality.3 As hypothesized by Dr Sethi, it is possible that they may reflect a sort of brain reactivity; our finding that SIRPDs appearing after targeted temperature management (TTM) are linked to a possible good outcome goes in the same direction.1 However, in a previous study, we found that SIRPDs during TTM—thus occurring earlier after cardiac arrest—are rather related to poor prognosis.4 These observations likely reflect a complex interplay between SIRPIDs and prognostic implications that certainly deserve more attention in future works. Finally, we agree that current evidence does not suggest that SIRPIDs need to be treated aggressively in these patients.

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