PeRampanel fOr Status ePilEpticus pRophylaxis Post-cardiac Arrest

Brain injury is the main cause of death and disability for patients surviving cardiac arrest resuscitation and seizures are diagnosed in up to a third of these patients. The investigators are proposing a pilot randomized placebo-controlled clinical trial to evaluate the safety and feasibility of perampanel use for post-cardiac arrest status epilepticus (PCARSE) prevention after cardiac arrest.

Inclusion Criteria: * Age ≥18 years old * Non-traumatic, out-of-hospital cardiac arrest * Comatose on admission - defined as not following commands * Return of spontaneous circulation (ROSC) within less than 45 minutes from the time of cardiac arrest (defined as the time of 911 or EMS (emergency medical services) witnessed arrest) * Admission to the intensive care unit at Zuckerberg San Francisco General Hospital Exclusion Criteria: * Acute cerebral hemorrhage or infarction * Pregnancy * Prisoner * Severe kidney function impairment with creatinine clearance inferior to 30 ml/min * Severe liver impairment with liver function tests five times above the upper limit of normal * Electrographic or electroclinical seizures diagnosis using American Clinical Neurophysiology criteria confirmed by an epileptologist after cardiac arrest