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guideline convulsive

E Lw Fung, B Bh Fung
Convulsive status epilepticus is the most extreme form of seizure. It is a medical and neurological emergency that requires prompt and appropriate treatment. Treatment of convulsive status epilepticus is usually divided into stages/steps. The International League Against Epilepsy has released a new definition of status epilepticus that may help to unify the definition in future studies. Over the last few years new information has become available regarding its management. The Rapid Anticonvulsant Medication Prior to Arrival Trial demonstrated non-inferiority of intramuscular midazolam in early status epilepticus compared with intravenous lorazepam...
January 6, 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
Elena Chiappini, Elisabetta Venturini, Giulia Remaschi, Nicola Principi, Riccardo Longhi, Pier-Angelo Tovo, Paolo Becherucci, Francesca Bonsignori, Susanna Esposito, Filippo Festini, Luisa Galli, Bice Lucchesi, Alessandro Mugelli, Gian Luigi Marseglia, Maurizio de Martino
OBJECTIVE: To review new scientific evidence to update the Italian guidelines for managing fever in children as drafted by the panel of the Italian Pediatric Society. STUDY DESIGN: Relevant publications in English and Italian were identified through search of MEDLINE and the Cochrane Database of Systematic Reviews from May 2012 to November 2015. RESULTS: Previous recommendations are substantially reaffirmed. Antipyretics should be administered with the purpose to control the child's discomfort...
January 2017: Journal of Pediatrics
Lin Shi
According to the seventh report of Joint National Committee (JNC 7), hypertensive emergency (HE), a kind of hypertensive crisis, is defined as a sudden and abrupt elevation in blood pressure so as to cause acute target organ dysfunctions, including central nervous system, cardiovascular system or kidneys. Patients with HE require immediate reduction in markedly elevated blood pressure. Currently, there are no international guidelines for children HE, so the JNC definition is commonly used. Hypertensive emergency in children is rare but a life-threatening emergency...
September 2016: Journal of Hypertension
Francesco Brigo, Nicola Luigi Bragazzi, Susanna Bacigaluppi, Raffaele Nardone, Eugen Trinka
BACKGROUND: Some guidelines or expert consensus indicate that intravenous (IV) lorazepam (LZP) is preferable to IV diazepam (DZP) for initial treatment of convulsive status epilepticus (SE). We aimed to critically assess all the available data on efficacy and tolerability of IV LZP compared with IV DZP as first-line treatment of convulsive SE. METHODS: Systematic search of the literature (MEDLINE, CENTRAL, EMBASE, to identify randomized controlled trials (RCTs) comparing IV LZP versus IV DZP used as first-line treatment for convulsive SE (generalized or focal)...
November 2016: Epilepsy & Behavior: E&B
Yusuke Toda, Mineo Yamazaki, Tomohiro Ota, Yosuke Fujisawa, Kazumi Kimura
A 64-year-old man with fever, appetite loss, and pain in the back of the neck visited our hospital. We diagnosed him as having bacterial meningitis because of pleocytosis of the cerebrospinal fluid, and started treatment with antibiotics. Multiple cerebral infarcts were found on brain MRI. We suspected that the origin of the bacterial meningitis was infective endocarditis, and administered Cefepime and Gentamicin according to the guidelines for treatment of infective endocarditis. Three days later, he became drowsy and had myoclonus and flapping of the extremities...
October 28, 2016: Rinshō Shinkeigaku, Clinical Neurology
Lin Shi
According to the seventh report of Joint National Committee (JNC 7), hypertensive emergency (HE), a kind of hypertensive crisis, is defined as a sudden and abrupt elevation in blood pressure so as to cause acute target organ dysfunctions, including central nervous system, cardiovascular system or kidneys. Patients with HE require immediate reduction in markedly elevated blood pressure. Currently, there are no international guidelines for children HE, so the JNC definition is commonly used. Hypertensive emergency in children is rare but a life-threatening emergency...
September 2016: Journal of Hypertension
Jun Natsume, Shin-Ichiro Hamano, Kuniaki Iyoda, Hideaki Kanemura, Masaya Kubota, Masakazu Mimaki, Shinichi Niijima, Takuya Tanabe, Harumi Yoshinaga, Noriko Kojimahara, Hirohumi Komaki, Kenji Sugai, Tokiko Fukuda, Yoshihiro Maegaki, Hideo Sugie
In 2015, the Japanese Society of Child Neurology released new guidelines for the management of febrile seizures, the first update of such guidelines since 1996. In 1988, the Conference on Febrile Convulsions in Japan published "Guidelines for the Treatment of Febrile Seizures." The Task Committee of the Conference proposed a revised version of the guidelines in 1996; that version released in 1996 was used for the next 19years in Japan for the clinical management of children with febrile seizures. Although the guidelines were very helpful for many clinicians, new guidelines were needed to reflect changes in public health and the dissemination of new medical evidence...
January 2017: Brain & Development
Julia N Bailey, Christopher Patterson, Laurence de Nijs, Reyna M Durón, Viet-Huong Nguyen, Miyabi Tanaka, Marco T Medina, Aurelio Jara-Prado, Iris E Martínez-Juárez, Adriana Ochoa, Yolli Molina, Toshimitsu Suzuki, María E Alonso, Jenny E Wight, Yu-Chen Lin, Laura Guilhoto, Elza Marcia Targas Yacubian, Jesús Machado-Salas, Andrea Daga, Kazuhiro Yamakawa, Thierry M Grisar, Bernard Lakaye, Antonio V Delgado-Escueta
PURPOSE: EFHC1 variants are the most common mutations in inherited myoclonic and grand mal clonic-tonic-clonic (CTC) convulsions of juvenile myoclonic epilepsy (JME). We reanalyzed 54 EFHC1 variants associated with epilepsy from 17 cohorts based on National Human Genome Research Institute (NHGRI) and American College of Medical Genetics and Genomics (ACMG) guidelines for interpretation of sequence variants. METHODS: We calculated Bayesian LOD scores for variants in coinheritance, unconditional exact tests and odds ratios (OR) in case-control associations, allele frequencies in genome databases, and predictions for conservation/pathogenicity...
July 28, 2016: Genetics in Medicine: Official Journal of the American College of Medical Genetics
Ana Vicente-Sanchez, Laura Segura, Amynah A Pradhan
In recent years, the delta opioid receptor has attracted increasing interest as a target for the treatment of chronic pain and emotional disorders. Due to their therapeutic potential, numerous tools have been developed to study the delta opioid receptor from both a molecular and a functional perspective. This review summarizes the most commonly available tools, with an emphasis on their use and limitations. Here, we describe (1) the cell-based assays used to study the delta opioid receptor. (2) The features of several delta opioid receptor ligands, including peptide and non-peptide drugs...
December 3, 2016: Neuroscience
Stephane Legriel, Fernando Pico, Yves-Roger Tran-Dinh, Virginie Lemiale, Jean-Pierre Bedos, Matthieu Resche-Rigon, Alain Cariou
Convulsive status epilepticus (CSE) is a major medical emergency associated with a 50 % morbidity rate. CSE guidelines have recommended prompt management for many years, but there is no evidence to date that they have significantly improved practices or outcomes. Developing neuroprotective strategies for use after CSE holds promise for diminishing morbidity and mortality rates. Hypothermia has been shown to afford neuroprotection in various health conditions. We therefore designed a trial to determine whether 90-day outcomes in mechanically ventilated patients with CSE requiring management in the intensive care unit (ICU) are improved by early therapeutic hypothermia (32-34 °C) for 24 h with propofol sedation...
December 2016: Annals of Intensive Care
C L Jones, J Koios
Convulsive status epilepticus (SE) is a medical emergency where successful treatment is associated with timely intervention and the use of a protocol has been recommended to provide the highest quality of care. Despite this, there is no nationally available protocol for the treatment of SE in adults in Australia. Treatment is therefore variable and often based on international guidelines or familiarity with certain medications. We have developed an Australian-based algorithm for the treatment of SE, focusing on simplifying management while delivering the safest possible care...
April 2016: Internal Medicine Journal
Marko Mornar Jelavić, Zdravko Babić, Hrvoje Hećimović, Vesna Erceg, Hrvoje Pintarić
The aim of this retrospective study (February 2012-September 2014) was to assess the role of head-up tilt-table test in patients with unexplained syncope. It was performed on 235 patients at Clinical Department of Cardiology, Sestre milosrdnice University Hospital Center. Patients were classified according to test indications: group A (convulsive syncope, n = 30), group B (suspected vasovagal syncope, n = 180), and group C (paroxysmal vertigo, n = 25). The groups were analyzed and compared according to demographic data (age and gender), referral specialist (cardiologist, neurologist, and others), and test results (positive/negative) with specific response (cardioinhibitory, vasodepressor, or mixed)...
December 2015: Acta Clinica Croatica
Eric H Grover, Yara Nazzal, Lawrence J Hirsch
Convulsive status epilepticus (CSE) is a medical emergency with an associated high mortality and morbidity. It is defined as a convulsive seizure lasting more than 5 min or consecutive seizures without recovery of consciousness. Successful management of CSE depends on rapid administration of adequate doses of anti-epileptic drugs (AEDs). The exact choice of AED is less important than rapid treatment and early consideration of reversible etiologies. Current guidelines recommend the use of benzodiazepines (BNZ) as first-line treatment in CSE...
March 2016: Current Treatment Options in Neurology
Tracy Glauser, Shlomo Shinnar, David Gloss, Brian Alldredge, Ravindra Arya, Jacquelyn Bainbridge, Mary Bare, Thomas Bleck, W Edwin Dodson, Lisa Garrity, Andy Jagoda, Daniel Lowenstein, John Pellock, James Riviello, Edward Sloan, David M Treiman
CONTEXT: The optimal pharmacologic treatment for early convulsive status epilepticus is unclear. OBJECTIVE: To analyze efficacy, tolerability and safety data for anticonvulsant treatment of children and adults with convulsive status epilepticus and use this analysis to develop an evidence-based treatment algorithm. DATA SOURCES: Structured literature review using MEDLINE, Embase, Current Contents, and Cochrane library supplemented with article reference lists...
January 2016: Epilepsy Currents
Lídia Hau, Györgyi Csábi, Tamás Tényi
OBJECTIVE: Anti-N-methyl-D-Aspartate encephalitis is a recently diagnosed autoimmune disorder with increasing significance. During this disease antibodies are produced against the subunit of the NMDA receptor, which cause different symptoms, both psychiatric and neurological. The aim of this publication is to introduce this disease, to facilitate the diagnosis and to recommend therapeutical guideline. MATERIALS AND METHODS: In this review we summarized the relevant literature published between 2007 and 2015 giving emphasis on etiopathogenesis, diagnosis, differential diagnosis, treatment and prognosis...
2015: Psychiatria Hungarica: A Magyar Pszichiátriai Társaság Tudományos Folyóirata
Rohit Shankar, Caryn Jory, Juliet Ashton, Brendan McLean, Matthew Walker
The NICE audit of epilepsy related deaths revealed that 1200 epilepsy deaths occur every year in the UK, with 42% potentially avoidable.[1] Convulsive status epilepticus (SE) is a life-threatening condition with over 20% mortality rate, especially if early treatment is not initiated.[2] Ten percent of all UK emergency department (ED) admissions are due to epilepsy, usually over represented by cases of SE.[3] Six out of seven epilepsy cases seen in the ED are admitted into medical care.[4] Patients with chronic and/or treatment resistant epilepsy carry a higher risk of premature death...
2015: BMJ Quality Improvement Reports
Edward Purssell, Jacqueline Collin
BACKGROUND: Fever phobia is a term that has been used to describe the exaggerated and unrealistic fear of fever expressed by parents and carers. Since the term was first used in the early 1980s, there have been numerous publications and guidelines stating that fever is not, in itself dangerous, however these fears persist. OBJECTIVES: Investigate the extent of fever phobia and to explore potential associations with time, under-5 mortality rate and geography. DATA SOURCES: Embase (1980 to week 1 2015) and Medline (1946 to week 1 2015) were searched using the terms 'fever' and 'phobia'; and 'fever phobia' as a free text term...
April 2016: International Journal of Nursing Studies
Ravindra Arya, Harsh Kothari, Zongjun Zhang, Baoguang Han, Paul S Horn, Tracy A Glauser
OBJECTIVE: This is a network meta-analysis of nonvenous drugs used in randomized controlled trials (RCTs) for treatment of acute convulsive seizures and convulsive status epilepticus. METHODS: Literature was searched according to Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines for RCTs examining treatment of acute convulsive seizures or status epilepticus with at least one of the study arms being a nonvenous medication. After demographic and outcome data extraction, a Bayesian network meta-analysis was performed and efficacy results were summarized using treatment effects and their credible intervals (CrI)...
November 24, 2015: Neurology
Benjamin J Wheeler, Nigel P Dickson, Lisa A Houghton, Leanne M Ward, Barry J Taylor
OBJECTIVE: To investigate the incidence and characteristics of vitamin D deficiency rickets in New Zealand (NZ). METHODS: Prospective surveillance among paediatricians of Vitamin D Deficiency Rickets was conducted by the New Zealand Paediatric Surveillance Unit (NZPSU) for 36 months, from July 2010 to June 2013, inclusive. Inclusion criteria were: children and adolescents <15 years of age with vitamin D deficiency rickets (defined by low serum 25-hydroxyvitamin D and elevated alkaline phosphatase levels, and/or radiological rickets)...
August 2015: Australian and New Zealand Journal of Public Health
M Leitinger, S Beniczky, A Rohracher, E Gardella, G Kalss, E Qerama, J Höfler, A Hess Lindberg-Larsen, G Kuchukhidze, J Dobesberger, P B Langthaler, E Trinka
BACKGROUND: Salzburg Consensus Criteria for diagnosis of Non-Convulsive Status Epilepticus (SCNC) were proposed at the 4th London-Innsbruck Colloquium on status epilepticus in Salzburg (2013). METHODS: We retrospectively analyzed the EEGs of 50 consecutive nonhypoxic patients with diagnoses of nonconvulsive status epilepticus (NCSE) at discharge and 50 consecutive controls with abnormal EEGs in a large university hospital in Austria. We implemented the American Clinical Neurophysiology Society's Standardized Critical Care EEG Terminology, 2012 version (ACNS criteria) to increase the test performance of SCNC...
August 2015: Epilepsy & Behavior: E&B
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