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management of status epilepticus

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https://www.readbyqxmd.com/read/28110410/neurophysiological-assessment-of-brain-dysfunction-in-critically-ill-patients-an-update
#1
REVIEW
Eric Azabou, Catherine Fischer, Jean Michel Guerit, Djillali Annane, François Mauguiere, Fréderic Lofaso, Tarek Sharshar
The aim of this review was to provide up-to-date information about the usefulness of clinical neurophysiology testing in the management of critically ill patients. Evoked potentials (EPs) and electroencephalogram (EEG) are non-invasive clinical neurophysiology tools that allow an objective assessment of the central nervous system's function at the bedside in intensive care unit (ICU). These tests are quite useful in diagnosing cerebral complications, and establishing the vital and functional prognosis in ICU...
January 21, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28099234/electrographic-seizures-in-children-and-neonates-undergoing-extracorporeal-membrane-oxygenation
#2
Jainn-Jim Lin, Brenda L Banwell, Robert A Berg, Dennis J Dlugos, Rebecca N Ichord, Todd J Kilbaugh, Roxanne E Kirsch, Matthew P Kirschen, Daniel J Licht, Shavonne L Massey, Maryam Y Naim, Natalie E Rintoul, Alexis A Topjian, Nicholas S Abend
OBJECTIVE: We aimed to determine the prevalence and risk factors for electrographic seizures in neonates and children requiring extracorporeal membrane oxygenation support. DESIGN: Prospective quality improvement project. SETTING: Quaternary care pediatric institution. PATIENTS: Consistent with American Clinical Neurophysiology Society electroencephalographic monitoring recommendations, neonates and children requiring extracorporeal membrane oxygenation support underwent clinically indicated electroencephalographic monitoring...
January 17, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28088560/role-of-comorbidities-and-in-hospital-complications-in-short-term-status-epilepticus-outcome
#3
Marco Belluzzo, Giovanni Furlanis, Lara Stragapede, Fabrizio Monti
OBJECTIVE: pre-morbid patient conditions and hospitalization complications possibly play a role in status epilepticus short-term outcome, although evidence is incomplete and non-conclusive. The study's aim was to define whether comorbidities and in-hospital complications arising after status epilepticus affect its prognosis. METHODS: A retrospective single center study was carried out. All selected patients were adults presenting an EEG-proven status epilepticus episode between 2003 and 2014...
December 30, 2016: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28061403/berberine-ameliorates-intrahippocampal-kainate-induced-status-epilepticus-and-consequent-epileptogenic-process-in-the-rat-underlying-mechanisms
#4
Reza Sedaghat, Yosra Taab, Zahra Kiasalari, Siamak Afshin-Majd, Tourandokht Baluchnejadmojarad, Mehrdad Roghani
Status epilepticus (SE) is a life-threatening neurologic condition, instigating epileptogenesis to transform normal brain to an epileptic condition. SE is followed by spontaneous recurrent seizures (SRS) and final development of temporal lobe epilepsy (TLE) that is resistant to treatment. Neuroprotective strategies are increasingly put forward as a promising therapy to prevent and/or manage epileptic conditions. In this study, we investigated whether berberis alkaloid, i.e. berberine (BBR), could ameliorate intrahippocampal kainate-induced SE and its consequent epileptogenic process and to explore some underlying mechanisms...
January 3, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28059037/status-epilepticus-an-overview
#5
Venkata Ramesh Yasam, V Senthil, Satya Lavanya Jakki, N Jawahar
Status epilepticus (SE) is an emergency situation, where immediate and effective treatment is required in least possible time as it is associated with neuronal damage, systemic complications, substantial morbidity and mortality depending on status type, duration, age and etiology. In the past few years, morbidity and mortality rate were improved, probably may be due to aggressive use of anti-epileptic drugs in emergency situations. Present literature gives an overview of the conditions leading to SE and its management guidelines in hospital and out of hospital setting emphasizing on the available drug therapies...
January 5, 2017: Current Drug Metabolism
https://www.readbyqxmd.com/read/28057897/review-and-update-of-the-hong-kong-epilepsy-guideline-on-status-epilepticus
#6
REVIEW
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
https://www.readbyqxmd.com/read/28042096/different-response-to-antiepileptic-drugs-according-to-the-type-of-epileptic-events-in-a-neonatal-ischemia-reperfusion-model
#7
Luc Morin, Julie Enderlin, Pierre-Louis Leger, Gaëtan Perrotte, Philippe Bonnin, Nina Dupuis, Olivier Baud, Christiane Charriaut-Marlangue, Stéphane Auvin
Perinatal arterial stroke is the most frequent form of cerebral infarction in children. Neonatal seizures are the most frequent symptom during the neonatal period. The current management of perinatal stroke is based on supportive care. It is currently unknown if treatment of the seizures modifies the outcome, and no clinical studies have focused on seizures during neonatal stroke. We studied the effect of phenobarbital and levetiracetam on an ischemic-reperfusion stroke model in P7 rats using prolonged electroencephalographic recordings and a histologic analysis of the brain (24h after injury)...
December 30, 2016: Neurobiology of Disease
https://www.readbyqxmd.com/read/28028820/risk-factors-for-mortality-in-patients-with-anti-nmda-receptor-encephalitis
#8
X Chi, W Wang, C Huang, M Wu, L Zhang, J Li, D Zhou
OBJECTIVE: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a severe autoimmune disorder with a mortality of 5%-7%, but few studies have focused on the predictors of death in this disease. In this study, we aim to investigate predictors and causes of death in patients with anti-NMDAR encephalitis. METHODS: In this cohort study, patients with anti-NMDAR encephalitis were enrolled at the West China Hospital of Sichuan University between June 2011 and October 2015...
December 27, 2016: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/28028789/isoflurane-use-in-the-treatment-of-super-refractory-status-epilepticus-is-associated-with-hippocampal-changes-on-mri
#9
Kristin M Ikeda, Robert Connors, Donald H Lee, Alexander G Khandji, Jan Claassen, G Bryan Young
BACKGROUND: Refractory status epilepticus (RSE) is associated with high morbidity and mortality. Experts recommend aggressive management with continuous intravenous infusions or inhaled anesthetics such as isoflurane. However, there is concern that MRI changes in RSE reflect isoflurane neurotoxicity. We performed a case-control study to determine whether isoflurane is neurotoxic, based on MRI signal changes. METHODS: We performed a retrospective case-control study of the incidence of MRI changes in RSE treated with and without isoflurane...
December 27, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/28026006/extended-eeg-and-non-convulsive-status-epilepticus-benefit-over-routine-eeg
#10
E Eskioglou, C Stähli, A O Rossetti, J Novy
OBJECTIVE: EEG monitoring is increasingly used in critically ill patients, but impact on clinical outcome remains unclear. We aimed to investigate the benefit of repeated extended EEG in the prognosis of patients with non-convulsive status epilepticus (SE). MATERIALS & METHODS: We retrospectively collected 29 consecutive patients with non-convulsive SE without coma, who underwent repeated extended EEG between 2013 and 2015. We compared these patients with an historical age-matched group of 58 patients managed between 2011 and 2013 with routine EEG only...
December 27, 2016: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/28011930/refractory-status-epilepticus-in-children-with-and-without-prior-epilepsy-or-status-epilepticus
#11
Iván Sánchez Fernández, Michele C Jackson, Nicholas S Abend, Ravindra Arya, James N Brenton, Jessica L Carpenter, Kevin E Chapman, William D Gaillard, Marina Gaínza-Lein, Tracy A Glauser, Joshua L Goldstein, Howard P Goodkin, Ashley Helseth, Kush Kapur, Tiffani L McDonough, Mohamad A Mikati, Katrina Peariso, James Riviello, Robert C Tasker, Alexis A Topjian, Mark S Wainwright, Angus Wilfong, Korwyn Williams, Tobias Loddenkemper
OBJECTIVE: To compare refractory convulsive status epilepticus (rSE) management and outcome in children with and without a prior diagnosis of epilepsy and with and without a history of status epilepticus (SE). METHODS: This was a prospective observational descriptive study performed from June 2011 to May 2016 on pediatric patients (1 month-21 years of age) with rSE. RESULTS: We enrolled 189 participants (53% male) with a median (25th-75th percentile) age of 4...
December 23, 2016: Neurology
https://www.readbyqxmd.com/read/27960131/prognosis-of-status-epilepticus-in-patients-requiring-intravenous-anesthetic-drugs-a-single-center-experience
#12
Estevo Santamarina, Gloria M González-Cuevas, Anna Sanchez, Rosa M Gracia, Isabel Porta, Manuel Toledo, Manuel Quintana, María Sueiras, Lorena Guzmán, Javier Salas-Puig
PURPOSE: There is concern about the safety of anesthetic drugs (IVADs) in the management of status epilepticus (SE). To clarify this aspect, we aimed to assess the factors associated with a poor prognosis in SE requiring anesthetics. METHOD: We analyzed all SE requiring IVADs between October 2011 and December 2015. Demographics, clinical data, etiology, SE duration, indications for sedation, electroencephalography features, complications and the prognosis at discharge were collected...
December 7, 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/27943132/new-non-intravenous-routes-for-benzodiazepines-in-epilepsy-a-clinician-perspective
#13
Marco Mula
Benzodiazepines represent the first-line treatment for the acute management of epileptic seizures and status epilepticus. The emergency use of benzodiazepines must be timely, and because most seizures occur outside of the hospital environment, there is a significant need for delivery methods that are easy for nonclinical caregivers to use and administer quickly and safely. In addition, the ideal route of administration should be reliable in terms of absorption. Rectal diazepam is the only licensed formulation in the USA, whereas rectal diazepam and buccal midazolam are currently licensed in the EU...
December 9, 2016: CNS Drugs
https://www.readbyqxmd.com/read/27930967/epidemiology-and-diagnostic-and-therapeutic-management-of-febrile-seizures-in-the-italian-pediatric-emergency-departments-a-prospective-observational-study
#14
Giovanna Vitaliti, Emanuele Castagno, Fulvio Ricceri, Antonio Urbino, Alberto Verrotti Di Pianella, Riccardo Lubrano, Elisa Caramaschi, Maurizio Prota, Rita Maria Pulvirenti, Patrizia Ajovalasit, Giuseppe Signorile, Carla Navone, Maria Rosaria La Bianca, Alberto Villani, Giovanni Corsello, Raffaele Falsaperla
AIM: Febrile seizures (FS) involve 2-5% of the paediatric population, among which Complex FS (CFS) account for one third of accesses for FS in Emergency Departments (EDs). The aim of our study was to define the epidemiology, the clinical, diagnostic and therapeutic approach to FS and CFSs in the Italian EDs. METHODS: A multicenter prospective observational study was performed between April 2014 and March 2015. Patients between 1 and 60 months of age, randomly accessing to ED for ongoing FS or reported FS at home were included...
November 16, 2016: Epilepsy Research
https://www.readbyqxmd.com/read/27907953/management-of-the-pediatric-neurocritical-care-patient
#15
Christopher M Horvat, Haifa Mtaweh, Michael J Bell
Pediatric neurocritical care is a growing subspecialty of pediatric intensive care that focuses on the management of acute neurological diseases in children. A brief history of the field of pediatric neurocritical care is provided. Neuromonitoring strategies for children are reviewed. Management of major categories of acute childhood central neurologic diseases are reviewed, including treatment of diseases associated with intracranial hypertension, seizures and status epilepticus, stroke, central nervous system infection and inflammation, and hypoxic-ischemic injury...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27886628/eeg-utilization-in-canadian-intensive-care-units-a-multicentre-prospective-observational-study
#16
Andrea Park, Martin Chapman, Victoria A McCredie, Derek Debicki, Teneille Gofton, Loretta Norton, J Gordon Boyd
PURPOSE: We have previously shown that electroencephalography (EEG) may be an underutilized monitoring modality in a single general medical-surgical ICU, that does not have a specific neurocritical care consultation service or neurocritical care unit. The present study was designed to describe the pattern of EEG utilization across 3 academic ICUs in Ontario, Canada that use different models of neurocritical care. METHOD: In this prospective multicentre observational study, ICU patients were screened weekly for 6 non-consecutive weeks to determine if they met the ESICM's recommendations or suggestions for EEG monitoring...
December 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/27862207/successful-management-of-super-refractory-status-epilepticus-with-thalamic-deep-brain-stimulation
#17
Kai Lehtimäki, Jaakko W Långsjö, Jyrki Ollikainen, Hanna Heinonen, Timo Möttönen, Timo Tähtinen, Joonas Haapasalo, Jyrki Tenhunen, Jani Katisko, Juha Öhman, Jukka Peltola
Super-refractory status epilepticus is a condition characterized by recurrence of status epilepticus despite use of deep general anesthesia, and it has high morbidity and mortality rates. We report a case of a 17-year-old boy with a prolonged super-refractory status epilepticus that eventually resolved after commencing deep brain stimulation of the centromedian nucleus of the thalamus. Later attempt to reduce stimulation parameters resulted in immediate relapse of status epilepticus, suggesting a pivotal role of deep brain stimulation in the treatment response...
November 9, 2016: Annals of Neurology
https://www.readbyqxmd.com/read/27860117/development-of-a-core-outcome-set-for-epilepsy-in-pregnancy-e-core-a-national-multi-stakeholder-modified-delphi-consensus-study
#18
B H Al Wattar, K Tamilselvan, R Khan, A Kelso, A Sinha, A M Pirie, D McCorry, K S Khan, S Thangaratinam
OBJECTIVE: To develop a set of core outcomes for studies on pregnant women with epilepsy. DESIGN: Delphi consensus study. POPULATION: Healthcare professionals, and patient representatives with lived experience of epilepsy in the UK. METHODS: We used a modified Delphi method and a consultation meeting to achieve consensus. Potential outcomes were identified by systematic review, and were scored using a Likert scale anchored between 1 (least important) and 5 (most important)...
November 16, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27851463/1828-use-of-amplitude-integrated-eeg-for-super-refractory-status-epilepticus-and-effective-icu-management
#19
Michael Miksa, Gracia Mui, Susan Duberstein Coad
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27844464/the-safety-and-effectiveness-of-intravenous-lacosamide-for-refractory-status-epilepticus-in-the-critically-ill
#20
C R Newey, N M Le, C Ahrens, P Sahota, S Hantus
BACKGROUND: Status epilepticus (SE) often does not respond to initial treatment. A second-line agent with a less established safety and efficacy profile is then required. This study examined the safety of intravenous (IV) lacosamide (LCM) in a critically ill population and obtained an estimate of effectiveness in patients with refractory SE on continuous video EEG monitoring (cEEG). METHODS: Retrospective review of critically ill patients in SE on cEEG treated with IV LCM from June 2009 to April 2011...
November 14, 2016: Neurocritical Care
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