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management of status epilepticus

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https://www.readbyqxmd.com/read/29108660/usefulness-of-electroencephalography-for-the-management-of-epilepsy-in-emergency-departments
#1
A Viloria Alebesque, A López Bravo, E Bellosta Diago, S Santos Lasaosa, J A Mauri Llerda
INTRODUCTION: Electroencephalography (EEG) is an essential diagnostic tool in epilepsy. Its use in emergency departments (ED) is usually restricted to the diagnosis and management of non-convulsive status epilepticus (NCSE). However, EDs may also benefit from EEG in the context of other situations in epilepsy. METHODS: We conducted a retrospective observational study using the clinical histories of patients treated at our hospital's ED for epileptic seizures and suspicion of NCSE and undergoing EEG studies in 2015 and 2016...
November 3, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/29099419/acute-systemic-complications-of-convulsive-status-epilepticus-a-systematic-review
#2
Raoul Sutter, Tolga Dittrich, Saskia Semmlack, Stephan Rüegg, Stephan Marsch, Peter W Kaplan
OBJECTIVES: Status epilepticus is a neurologic emergency with high morbidity and mortality requiring neurointensive care and treatment of systemic complications. This systematic review compiles the current literature on acute systemic complications of generalized convulsive status epilepticus in adults and their immediate clinical impact along with recommendations for optimal neurointensive care. DATA SOURCES: We searched PubMed, Medline, Embase, and the Cochrane library for articles published between 1960 and 2016 and reporting on systemic complications of convulsive status epilepticus...
November 2, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29034137/valproic-induced-hyperammonemic-encephalopathy-in-a-known-case-of-epilepsy
#3
Syed F Imam, Omair Ul Haq Lodhi, Rizwan Zafar, Saneeya Nasim, Waseem T Malik
Valproic acid, a broad-spectrum anticonvulsant drug, commonly causes elevated ammonia levels, which is usually asymptomatic in most cases. On rare occasions, potentially fatal hyperammonemia-induced encephalopathy can occur. We present a case of a 24-year-old female who presented to the emergency department with status epilepticus that was being managed with valproic acid. Further workup was done because of prolonged postictal state, which revealed increased ammonia levels; she was eventually diagnosed with valproic-induced hyperammonemic encephalopathy...
August 10, 2017: Curēus
https://www.readbyqxmd.com/read/28982530/variability-in-preferred-management-of-electrographic-seizures-in-neonatal-hypoxic-ischemic-encephalopathy
#4
Melanie A McNally, Adam L Hartman
BACKGROUND: Seizures may cause added harm in neonates with hypoxic-ischemic encephalopathy (HIE). Specific recommendations about seizure treatment in this context are lacking. We sought to determine the scope of practice regarding management of non-status epilepticus electrographic-only seizures in this setting. METHODS: A case-based survey was distributed to members of the Child Neurology Society. Providers were asked about their preferred management strategy for sequential clinical scenarios...
June 15, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28979520/status-epilepticus-and-anti-nmda-receptor-encephalitis-after-resection-of-an-ovarian-teratoma
#5
Amritpal S Jandu, Peter M Odor, Steven D Vidgeon
Anti-N-methyl-D-aspartate receptor encephalitis is a recently recognised autoimmune, paraneoplastic syndrome that typically presents with psychiatric disturbance, reduced conscious level and seizures. The disorder has been previously associated with ovarian teratomas. We present the case of a 35-year-old female, with a previous surgical history for resection of an ovarian teratoma, who later developed status epilepticus and anti-N-methyl-D-aspartate receptor encephalitis requiring intensive care management...
November 2016: J Intensive Care Soc
https://www.readbyqxmd.com/read/28969235/super-refractory-status-epilepticus-a-therapeutic-challenge-in-paediatrics
#6
Shrikiran Aroor, Kanaparthi Shravan, Suneel C Mundkur, C Jayakrishnan, Sai Sripad Rao
A status epilepticus which persists for 24 hours or more after starting treatment with anaesthesia or has recurred inspite of general anaesthesia is known as Super-Refractory Status Epilepticus (SRSE). It includes cases where status epilepticus recurs on reduction or withdrawal of anaesthesia. SRSE, though infrequently seen, constitutes a medical emergency due to the associated high morbidity and mortality. No clear cut guidelines are available till date for the management of SRSE. Most of the published literature was case reports and expert opinion...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28963902/clinical-and-neuroimaging-predictors-of-seizure-recurrence-in-solitary-calcified-neurocysticercosis-a-prospective-observational-study
#7
Alok Kumar Singh, Ravindra Kumar Garg, Imran Rizvi, Hardeep Singh Malhotra, Neeraj Kumar, Rakesh Kumar Gupta
BACKGROUND: Solitary calcified neurocysticercosis is a common cause of seizures in the developing countries. Factors responsible for seizure recurrence in patients with solitary calcified neurocysticercosis are not known. We evaluated the clinical, neuroimaging and biochemical predictors of seizure recurrence. METHODS: This was a prospective observational study. Patients with new-onset seizures and a solitary calcified neurocysticercosis were included. Patients were evaluated clinically; baseline electroencephalography and magnetic resonance imaging of brain were done for all patients...
November 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28962812/new-developments-in-refractory-status-epilepticus
#8
REVIEW
Sudhir Datar
Status epilepticus (SE) is a medical emergency and presents with either a continuous prolonged seizure or multiple seizures without full recovery of consciousness in between them. The goals of treatment are prompt recognition, early seizure termination, and simultaneous evaluation for any potentially treatable cause. Improved understanding of the pathophysiology has led to a more practical definition. New data have emerged regarding the safety and efficacy of alternative agents, which are increasingly used in the management of these patients...
November 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/28941387/management-protocols-for-status-epilepticus-in-the-pediatric-emergency-room-systematic-review-article
#9
REVIEW
Cheuk C Au, Ricardo G Branco, Robert C Tasker
OBJECTIVE: This systematic review of national or regional guidelines published in English aimed to better understand variance in pre-hospital and emergency department treatment of status epilepticus. SOURCES: Systematic search of national or regional guidelines (January 2000 to February 2017) contained within PubMed and Google Scholar databases, and article reference lists. The search keywords were status epilepticus, prolonged seizure, treatment, and guideline...
November 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28937549/electroconvulsive-therapy-for-super-refractory-status-epilepticus
#10
Jayme Ahmed, Michael Metrick, Anne Gilbert, Anita Glasson, Ranjeet Singh, Wayne Ambrous, Lori Brown, Laura Aykroyd, Karen Bobel
OBJECTIVES: Super refractory status epilepticus (SRSE) is a stage beyond refractory status that requires general anesthesia as management. Electroconvulsive therapy (ECT) is recommended only as a potential treatment option beyond general anesthesia and after all other options have been exhausted. Its effect on aborting status has been minimally researched. We present the largest case series to our knowledge exploring the effect of ECT on SRSE. METHODS: Eight adults hospitalized for SRSE received ECT in an attempt to abort status after other treatment modalities were exhausted...
September 20, 2017: Journal of ECT
https://www.readbyqxmd.com/read/28899640/status-epilepticus-in-pregnancy-etiology-management-and-clinical-outcomes
#11
Keni Ravish Rajiv, Ashalatha Radhakrishnan
BACKGROUND: Status epilepticus (SE) in pregnancy carries significant risk to both mother and fetus. There is limited literature available on SE occurring in pregnancy world-over, with majority being from obstetric centers. METHODS: All women who developed SE related to pregnancy (gestation, labor, or puerperium) between January 2000 and December 2016 were included in the study. Data were collected from our SE registry, maintained, and archived in the institute. The variables influencing the maternal and fetal outcome were compared using Student's t-test for continuous variables and Fisher's exact test for discrete variables...
September 9, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28892919/plasma-exchange-as-a-therapeutic-modality-in-a-rare-case-of-cryptogenic-new-onset-refractory-status-epilepticus-norse
#12
Manisha Shrivastava, Smita Chouhan, Seema Navaid
Refractory Status Epilepticus (RSE) not responding to any therapy and not associated with any aetiology has been termed as New Onset Refractory Status Epilepticus (NORSE). Guidelines for optimal management of cryptogenic NORSE are not clearly defined so far in the literature. Other than common medication, use of high-dose steroids, IV immune globulins and plasma exchanges in NORSE of unknown aetiology have been scarcely described. Immunomodulatory therapy like plasmapheresis is based on the fact that a pathological substance exists in the plasma that contributes to the disease process and its symptoms, which gets removed...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28891483/emergency-surgery-for-refractory-status-epilepticus
#13
Abhijeet Botre, Vrajesh Udani, Neelu Desai, Spoorthy Jagadish, Milind Sankhe
BACKGROUND: Management of refractory status epilepticus in children is extremely challenging. CASE CHARACTERISTICS: Two children with medically refractory status epilepticus, both of whom had lesional pathology on MRI and concordant data on EEG and PET scan. INTERVENTION: Emergency hemispherotomy performed in both patients. A complete, sustained seizure freedom obtained postoperatively. MESSAGE: Emergency surgery is a treatment option in selected cases of drug refractory status epilepticus with lesional pathology and concordant data...
August 15, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/28872032/atlas-of-electroencephalography-3rd-edition
#14
Ali Akbar Asadi-Pooya, Dennis Dlugos, Christopher Skidmore, Michael R Sperling
Electroencephalography (EEG) is the recording of the electrical activity of the brain. EEG is a reliable test to assess cerebral function. It aids in diagnosis, classification, and management of patients with epilepsy. It also has practical uses in conditions other than epilepsy. Moreover, it is harmless and inexpensive. EEG is an important tool for evaluating patients with epilepsy. It may help classify the syndrome, identify the likely source of focal seizures, and confirm a diagnosis of status epilepticus...
September 5, 2017: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/28867038/-therapeutic-management-of-neonatal-arterial-cerebral-infarction-and-neuroprotection-perspectives
#15
O Baud, S Auvin, E Saliba, V Biran
Neonatal seizure related to stroke is a common diagnostic feature. Their treatment, although widely debated even today must be initiated in case of status epilepticus, clinical seizures of more than 5 minutes duration or short (> 30 secondes) and repeated clinical seizures (2 or more per hour). The treatment of neonatal seizures is a challenge that remains only partially solved. It should take into account the etiology of seizures, type of brain lesions and clinical/electrical response to treatment after the first line treatment...
September 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28867037/-place-of-eeg-in-the-management-of-arterial-ischemic-stroke-newborn
#16
S Nguyen The Tich
The EEG has a key role in the management of neonatal seizures, which are the typical mode of revelation of neonatal ischemic stroke. The EEG should be started as soon as possible in case of suspected seizure. Some EEG features are evocative of neonatal stroke, typically asymmetry of background activity with the presence of focal spikes and focal seizures. The EEG should be prolonged and always associated with a video as pauci-symptomatic or subclinical seizures are frequent, including some status epilepticus...
September 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28866335/predictors-of-outcomes-and-refractoriness-in-status-epilepticus-a-prospective-study
#17
Murat Mert Atmaca, Nerses Bebek, Betül Baykan, Ayşen Gökyiğit, Candan Gürses
OBJECTIVE: The objective of this study was to determine the predictors of outcomes and refractoriness in status epilepticus (SE). METHODS: This is a prospective study of 59 adult patients with SE who were admitted to the Emergency Department between February 2012 and December 2013. The effects of clinical, demographic, and electrophysiologic features of patients with SE were evaluated. To evaluate outcome in SE, STESS, mSTESS, and EMSE scales were used. RESULTS: Logistic regression analysis showed that being aged ≥65years (p=0...
August 31, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28834781/clinical-management-of-elderly-patients-with-epilepsy-the-use-of-lacosamide-in-a-single-center-setting
#18
Sirpa Rainesalo, Jussi Mäkinen, Jani Raitanen, Jukka Peltola
INTRODUCTION: Lacosamide (LCM) is a third-generation antiepileptic drug (AED) for which there is limited experience in the treatment of elderly patients with epilepsy. This study was performed to evaluate the use of LCM in this particular patient group, focusing on its tolerability and effectiveness. This is a retrospective, single-center study, in patients over 60years old treated with LCM between 1/2010 and 5/2015. Altogether, 233 elderly patients receiving LCM were identified; of these, 67 fulfilled the inclusion criteria, i...
August 20, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28802513/nonconvulsive-status-epilepticus-after-electroconvulsive-therapy-a-review-of-literature
#19
Awais Aftab, Ashley VanDercar, Ayham Alkhachroum, Christine LaGrotta, Keming Gao
BACKGROUND: The clinical presentation and risk factors of nonconvulsive status epilepticus (NCSE) in the context of electroconvulsive therapy (ECT) are poorly understood, and guidance regarding diagnosis and management remains scarce. In this article, we identify case reports of ECT-induced NCSE from literature, and discuss the presentation, diagnosis, and management of these cases in the context of what is known about NCSE from the neurology literature. METHODS: A literature search on PubMed for case reports of NCSE after ECT...
July 15, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28781312/the-prehospital-predictors-of-tracheal-intubation-for-in-patients-who-experience-convulsive-seizures-in-the-emergency-department
#20
Kenichiro Sato, Noritoshi Arai, Aki Omori-Mitsue, Ayumi Hida, Akio Kimura, Sousuke Takeuchi
Objective To identify the prehospital factors predicting the performance of tracheal intubation (TI) at the emergency department (ED) in patients with convulsive seizure or epilepsy. Methods We performed a retrospective analysis of seizure patients who underwent TI at the ED soon after arrival. The clinical variables obtained in the prehospital setting were reviewed. Patients The study population included consecutive adult patients who were transported to an urban tertiary care ED due to convulsive seizure between August 2010 and September 2015...
August 15, 2017: Internal Medicine
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