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https://www.readbyqxmd.com/read/29456482/ring-chromosome-17-not-involving-the-miller-dieker-region-a-case-with-drug-resistant-epilepsy
#1
Antonietta Coppola, Deborah Morrogh, Fiona Farrell, Simona Balestrini, Laura Hernandez-Hernandez, S Krithika, Josemir W Sander, Jonathan J Waters, Sanjay M Sisodiya
Chromosomal abnormalities are often identified in people with neurodevelopmental disorders including intellectual disability, autism, and epilepsy. Ring chromosomes, which usually involve gene copy number loss, are formed by fusion of subtelomeric or telomeric chromosomal regions. Some ring chromosomes, including ring 14, 17, and 20, are strongly associated with seizure disorders. We report an individual with a ring chromosome 17, r(17)(p13.3q25.3), with a terminal 17q25.3 deletion and no short arm copy number loss, and with a phenotype characterized by intellectual disability and drug-resistant epilepsy, including a propensity for nonconvulsive status epilepticus...
December 2017: Molecular Syndromology
https://www.readbyqxmd.com/read/29443785/can-endotracheal-intubation-be-the-first-step-in-management-of-nonconvulsive-status-epilepticus-a-case-report
#2
Saad Warraich, Abbas Ali, Atif Nizami, Moiz Bakhiet
RATIONALE: Nonconvulsive status epilepticus (NCSE) is prolonged seizure activity without motor manifestations. Clinically, there are certain examination findings, in addition to elements of history, that help differentiate it from other encephalopathies. When diagnosing NCSE, the physician faces significant difficulties due to inconsistent clinical presentation and somewhat nonspecific electroencephalogram (EEG) criteria. PATIENT CONCERNS: To highlight the problems faced when dealing with such a patient, a case of a 29-year-old male who presented with an altered state of consciousness is put forth for the reader...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29442558/progression-of-convulsive-and-nonconvulsive-seizures-during-epileptogenesis-after-pilocarpine-induced-status-epilepticus
#3
Zachariah Z Smith, Alexander M Benison, Florencia M Bercum, F Edward Dudek, Daniel S Barth
Although convulsive seizures occurring during pilocarpine-induced epileptogenesis have received considerable attention, nonconvulsive seizures have not been closely examined, even though they may reflect the earliest signs of epileptogenesis and potentially guide research on antiepileptogenic interventions. The definition of nonconvulsive seizures based on brain electrical activity alone has been controversial. Here, we define and quantify electrographic properties of convulsive and nonconvulsive seizures in the context of the acquired epileptogenesis that occurs after pilocarpine-induced status epilepticus (SE)...
February 14, 2018: Journal of Neurophysiology
https://www.readbyqxmd.com/read/29432248/neurologic-complications-in-the-pediatric-intensive-care-unit
#4
Mark S Wainwright
PURPOSE OF REVIEW: All critical care is directed at maintaining brain health, but recognizing neurologic complications of critical illness in children is difficult, and limited data exist to guide practice. This article discusses an approach to the recognition and management of seizures, stroke, and cardiac arrest as complications of other critical illnesses in the pediatric intensive care unit. RECENT FINDINGS: Convulsive and nonconvulsive seizures occur frequently in children after cardiac arrest or traumatic brain injury and during extracorporeal membrane oxygenation...
February 2018: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/29414555/specificity-of-electroclinical-features-in-the-diagnosis-of-ring-chromosome-20
#5
A B Gago-Veiga, R Toledano, I García-Morales, M A Pérez-Jiménez, J Bernar, A Gil-Nagel
BACKGROUND: Ring chromosome 20 (R20) syndrome is a chromosomal disorder characterized mainly by drug-resistant frontal lobe seizures, recurrent nonconvulsive status epilepticus (NCSE), and typical EEG features. The aim of this study was to investigate if this triad is common and specific to all patients with R20. METHODS: In this cross-sectional study (from 2000 to 2011), we selected patients who fulfilled at least two out of three criteria: drug-resistant frontal lobe seizures, recurrent NCSE, and characteristic electroencephalography (EEG) features...
February 2, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29344469/successful-use-of-therapeutic-hypothermia-for-refractory-nonconvulsive-status-epilepticus
#6
Do-Hyung Kim, Hye-Hoon Kang, Minjung Kim, Tae-Won Yang, Oh-Young Kwon, Jung Sook Yeom, Bong Su Kang, Yong Hwan Kim, Young-Soo Kim
Therapeutic hypothermia (TH) has rarely been utilized as an adjunct to anticonvulsants in treating patients with refractory convulsive status epilepticus (CSE). However, determining the effectiveness of TH in CSE is difficult due to the unavoidable use of sedative drugs to manage hypothermia. Additionally, the effectiveness of TH has not been studied in patients with refractory non-convulsive status epilepticus (NCSE). Here, we report the successful use of TH without additional sedative drugs in a patient with temporal lobe epilepsy and refractory NCSE...
December 2017: Journal of Epilepsy Research
https://www.readbyqxmd.com/read/29262437/ictal-interictal-continuum-when-to-worry-about-the-continuous-electroencephalography-pattern
#7
Justine Cormier, Carolina B Maciel, Emily J Gilmore
Continuous electroencephalography (cEEG) monitoring is an invaluable tool in the evaluation of encephalopathy and coma in critically ill patients. Marked increases in cEEG monitoring, coinciding with several societal guideline statements in the last decade, have allowed earlier detection and treatment of clearly harmful patterns, including nonconvulsive seizures (NCSz) and nonconvulsive status epilepticus (NCSE). However, it has also unmasked a range of EEG patterns of less clear clinical significance, with some more "malignant" than others given their potential association with increased neuronal stress and secondary brain injury...
December 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29260591/subacute-encephalopathy-with-seizures-in-alcoholics-sesa-presenting-as-focal-nonconvulsive-status-epilepticus
#8
Peter W Kaplan, Andrew Billnitzer, José Luis Fernández-Torre
PURPOSE: To acquaint readers with the underrecognized subacute encephalopathy with seizures in chronic alcoholics (SESA) that has more recently been associated with different types of status epilepticus. METHODS: Case reports and review of the literature on SESA and nonconvulsive status epilepticus (NCSE). RESULTS: Two cases: one with alternating bifrontoparietal NCSE, and one with focal, confusional NCSE, with imaging and EEG correlates. CONCLUSION: Underrecognized SESA may present as NCSE with focal clinical, EEG and reversible diffusion-weighted MRI abnormalities, warranting expedited diagnosis and antiseizure treatment to minimize morbidity...
December 1, 2017: Clinical EEG and Neuroscience: Official Journal of the EEG and Clinical Neuroscience Society (ENCS)
https://www.readbyqxmd.com/read/29248799/early-withdrawal-of-non-anesthetic-antiepileptic-drugs-after-successful-termination-of-nonconvulsive-seizures-and-nonconvulsive-status-epilepticus
#9
Jennifer A Creed, Jake Son, Alfredo E Farjat, Christa B Swisher
PURPOSE: Multiple antiepileptic drugs (AEDs) are often necessary to treat nonconvulsive seizures (NCS) and nonconvulsive status epilepticus (NCSE). AED polypharmacy places patients at risk for adverse side effects and drug-drug interactions. Identifying the likelihood of seizure relapse when weaning non-anesthetic AEDs may provide guidance in the critical care unit. METHOD: Ninety-nine adult patients with successful treatment of electrographic-proven NCS or NCSE on continuous critical care EEG (CCEEG) monitoring were identified retrospectively...
January 2018: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29125184/hepatic-and-hippocampal-cytochrome-p450-enzyme-overexpression-during-spontaneous-recurrent-seizures
#10
Leonie Runtz, Benoit Girard, Marion Toussenot, Julie Espallergues, Alexis Fayd'Herbe De Maudave, Alexandre Milman, Frederic deBock, Chaitali Ghosh, Nathalie C Guérineau, Jean-Marc Pascussi, Federica Bertaso, Nicola Marchi
OBJECTIVE: Available evidence points to a role of cytochrome P450 (Cyp) drug biotransformation enzymes in central nervous system diseases, including epilepsy. Deviations in drug pharmacokinetic profiles may impact therapeutic outcomes. Here, we ask whether spontaneous recurrent seizure (SRS) activity is sufficient to modulate the expression of major Cyp enzymes in the liver and brain. METHODS: Unilateral intrahippocampal (IH) kainic acid (KA) injections were used to elicit nonconvulsive status epilepticus (SE), epileptogenesis, and SRS, as monitored by video-electroencephalography...
November 10, 2017: Epilepsia
https://www.readbyqxmd.com/read/29071284/characterizing-cefepime-neurotoxicity-a-systematic-review
#11
REVIEW
Ayesha A Appa, Rupali Jain, Robert M Rakita, Shahin Hakimian, Paul S Pottinger
Neurotoxicity due to cefepime has not been well characterized. We performed a systematic review of the literature and included 5 additional cases from our center. Of the 198 cases found, the mean age was 67 years and 87% of patients had renal dysfunction. The most common clinical features were diminished level of consciousness (80%), disorientation/agitation (47%), and myoclonus (40%). It is worth noting that nonconvulsive status epilepticus was relatively common with 31% of cases, whereas only 11% had convulsive seizures...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29064811/-the-risk-of-epileptic-seizures-during-antibiotic-therapy
#12
Ewa Czapińska-Ciepiela
Numerous antibiotics may trigger epileptic seizures or status epilepticus by decreasing inhibitory transmission in the brain, thus lowering the seizure threshold. The most potent seizurogenic effect is exerted by penicillins, cephalosporins, fluorochinolons and carbapenems. Predisposing factors that facilitate development of epileptic seizures in the course of antibiotic therapy comprise all conditions accompanied by damage to the blood-brain barrier (including cerebral trauma and encephalitis), a high dose of an antibiotic or lack of adequate dose adjustment in patients with renal failure...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29049053/treatment-options-for-posttraumatic-epilepsy
#13
Lara L Zimmermann, Ryan M Martin, Fady Girgis
PURPOSE OF REVIEW: Posttraumatic seizures (PTS) and posttraumatic epilepsy (PTE) are common and debilitating consequences of traumatic brain injury (TBI). Early PTS result in secondary brain injury by raising intracranial pressure and worsening cerebral edema and metabolic crisis. PTE is a localization-related epilepsy strongly associated with TBI severity, but risk factors for PTE and epileptogenesis are incompletely understood and are active areas of research. Medical management of PTS in adults and children is reviewed...
December 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28963903/fatty-acid-amide-hydrolase-inhibitor-urb597-may-protect-against-kainic-acid-induced-damage-to-hippocampal-neurons-dependence-on-the-degree-of-injury
#14
Irina B Mikheeva, Liubov Shubina, Nataliya Matveeva, Luybov L Pavlik, Valentina F Kitchigina
OBJECTIVE: Status epilepticus (SE) provokes changes, which lead to neuronal alterations. Endocannabinoids (eCBs) can affect the neuronal survival during excitotoxicity and brain damage. Using a kainic acid (KA)-induced experimental SE model, we investigated whether cellular changes entail damage to endoplasmic reticulum (ER), mitochondria, and nuclei in hippocampal cells (CA1 field), and whether these alterations can be diminished by treatment with URB597, an inhibitor of eCB enzymatic degradation...
September 22, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28886073/outcomes-of-patients-with-altered-level-of-consciousness-and-abnormal-electroencephalogram-a-retrospective-cohort-study
#15
Paula Rodrigues Sanches, Thiago Domingos Corrêa, Taissa Ferrari-Marinho, Pedro Vicente Ferreira Naves, Carol Ladeia-Frota, Luís Otávio Caboclo
INTRODUCTION: Nonconvulsive seizures (NCS) are frequent in hospitalized patients and may further aggravate injury in the already damaged brain, potentially worsening outcomes in encephalopathic patients. Therefore, both early seizure recognition and treatment have been advocated to prevent further neurological damage. OBJECTIVE: Evaluate the main EEG patterns seen in patients with impaired consciousness and address the effect of treatment with antiepileptic drugs (AEDs), continuous intravenous anesthetic drugs (IVADs), or the combination of both, on outcomes...
2017: PloS One
https://www.readbyqxmd.com/read/28844159/do-video-eeg-monitoring-findings-in-icu-patients-with-acute-stroke-predict-development-of-seizures-and-survival-during-follow-up
#16
Halil Onder, Ethem Murat Arsava, Mehmet Akif Topcuoglu, Nese Dericioglu
PURPOSE: Ischemic or hemorrhagic stroke are among the most common causes of seizures, especially in the elderly. EEG is the only technique that can detect epileptiform abnormalities (EA) and nonconvulsive status epilepticus (NCSE), which may negatively affect recovery of these patients. Herein we aimed to investigate the potential predictive value of long-term EEG findings in terms of poststroke seizures (PSS) and survival, in stroke patients followed up in the neurological intensive care unit (NICU)...
November 2017: Clinical EEG and Neuroscience: Official Journal of the EEG and Clinical Neuroscience Society (ENCS)
https://www.readbyqxmd.com/read/28808577/transition-from-intravenous-to-enteral-ketamine-for-treatment-of-nonconvulsive-status-epilepticus
#17
Michael A Pizzi, Prasuna Kamireddi, William O Tatum, Jerry J Shih, Daniel A Jackson, William D Freeman
BACKGROUND: Nonconvulsive status epilepticus (NCSE) is a diagnosis that is often challenging and one that may progress to refractory NCSE. Ketamine is a noncompetitive N-methyl-d-aspartate antagonist that increasingly has been used to treat refractory status epilepticus. Current Neurocritical Care Society guidelines recommend intravenous (IV) ketamine infusion as an alternative treatment for refractory status epilepticus in adults. On the other hand, enteral ketamine use in NCSE has been reported in only 6 cases (1 adult and 5 pediatric) in the literature to date...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28802513/nonconvulsive-status-epilepticus-after-electroconvulsive-therapy-a-review-of-literature
#18
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/28682826/misleading-eeg-lateralization-associated-with-midline-shift
#19
Gena R Ghearing, Sergiu Abramovici, Alexandra Popescu, Maria E Baldwin
Midline discharges, lateralized periodic discharges, and seizures have been described with ipsilateral lesions that result in midline shift (MLS). Periodic discharges and seizures arising contralateral to a known lesion have not previously been described as a sign of MLS. We present four patients with focal brain lesions, resulting in MLS and epileptiform discharges arising from the contralateral hemisphere. Patient 1 underwent a right anterior temporal lobectomy. On postoperative day 2, computed tomography demonstrated a right to left MLS of 12 mm, and EEG was remarkable for left temporal nonconvulsive status epilepticus...
July 4, 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28680316/electroencephalographic-patterns-recorded-by-continuous-eeg-monitoring-in-patients-with-change-of-consciousness-in-the-neurological-intensive-care-unit
#20
Ebru Altindağ, Zeynep Vildan Okudan, Sedef Tavukçu Özkan, Yakup Krespi, Betül Baykan
INTRODUCTION: Our aim was to examine the frequency of various electrographic patterns including periodic discharges (PD), repetitive spike waves (RSW), rhythmic delta activities (RDA), nonconvulsive seizures (NCS) and nonconvulsive status epilepticus (NCSE) in continuous EEG monitoring (cEEG) of the critically ill patients with change of consciousness and the presence of specific clinical and laboratory findings associated with these important patterns in this study. METHODS: Patients with changes of consciousness in the neurological intensive care unit (NICU) were consecutively monitored with cEEG during 2 years...
June 2017: Noro Psikiyatri Arsivi
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