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midazolam seizure

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https://www.readbyqxmd.com/read/29743770/paradoxical-reaction-to-midazolam-in-preterm-neonates-a-case-series
#1
Mahendra Kumar Gupta, Jayashree A Mondkar, Deepraj Hegde
Midazolam is a drug belonging to the benzodiazepine group and is used commonly for seizure control as well as preoperative and procedure-related sedation in neonates. Many adverse effects of midazolam have been reported in the past. Paradoxical stimulation of the central nervous system such as restlessness, nightmare, and hallucinations as well as hypomanic behavior has been reported in adults and children. Seizure is a rare adverse effect of midazolam. Cases of myoclonic movements associated with midazolam have been published worldwide; however, none so far have been reported from India...
April 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29679985/does-burst-suppression-achieve-seizure-control-in-refractory-status-epilepticus
#2
Kanitpong Phabphal, Suparat Chisurajinda, Thapanee Somboon, Kanjana Unwongse, Alan Geater
BACKGROUND: The general principles in the administration of anesthetic drugs entail not only the suppression of seizure activity but also the achievement of electroencephalography burst suppression (BS). However, previous studies have reported conflicting results, possibly owing to the inclusion of various anesthetic agents, not all patients undergoing continuous electroencephalography (cEEG), and the inclusion of anoxic encephalopathy. This study aimed to analyze the effects of midazolam-induced BS on the occurrence outcomes in refractory status epilepticus patients...
April 21, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29650892/-continuous-subcutaneous-injection-therapy-in-end-of-life-symptoms-of-cancer-and-non-cancer-patients
#3
Tatsuo Oshiro, Hisako Oshiro, Masahito Tanimizu
The significance of continuous subcutaneous injection(CSI)therapy was assessed in end-of-life symptoms of cancer and non-cancer home hospice patients. In a retrospective analysis of 106 advanced cancer patients who underwent opioid CSI therapy, the most frequent symptom was pain(65%), followed by dyspnea(46%), seizure(8%), ileus(8%), and other uncontrolled end-of-life symptoms(23%). The median oral morphine equivalent daily opioid dose was 90 mg(2.5-1,920 mg)and the median duration of CSI administration was 3 days(1-350 days)...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29587188/nonconvulsive-status-epilepticus-after-cessation-of-convulsive-status-epilepticus-in-pediatric-intensive-care-unit-patients
#4
Jin Chen, Lingling Xie, Yue Hu, Xinghui Lan, Li Jiang
Little is known about pediatric patients suffering from nonconvulsive status epilepticus (NCSE) after convulsive status epilepticus (CSE) cessation. The aim of this study was to identify in pediatric patients the clinical characteristics of NCSE after CSE cessation and the factors that contribute to patient outcomes. Data from clinical features, electroencephalography (EEG) characteristics, neuroimaging findings, treatments, and prognosis were systematically summarized, and the associations between clinical characteristics and prognosis were quantified...
March 24, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29525722/a-self-completed-questionnaire-study-of-attitudes-and-perceptions-of-paramedic-and-prehospital-practitioners-towards-acute-seizure-care-in-northern-ireland
#5
Michael Owen Kinney, Stephen J Hunt, Ciaran McKenna
INTRODUCTION: Paramedics are increasingly expected to take on wider roles in the management of epilepsy in the community by making nonconveyance decisions after patients have had seizures. Studies have identified barriers to the successful implementation of this clinical role. We sought to determine levels of confidence, training, perceived barriers, and self-identified learning needs and methods to address these needs regarding seizure management. METHODS AND MATERIALS: A questionnaire was developed by consensus and administered to 63 paramedic and prehospital clinicians at various mandatory training days occurring at the central headquarters of the regional ambulance service in Northern Ireland...
April 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29459611/non-convulsive-status-epilepticus-in-children-clinical-profile-eeg-characteristics-and-treatment
#6
K Fatema, M M Rahman, S Akhter, N Akter, S Begum
Non-convulsive status epilepticus (NCSE) is a term used to denote a range of conditions in which electrographic seizure activity is prolonged and results in non-convulsive clinical symptoms. This study was done to describe the clinical spectrum, EEG findings and to evaluate the efficacy of different therapeutic agents in children with NCSE in 33 patients from January 2011 to December 2015 period. All patients had EEG before and after treatment. Age range was 6 months to 14 year, 25 were male. Regarding development status, 48% had developmental delay, 21% had normal development, 9% had regression and 21% had both developmental delay and regression...
January 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29422735/successful-use-of-ketamine-for-burst-suppression-in-super-refractory-status-epilepticus-following-substance-abuse
#7
Dnyaneshwar P Mutkule, S Manimala Rao, Jaydip Ray Chaudhuri, Kunche Rajasri
Status epilepticus is frequently encountered in neuro Intensive Care Units. It is a medical emergency and if not treated promptly can lead to severe brain damage and even death. Here, we present the case of a 18-year-old male with uncontrolled and unrelenting seizures with a rare etiology requiring ketamine infusion for burst suppression as it was resistant to thiopentone and midazolam infusions. The management of this case is presented in detail.
January 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29414381/dexmedetomidine-stops-benzodiazepine-refractory-nerve-agent-induced-status-epilepticus
#8
Hilary S McCarren, Julia A Arbutus, Cherish Ardinger, Emily N Dunn, Cecelia E Jackson, John H McDonough
Nerve agents are highly toxic chemicals that pose an imminent threat to soldiers and civilians alike. Nerve agent exposure leads to an increase in acetylcholine within the central nervous system, resulting in development of protracted seizures known as status epilepticus (SE). Currently, benzodiazepines are the standard of care for nerve agent-induced SE, but their efficacy quickly wanes as the time to treatment increases. Here, we examine the role of the α2-adrenoceptor in termination of nerve agent-induced SE using the highly specific agonist dexmedetomidine (DEX)...
March 2018: Epilepsy Research
https://www.readbyqxmd.com/read/29408771/headache-in-mitochondrial-disorders
#9
REVIEW
Josef Finsterer, Sinda Zarrouk-Mahjoub
Headache is a prominent feature in mitochondrial disorders (MIDs) but no comprehensive overview is currently available. This review aims at summarising and discussing findings concerning type, frequency, pathogenesis, and treatment of headache in MIDs. The most frequent headache types in MIDs are migraine and migraine-like headache (MLH). MLH is classified as secondary headache. More rarely, tension-type headache, trigemino-autonomic headache, or different secondary headaches can be found. Migraine or MLH may manifest with or without aura...
March 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29368126/pharmacotherapy-for-refractory-and-super-refractory-status-epilepticus-in-adults
#10
Martin Holtkamp
Patients with prolonged seizures that do not respond to intravenous benzodiazepines and a second-line anticonvulsant suffer from refractory status epilepticus and those with seizures that do not respond to continuous intravenous anesthetic anticonvulsants suffer from super-refractory status epilepticus. Both conditions are associated with significant morbidity and mortality. A strict pharmacological treatment regimen is urgently required, but the level of evidence for the available drugs is very low. Refractory complex focal status epilepticus generally does not require anesthetics, but all intravenous non-anesthetizing anticonvulsants may be used...
January 24, 2018: Drugs
https://www.readbyqxmd.com/read/29364730/improving-prehospital-protocol-adherence-using-bundled-educational-interventions
#11
Megan C Marino, Daniel G Ostermayer, Juan A Mondragon, Elizabeth A Camp, Elizabeth M Keating, Louis B Fornage, Charles A Brown, Manish I Shah
BACKGROUND: Seizures and anaphylaxis are life-threatening conditions that require immediate treatment in the prehospital setting. There is variation in treatment of pediatric prehospital patients for both anaphylaxis and seizures. This educational study was done to improve compliance with pediatric prehospital protocols, educate prehospital providers and decrease variation in care. OBJECTIVE: To improve the quality of care for children with seizures and anaphylaxis in the prehospital setting using a bundled, multifaceted educational intervention...
May 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29320603/drug-management-for-acute-tonic-clonic-convulsions-including-convulsive-status-epilepticus-in-children
#12
REVIEW
Amy McTague, Timothy Martland, Richard Appleton
BACKGROUND: Tonic-clonic convulsions and convulsive status epilepticus (currently defined as a tonic-clonic convulsion lasting at least 30 minutes) are medical emergencies and require urgent and appropriate anticonvulsant treatment. International consensus is that an anticonvulsant drug should be administered for any tonic-clonic convulsion that has been continuing for at least five minutes. Benzodiazepines (diazepam, lorazepam, midazolam) are traditionally regarded as first-line drugs and phenobarbital, phenytoin and paraldehyde as second-line drugs...
January 10, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29318511/midazolam-efficacy-against-acute-hydrogen-sulfide-induced-mortality-and-neurotoxicity
#13
Poojya Anantharam, Dong-Suk Kim, Elizabeth M Whitley, Belinda Mahama, Paula Imerman, Piyush Padhi, Wilson K Rumbeiha
Hydrogen sulfide (H2 S) is a colorless, highly neurotoxic gas. It is not only an occupational and environmental hazard but also of concern to the Department of Homeland Security for potential nefarious use. Acute high-dose H2 S exposure causes death, while survivors may develop neurological sequelae. Currently, there is no suitable antidote for treatment of acute H2 S-induced neurotoxicity. Midazolam (MDZ), an anti-convulsant drug recommended for treatment of nerve agent intoxications, could also be of value in treating acute H2 S intoxication...
March 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29306558/high-dose-phenobarbitone-coma-in-pediatric-refractory-status-epilepticus-a-retrospective-case-record-analysis-a-proposed-protocol-and-review-of-literature
#14
Sheffali Gulati, Vishal Sondhi, Biswaroop Chakrabarty, Prashant Jauhari, Rakesh Lodha, Jhuma Sankar
BACKGROUND: Ongoing refractory status epilepticus is associated with significant morbidity and mortality. Therapeutic coma induction with midazolam, thiopentone, phenobarbitone or propofol is indicated when conventional antiepileptics fail to abort seizure. Of these, the most extensively studied is midazolam. Amongst the remaining three, phenobarbitone has the most favourable pharmacological profile, but has not been studied adequately, more so in the pediatric age group. The current retrospective case records analysis is an attempt to describe use of phenobarbitone coma in pediatric refractory status epilepticus...
April 2018: Brain & Development
https://www.readbyqxmd.com/read/29303424/seizing-the-opportunity-exploring-barriers-to-use-of-transmucosal-midazolam-in-hospice-patients
#15
Samuel J Perna, James M Rhinewalt, Erin R Currie
BACKGROUND: Status epilepticus seizures are distressing events for hospice and palliative care patients. Currently, rectal diazepam is the only abortive therapy approved by the U.S. Food and Drug Administration for seizures occurring out of hospital. However, transmucosal (buccal and intranasal) midazolam hydrochloride is a less expensive, equally effective, and a more socially acceptable alternative. OBJECTIVE: To explore the use of transmucosal midazolam in out-of-hospital hospice patients in the State of Alabama...
January 5, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29289522/effect-of-rescue-medication-on-seizure-duration-in-non-institutionalized-children-with-epilepsy
#16
Federico Vigevano, Fenella J Kirkham, Bernd Wilken, Miquel Raspall-Chaure, Regina Grebla, Dawn Lee, Tamara Werner-Kiechle, Lieven Lagae
OBJECTIVES: Characterize the real-world management of and outcomes for children with epilepsy receiving rescue medication for prolonged acute convulsive seizures (PACS) in the community. METHODS: PERFECT-3 (Practices in Emergency and Rescue medication For Epilepsy managed with Community-administered Therapy 3) was a European, retrospective observational study. Eligible patients were non-institutionalized children with epilepsy aged 3-16 years who had experienced ≥1 PACS in the past year and had ≥1 currently prescribed PACS rescue medication...
January 2018: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/29245268/posterior-reversible-encephalopathy-syndrome-after-postpartum-hemorrhage-and-uterine-artery-embolization-a-case-report
#17
Fangfang Shi, Liwei Shen, Yonghui Shi, Lei Shi, Xiaoli Yang, Zhi Jin, Wenpeng Liu, Danhong Wu
RATIONALE: Posterior reversible encephalopathy syndrome (PRES) is characterized by clinical and radiological features, including headache, disturbed consciousness, seizures, and cortical blindness associated with findings indicating posterior leukoencephalopathy on imaging studies. Ours is the first case of PRES developing after postpartum hemorrhage and uterine artery embolization. PATIENT CONCERNS: An 18-year-old patient had postpartum hemorrhage after a normal delivery...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29218705/randomized-controlled-study-comparing-the-efficacy-of-rapid-and-slow-withdrawal-of-antiepileptic-drugs-during-long-term-video-eeg-monitoring
#18
Shambhu Kumar, Bhargavi Ramanujam, P S Chandra, Deepa Dash, Santosh Mehta, Sharma Anubha, Renjith Appukutan, Manit Kumar Rana, Manjari Tripathi
OBJECTIVE: Antiepileptic drugs (AEDs) are routinely withdrawn during long-term video-electroencephalography (EEG) monitoring (LTM), to record sufficient number of seizures. The efficacy of rapid and slow AED taper has never been compared in a randomized control trial (RCT), which was the objective of this study. METHODS: In this open-label RCT, patients aged 2-80 years with drug-resistant epilepsy (DRE) were randomly assigned (1:1) to rapid and slow AED taper groups...
February 2018: Epilepsia
https://www.readbyqxmd.com/read/29203057/febrile-infection-related-epilepsy-syndrome-fires-with-super-refractory-status-epilepticus-revealing-autoimmune-encephalitis-due-to-gaba-a-r-antibodies
#19
D Caputo, R Iorio, F Vigevano, L Fusco
BACKGROUND: Febrile infection-related epilepsy syndrome (FIRES) has been described as an epileptic encephalopathy of unknown etiology affecting previously healthy children following febrile illness. Despite large investigations on autoimmune pathogenesis no membrane antibodies has been associated since now. CASE STUDY: We report a 13 years-old girl with negative history for neurological or autoimmune disease that developed at the sixth day of high fever a super-refractory status epilepticus...
January 2018: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/29111005/impact-of-non-guideline-based-treatment-of-status-epilepticus
#20
James Braun, Elizabeth Gau, Stacy Revelle, Laurie Byrne, Abhay Kumar
BACKGROUND: This retrospective study analyzed benzodiazepine usage patterns in relation to guideline recommendations for the treatment of generalized convulsive status epilepticus (GCSE) as practiced by emergency medical services (EMS) and the emergency department (ED) of an inner-city hospital. Secondary outcomes of interest were adverse events and admission/discharge outcomes. METHODS: Records of all patients≥18years old diagnosed with GCSE between June 2012 and September 2015 and transported by EMS to our hospital ED were reviewed...
November 15, 2017: Journal of the Neurological Sciences
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