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Status epilepticus treatment

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https://www.readbyqxmd.com/read/28090524/the-samukeppra-study-in-prehospital-status-epilepticus-lessons-for-future-study
#1
COMMENT
Andrew C Schomer, Jaideep Kapur
In the Lancet Neurology article "Prehospital treatment with levetiracetam plus clonazepam or placebo plus clonazepam in status epilepticus (SAMUKeppra): a randomised, double-blind, phase 3 trial" the authors conducted a prehospital, randomized controlled study to determine which treatment is more effective for status epilepticus (SE): benzodiazepine alone, or in combination with levetiracetam (LEV). Although the study had negative results, several aspects of the trial design likely masked any added effect that LEV may have had in controlling SE, including: higher doses of benzodiazepines, lower thresholds for determining cessation of SE, and a smaller sample size...
December 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28087260/seizure-recurrence-in-children-after-stopping-antiepileptic-medication-5-year-follow-up
#2
Inn-Chi Lee, Shuan-Yow Li, Yung-Jung Chen
BACKGROUND: We wanted to identify in children with epilepsy the factors associated with seizure control and recurrence after a 2-year remission. METHODS: We did a 5-year follow-up of epileptic children whose antiepileptic medication had been stopped. Bivariate and multivariate analyses were used to compare features of electroencephalograms (EEGs) and clinical findings. In this study, 43 patients with and 64 without a seizure recurrence (SR) were enrolled. RESULTS: Clinical features strongly associated with SR in the univariate analysis included a symptomatic etiology for seizures, a history of status epilepticus, treatment duration before stopping antiepileptic drugs, and abnormal EEG findings at the time of stopping antiepileptic drugs...
December 18, 2016: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28074997/-classification-of-idiopathic-generalised-epilepsies-in-patients-over-16-years-of-age
#3
J Sala-Padro, M Toledo, E Santamarina, M Gonzalez-Cuevas, M Raspall-Chaure, M Sueiras-Gil, M Quintana, J Salas-Puig
INTRODUCTION: Idiopathic generalised epilepsies (IGE) are a set of electroclinical syndromes with different phenotypes. Our aim is to analyse those phenotypes in patients over 16 years of age. PATIENTS AND METHODS: We conducted a retrospective analysis of a series of patients with IGE. They were classified as childhood absence epilepsy (CAE), juvenile absence epilepsy (JAE), juvenile myoclonic epilepsy (JME), epilepsy with tonic-clonic seizures only (TCSE), epilepsy with eyelid myoclonias and absences (EMA) and pure photogenic epilepsy (PE)...
January 16, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28074934/disease-modifying-effect-of-intravenous-immunoglobulin-in-an-experimental-model-of-epilepsy
#4
Min Chen, Thiruma V Arumugam, Gayeshika Leanage, Quang M Tieng, Ashwin Yadav, Jeremy F P Ullmann, David T She, Vy Truong, Marc J Ruitenberg, David C Reutens
Novel therapies that prevent or modify the development of epilepsy following an initiating brain insult could significantly reduce the burden of this disease. In light of evidence that immune mechanisms play an important role in generating and maintaining the epileptic condition, we evaluated the effect of a well-established immunomodulatory treatment, intravenous immunoglobulin (IVIg), on the development of epilepsy in an experimental model of epileptogenesis. In separate experiments, IVIg was administered either before (pre-treatment) or after (post-treatment) the onset of pilocarpine status epilepticus (SE)...
January 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28066149/neuroprotective-effect-of-lithium-after-pilocarpine-induced-status-epilepticus-in-mice
#5
Namgue Hong, Yun-Sik Choi, Seong Yun Kim, Hee Jung Kim
Status epilepticus is the most common serious neurological condition triggered by abnormal electrical activity, leading to severe and widespread cell loss in the brain. Lithium has been one of the main drugs used for the treatment of bipolar disorder for decades, and its anticonvulsant and neuroprotective properties have been described in several neurological disease models. However, the therapeutic mechanisms underlying lithium's actions remain poorly understood. The muscarinic receptor agonist pilocarpine is used to induce status epilepticus, which is followed by hippocampal damage...
January 2017: Korean Journal of Physiology & Pharmacology
https://www.readbyqxmd.com/read/28061403/berberine-ameliorates-intrahippocampal-kainate-induced-status-epilepticus-and-consequent-epileptogenic-process-in-the-rat-underlying-mechanisms
#6
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
#7
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
#8
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
#9
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/28033307/effect-of-sodium-valproate-on-cognitive-function-and-hippocampus-of-rats-after-convulsive-status-epilepticus
#10
Peng Wu, Siqi Hong, Min Zhong, Yi Guo, Hengsheng Chen, Li Jiang
BACKGROUND The aim of this study was to explore the effect and possible mechanism of sodium valproate (VPA) on the cognitive function and the hippocampus of rats after convulsive status epilepticus (CES). MATERIAL AND METHODS A rat model of CES was established and the Morris water maze was used to observe changes in the cognitive function of the rats after the administration of VPA. Acute hippocampal slices were made to detect field excitatory postsynaptic potential. Western blot analysis was used to test for the expression of CaMKII and p-CaMKII...
December 29, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28029552/epilepsia-partialis-continua-a-review
#11
REVIEW
Rūta Mameniškienė, Peter Wolf
Epilepsia partialis contina (EPC) in a narrow definition is a variant of simple focal motor status epilepticus in which frequent repetitive muscle jerks, usually arrhythmic, continue over prolonged periods of time. In a broader definition (used in this review) it also includes non-motor manifestations otherwise known as aura continua. EPC may occur as a single episode, repetitive episodes, it may be chronic progressive or non-progressive. It appears as an unusual manifestation of epilepsy in which more typical paroxysmal events are partly or entirely replaced by the sustained repetition of seizure fragments in rapid succession...
October 18, 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28028790/autoimmune-encephalitis-at-the-neurological-intensive-care-unit-etiologies-reasons-for-admission-and-survival
#12
Gayane Harutyunyan, Larissa Hauer, Martin W Dünser, Anush Karamyan, Tobias Moser, Slaven Pikija, Markus Leitinger, Helmut F Novak, Eugen Trinka, Johann Sellner
BACKGROUND: Early recognition and treatment of autoimmune encephalitis (AE) has become an essential issue in clinical practice. However, little is known about patients with deteriorating conditions and the need for intensive care treatment. Here, we aimed to characterize underlying aetiologies, clinical symptoms, reasons for intensive care admission, and mortality of critically ill patients with AE. METHODS: We conducted a retrospective chart review of all patients with "definite" or "probable" diagnoses of AE treated at our neurological intensive care unit between 2002 and 2015...
December 27, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/28028789/isoflurane-use-in-the-treatment-of-super-refractory-status-epilepticus-is-associated-with-hippocampal-changes-on-mri
#13
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/28027569/treatment-of-super-refractory-status-epilepticus-in-fires
#14
Bernd A Neubauer
No abstract text is available yet for this article.
December 27, 2016: Neuropediatrics
https://www.readbyqxmd.com/read/28026006/extended-eeg-and-non-convulsive-status-epilepticus-benefit-over-routine-eeg
#15
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/28017648/non-invasive-pet-imaging-of-brain-inflammation-at-disease-onset-predicts-spontaneous-recurrent-seizures-and-reflects-comorbidities
#16
Daniele Bertoglio, Jeroen Verhaeghe, Eva Santermans, Halima Amhaoul, Elisabeth Jonckers, Leonie Wyffels, Annemie Van Der Linden, Niel Hens, Steven Staelens, Stefanie Dedeurwaerdere
Brain inflammation is an important factor in the conversion of a healthy brain into an epileptic one, a phenomenon known as epileptogenesis, offering a new entry point for prognostic tools. The development of anti-epileptogenic therapies to treat before or at disease onset is hampered by our inability to predict the severity of the disease outcome. In a rat model of temporal lobe epilepsy we aimed to assess whether in vivo non-invasive imaging of brain inflammation at disease onset was predictive of spontaneous recurrent seizures (SRS) frequency and severity of depression-like and sensorimotor-related comorbidities...
December 22, 2016: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/28013000/galanin-contributes-to-monoaminergic-dysfunction-and-to-dependent-neurobehavioral-comorbidities-of-epilepsy
#17
Jesus-Servando Medel-Matus, Don Shin, Raman Sankar, Andrey Mazarati
Status epilepticus (SE) in rats, along with chronic epilepsy, leads to the development of behavioral impairments resembling depressive disorder and/or attention deficit/hyperactivity disorder (ADHD), thus reflecting respective comorbidities in epilepsy patients. Suppressed neurotransmitter tone in the raphe nucleus (RN)-prefrontal cortex (PFC) serotonergic pathway and in the locus coeruleus (LC)-PFC noradrenergic pathway underlies depressive- and impulsive-like behavioral deficits respectively. We examined possible mechanisms leading to the monoamine dysfunction in brainstem efferents, namely modulatory effects of the neuropeptide galanin on serotonin (5-HT) and norepinephrine (NE) signaling...
December 22, 2016: Experimental Neurology
https://www.readbyqxmd.com/read/28011930/refractory-status-epilepticus-in-children-with-and-without-prior-epilepsy-or-status-epilepticus
#18
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/28004305/topiramate-in-the-treatment-of-generalized-convulsive-status-epilepticus-in-adults-a-systematic-review-with-individual-patient-data-analysis
#19
REVIEW
Francesco Brigo, Nicola Luigi Bragazzi, Stanley C Igwe, Raffaele Nardone, Eugen Trinka
BACKGROUND: Generalized convulsive status epilepticus (GCSE) is a medical emergency associated with high morbidity and mortality that requires prompt medical intervention. Topiramate (TPM) is an antiepileptic drug effective against a broad spectrum of seizure types, and has been proposed as a possible therapeutic option for super-refractory status epilepticus (SRSE), the most severe form of GCSE. AIM: This review aimed to evaluate the role of TPM in GCSE, including SRSE...
December 21, 2016: Drugs
https://www.readbyqxmd.com/read/28003499/new-onset-seizure-in-hiv-infected-adult-zambians-a-search-for-causes-and-consequences
#20
Omar K Siddiqi, Melissa A Elafros, Christopher M Bositis, Igor J Koralnik, William H Theodore, Jason F Okulicz, Lisa Kalungwana, Michael J Potchen, Izukanji Sikazwe, Gretchen L Birbeck
OBJECTIVE: To identify the etiology of new-onset seizure in HIV-infected Zambian adults and identify risk factors for seizure recurrence. METHODS: A prospective cohort study enrolling HIV-infected adults with new-onset seizure within 2 weeks of index seizure obtained clinical, laboratory, and neuroimaging data to determine seizure etiology. Participants were followed to identify risk factors for seizure recurrence. Risk factors for mortality were examined as mortality rates were unexpectedly high...
December 21, 2016: Neurology
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