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Status epilepticus treatment

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https://www.readbyqxmd.com/read/29687739/vigabatrin-for-epileptic-spasms-and-tonic-seizures-in-tuberous-sclerosis-complex
#1
Emma A van der Poest Clement, Mustafa Sahin, Jurriaan M Peters
Vigabatrin is recommended as first-line treatment for infantile spasms in tuberous sclerosis complex (TSC), but other indications in children with tuberous sclerosis complex are less known. We retrospectively reviewed 201 children with tuberous sclerosis complex, and identified 21 children older than 1 year started on vigabatrin for any indication and with sufficient follow-up data. The indication for vigabatrin was epileptic spasms (n = 13), tonic seizures (n = 5), both (n = 2), and status epilepticus (n = 1)...
January 1, 2018: Journal of Child Neurology
https://www.readbyqxmd.com/read/29687372/alterations-in-the-neurobehavioral-phenotype-and-znt3-cb-d28k-expression-in-the-cerebral-cortex-following-lithium-pilocarpine-induced-status-epilepticus-the-ameliorative-effect-of-leptin
#2
Hong Ni, Su-Hong Chen, Li-Li Li, Mei-Fang Jin
Zinc transporter 3 (ZnT3)-dependent "zincergic" vesicular zinc accounts for approximately 20% of the total zinc content of the mammalian telencephalon. Elevated hippocampal ZnT3 expression is acknowledged to be associated with mossy fiber sprouting and cognitive deficits. However, no studies have compared the long-term neurobehavioral phenotype with the expression of ZnT3 in the cerebral cortex following status epilepticus (SE). The aim of this study was to investigate changes in the long-term neurobehavioral phenotype as well as the expression of ZnT3 and calcium homeostasis-related CB-D28k in the cerebral cortex of rats subjected to neonatal SE and to determine the effects of leptin treatment immediately after neonatal SE...
April 23, 2018: Biological Trace Element Research
https://www.readbyqxmd.com/read/29672844/longitudinal-positron-emission-tomography-imaging-of-glial-cell-activation-in-a-mouse-model-of-mesial-temporal-lobe-epilepsy-toward-identification-of-optimal-treatment-windows
#3
Duc-Loc Nguyen, Catriona Wimberley, Charles Truillet, Benoit Jego, Fabien Caillé, Géraldine Pottier, Raphaël Boisgard, Irène Buvat, Viviane Bouilleret
OBJECTIVE: Mesiotemporal lobe epilepsy is the most common type of drug-resistant partial epilepsy, with a specific history that often begins with status epilepticus due to various neurological insults followed by a silent period. During this period, before the first seizure occurs, a specific lesion develops, described as unilateral hippocampal sclerosis (HS). It is still challenging to determine which drugs, administered at which time point, will be most effective during the formation of this epileptic process...
April 19, 2018: Epilepsia
https://www.readbyqxmd.com/read/29665500/aromatase-inhibition-by-letrozole-attenuates-kainic-acid-induced-seizures-but-not-neurotoxicity-in-mice
#4
Ramsha Iqbal, Gaurav K Jain, Fouzia Siraj, Divya Vohora
Evidence shows neurosteroids play a key role in regulating epileptogenesis. Neurosteroids such as testosterone modulate seizure susceptibility through its transformation to metabolites which show proconvulsant and anticonvulsant effects, respectively. Reduction of testosterone by aromatase generates proconvulsant 17-β estradiol. Alternatively, testosterone is metabolized into 5α-dihydrotestosterone (5α-DHT) by 5α-reductase, which is then reduced by 3α-hydroxysteroid oxidoreductase enzyme (3α-HSOR) to form anticonvulsant metabolite 3α-androstanediol (3α-Diol), a potent GABAA receptor modulating neurosteroid...
April 9, 2018: Epilepsy Research
https://www.readbyqxmd.com/read/29663692/profiles-of-gene-expression-in-the-hippocampal-formation-of-rats-with-experimentally-induced-brain-dysplasia
#5
Michal Kielbinski, Zuzanna Setkowicz, Kinga Gzielo, Krzysztof Janeczko
Malformations of cortical development (MCD) are a common cause of intractable seizures in humans. Among these, focal cortical dysplasia (FCD) poses an outstanding challenge. There are several subtypes of FCD that show significant variation in pathology and clinical presentation. All types exhibit disturbed cortical cytoarchitecture and increased propensity for seizures. The etiology is likely heterogenous, with mutations, specifically in genes related to mammalian target of rapamycin (mTOR), identified in only a subset of cases...
April 16, 2018: Developmental Neurobiology
https://www.readbyqxmd.com/read/29663350/the-role-of-ampa-receptors-and-their-antagonists-in-status-epilepticus
#6
Antonio Leo, Giada Giovannini, Emilio Russo, Stefano Meletti
Status epilepticus (SE) is typically defined as a prolonged self-sustaining seizure or repeated seizures showing an incomplete recovery between them. SE represents a medical emergency often associated with significant disability, morbidity, and mortality. Despite the clinical impact, the mechanisms underlying the transition from self-limited seizures to protracted, medically refractory seizures are not completely understood. About 40% of patients in established SE are refractory to antiepileptic drugs (first-line treatment); therefore, there is a need for more efficacious drugs...
April 17, 2018: Epilepsia
https://www.readbyqxmd.com/read/29663283/eeg-artifact-versus-subclinical-status-epilepticus-in-a-patient-following-cardiac-arrest
#7
Jean E Cibula, Daniel S Demos, Brenda G Fahy
BACKGROUND: A challenge in ICU EEG interpretation is identifying subclinical status epilepticus versus patterns on the ictal-interictal continuum versus other repetitive patterns. In the electrically noisy intensive care unit, identifying and eliminating interference and artifact allow accurate diagnoses from the EEG, avoiding unnecessary treatment or sedation. METHODS: We present a case during Impella (Abiomed Inc, Danvers, MA) continuous flow left ventricular assist device use where the EEG artifact was initially misinterpreted as seizure by the resident and treated as status epilepticus because of the "focal" sharply contoured repetitive pattern...
April 16, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29660507/does-semiology-of-status-epilepticus-have-an-impact-on-treatment-response-and-outcome
#8
Leyla Baysal-Kirac, Berend Feddersen, Marion Einhellig, Jan Rémi, Soheyl Noachtar
OBJECTIVE: This study investigated whether there is an association between semiology of status epilepticus (SE) and response to treatment and outcome. METHOD: Two hundred ninety-eight consecutive adult patients (160 females, 138 males) with SE at the University of Munich Hospital were prospectively enrolled. Mean age was 63.2±17.5 (18-97) years. Patient demographics, SE semiology and electroencephalography (EEG) findings, etiology, duration of SE, treatment, and outcome measures were investigated...
April 13, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29653194/chronic-agomelatine-treatment-prevents-comorbid-depression-in-the-post-status-epilepticus-model-of-acquired-epilepsy-through-suppression-of-inflammatory-signaling
#9
Jana Tchekalarova, Dimitrinka Atanasova, Lidia Kortenska, Milena Atanasova, Nikolai Lazarov
Inflammatory signal molecules are suggested to be involved in the mechanism underlying comorbid depression in epilepsy. In the present study, we tested the hypothesis that the novel antidepressant agomelatine, a potent melatonin MT1 and MT2 receptor agonist and serotonin 5HT2C receptor antagonist, can prevent depressive symptoms developed during the chronic epileptic phase by suppressing an inflammatory response. Chronic treatment with agomelatine (40 mg/kg, i.p.) was initiated an hour after the kainate acid (KA)-induced status epilepticus (SE) and maintained for a period of 10 weeks in Wistar rats...
April 10, 2018: Neurobiology of Disease
https://www.readbyqxmd.com/read/29650639/non-convulsive-status-epilepticus-mimics-and-chameleons
#10
REVIEW
Michael Owen Kinney, John J Craig, P W Kaplan
Non-convulsive status epilepticus (NCSE) is an enigmatic condition with protean manifestations. It often goes unrecognised, leading to delays in its diagnosis and treatment. The principal reason for such delay is the failure to consider and request an electroencephalogram (EEG), although occasional presentations have no scalp or surface electroencephalographic correlate. In certain settings with limited EEG availability, particularly out-of-hours, clinicians should consider treating without an EEG. Patients need a careful risk-benefit analysis to assess the risks of neuronal damage and harm versus the risks of adverse effects from various intensities of therapeutic intervention...
April 12, 2018: Practical Neurology
https://www.readbyqxmd.com/read/29648925/intravenous-carbamazepine-for-the-treatment-of-epilepsy
#11
Francesco Brigo, Antonio Leo, Emilio Russo, Pasquale Striano, Vincenzo Belcastro
Recently, an intravenous formulation of carbamazepine (CBZ) (sulphobutylether-7-beta-cyclodextrine carbamazepine, SBECD CBZ) has been developed and approved by the U.S. Food and Drug Administration. It is indicated as a short-term replacement therapy for oral CBZ formulations, when oral administration is temporarily not feasible and in adults with focal seizures with complex symptomatology as well as generalized tonic-clonic seizures and mixed seizure patterns. Areas covered: This review focuses on the drug development, pharmacokinetics and pharmacodynamics of intravenous CBZ and provides a comprehensive overview of the studies assessing its clinical efficacy, tolerability and safety in adults with epilepsy...
April 12, 2018: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/29644157/persistent-bradycardia-with-the-long-term-use-of-phenytoin-and-oxycodone-first-case-report
#12
Intekhab Askari Syed, Aaron R Kuzel, Muhammad Uzair Lodhi, Waliul Chowdhury, Umar Rahim, Mustafa Rahim
Phenytoin is a medication that is used primarily in the treatment of epilepsy as well as generalized tonic-clonic seizures and status epilepticus. Phenytoin is also considered a class IB antiarrhythmic medication by shortening the duration of the action potential and increasing myocardial conduction. The neurologic adverse effects of phenytoin are well-documented and include altered mental status, ataxia, and nystagmus. Some adverse cardiac manifestations have also been reported, including arrhythmias, hypotension, and respiratory arrest...
February 8, 2018: Curēus
https://www.readbyqxmd.com/read/29643084/factors-associated-with-treatment-delays-in-pediatric-refractory-convulsive-status-epilepticus
#13
I Sánchez Fernández, M Gaínza-Lein, N S Abend, A E Anderson, R Arya, J N Brenton, J L Carpenter, K E Chapman, J Clark, W D Gaillard, T A Glauser, J L Goldstein, H P Goodkin, A R Helseth, M C Jackson, K Kapur, Y-C Lai, T L McDonough, M A Mikati, A Nayak, K Peariso, J J Riviello, R C Tasker, D Tchapyjnikov, A A Topjian, M S Wainwright, A Wilfong, K Williams, T Loddenkemper
OBJECTIVE: To identify factors associated with treatment delays in pediatric patients with convulsive refractory status epilepticus (rSE). METHODS: This prospective, observational study was performed from June 2011 to March 2017 on pediatric patients (1 month to 21 years of age) with rSE. We evaluated potential factors associated with increased treatment delays in a Cox proportional hazards model. RESULTS: We studied 219 patients (53% males) with a median (25th-75th percentiles [p25 -p75 ]) age of 3...
April 11, 2018: Neurology
https://www.readbyqxmd.com/read/29625197/a-single-subconvulsant-dose-of-domoic-acid-at-mid-gestation-does-not-cause-temporal-lobe-epilepsy-in-mice
#14
Fanny Demars, Kristen Clark, Megan S Wyeth, Emily Abrams, Paul S Buckmaster
Harmful blooms of domoic acid (DA)-producing algae are a problem in oceans worldwide. DA is a potent glutamate receptor agonist that can cause status epilepticus and in survivors, temporal lobe epilepsy. In mice, one-time low-dose in utero exposure to DA was reported to cause hippocampal damage and epileptiform activity, leading to the hypothesis that unrecognized exposure to DA from contaminated seafood in pregnant women can damage the fetal hippocampus and initiate temporal lobe epileptogenesis. However, development of epilepsy (i...
April 3, 2018: Neurotoxicology
https://www.readbyqxmd.com/read/29624640/why-we-prefer-levetiracetam-over-phenytoin-for-treatment-of-status-epilepticus
#15
G Zaccara, F S Giorgi, A Amantini, G Giannasi, R Campostrini, F Giovannelli, M Paganini, P Nazerian
Over last fifty years, intravenous (iv) phenytoin (PHT) loading dose has been the treatment of choice for patients with benzodiazepine-resistant convulsive status epilepticus and several guidelines recommended this treatment regimen with simultaneous iv diazepam. Clinical studies have never shown a better efficacy of PHT over other antiepileptic drugs. In addition, iv PHT loading dose is a complex and time-consuming procedure which may expose patients to several risks, such as local cutaneous reactions (purple glove syndrome), severe hypotension and cardiac arrhythmias up to ventricular fibrillation and death, and increased risk of severe allergic reactions...
April 6, 2018: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/29623064/predictability-and-resetting-in-a-case-of-convulsive-status-epilepticus
#16
Timothy Hutson, Diana Pizarro, Sandipan Pati, Leon D Iasemidis
In this case study, we present evidence of resetting of brain dynamics following convulsive status epilepticus (SE) that was treated successfully with antiepileptic medications (AEDs). The measure of effective inflow (EI), a novel measure of network connectivity, was applied to the continuously recorded multichannel intracranial stereoelectroencephalographic (SEEG) signals before, during and after SE. Results from this analysis indicate trends of progressive reduction of EI over hours up to the onset of SE, mainly at sites of the epileptogenic focus with reversal of those trends upon successful treatment of SE by AEDs...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29623027/preclinical-to-clinical-translation-of-studies-of-transcranial-direct-current-stimulation-in-the-treatment-of-epilepsy-a-systematic-review
#17
Gabriela G Regner, Patrícia Pereira, Douglas T Leffa, Carla de Oliveira, Rafael Vercelino, Felipe Fregni, Iraci L S Torres
Epilepsy is a chronic brain syndrome characterized by recurrent seizures resulting from excessive neuronal discharges. Despite the development of various new antiepileptic drugs, many patients are refractory to treatment and report side effects. Non-invasive methods of brain stimulation, such as transcranial direct current stimulation (tDCS), have been tested as alternative approaches to directly modulate the excitability of epileptogenic neural circuits. Although some pilot and initial clinical studies have shown positive results, there is still uncertainty regarding the next steps of investigation in this field...
2018: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/29620008/de-novo-late-onset-absence-status-epilepticus-or-late-onset-idiopathic-generalized-epilepsy-a-case-report-and-systematic-review-of-the-literature
#18
Francesco Brigo, Veronica Tavernelli, Raffaele Nardone, Eugen Trinka
Idiopathic (genetic) generalized epilepsies (IGEs) are age-related epileptic syndromes with typical age onset in childhood or adolescence. We report a patient with de novo late-onset absence status epilepticus (ASE) occurring at the age of 64 years, with clinical and EEG features suggestive of late-onset IGE. We also discuss the relationship between de novo late-onset ASE and late-onset IGE, and provide a comprehensive and critical review of the available literature on late-onset (i.e. onset ≥60 years) IGE...
April 5, 2018: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/29609074/combination-of-intravenous-immunoglobulin-and-steroid-pulse-therapy-improves-outcomes-of-febrile-refractory-status-epilepticus
#19
Jainn-Jim Lin, Yu Wang, Shih-Yun Lan, Oi-Wa Chan, Shao-Hsuan Hsia, Min-Liang Chou, Po-Cheng Hung, Meng-Ying Hsieh, I-Jun Chou, Huei-Shyong Wang, Kuang-Lin Lin
BACKGROUND: Febrile infections are an important cause of paediatric refractory status epilepticus, and immune-mediated mechanisms and inflammatory processes have been associated with neurological manifestations in such patients. The aim of this study was to investigate the effects of immunotherapy as adjuvant treatment for febrile refractory status epilepticus. METHODS: We retrospectively reviewed cases of febrile refractory status epilepticus in a paediatric intensive care unit between January 2000 and December 2013 and analysed their clinical characteristics...
March 26, 2018: Epilepsy Research
https://www.readbyqxmd.com/read/29600811/outcome-prediction-in-patients-with-acute-repetitive-seizures-application-of-the-status-epilepticus-severity-score
#20
Sebastian Szklener, Magdalena Godek, Agnieszka Korchut, Luiza Balicka-Adamik, Robert Rejdak, Andrea O Rossetti, Konrad Rejdak
Acute repetitive seizures (ARS) pose a risk of hospital admission with status epilepticus and a mortality threat, which underscores the need for the early prediction of a clinical course. Unfortunately, little attention has been given to ARS in this context, even though we possess the appropriate predictive tools for the stages of status epilepticus. Therefore, the main aim of this study was to assess the prognostic value of the Status Epilepticus Severity Score (STESS) in the population of patients with ARS...
March 30, 2018: Epilepsia
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