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https://www.readbyqxmd.com/read/28926844/atypical-presentation-of-a-pediatric-cerebellar-ganglioglioma
#1
Richard Bram, Roberta J Seidman, David Chesler
BACKGROUND/AIMS: Gangliogliomas (GGs) are rare central nervous system tumors occurring primarily in the supratentorial compartment with infratentorial instances most often involving the brain stem. Infratentorial GGs typically present with signs and symptoms of increased intracranial pressure (ICP), cranial nerve deficits, or focal cerebellar findings; rarely, these tumors have been associated with focal seizures. METHODS: In this report, we describe an atypical presentation of a cerebellar GG in a 20-month-old male who initially presented with syncope and emesis in the absence of electrographic evidence of seizures, radiographic evidence of hydrocephalus, or elevated ICP...
September 20, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28900842/early-postictal-serum-lactate-concentrations-are-superior-to-serum-creatine-kinase-concentrations-in-distinguishing-generalized-tonic-clonic-seizures-from-syncopes
#2
Oliver Matz, Jan Heckelmann, Sebastian Zechbauer, Jens Litmathe, Jörg C Brokmann, Klaus Willmes, Jörg B Schulz, Manuel Dafotakis
Concentrations of serum creatine kinase (CK) and serum lactate are frequently measured to help differentiate between generalized tonic-clonic seizures (GTCS) and syncope. The aim of this prospective cohort study was to systematically compare these two markers. The primary outcome is the measurement of serum lactate and CK in blood samples drawn within 2 h of the event in patients admitted with either a GTCS (n = 49) or a syncope (n = 36). Furthermore, the specificity and sensitivity of serum lactate and CK are determined as diagnostic markers in distinguishing between GTCS and syncope...
September 12, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28869205/ictal-asystole-in-a-patient-with-posterior-reversible-encephalopathy-syndrome-pres-and-seizures
#3
Joanna Suski, Reginald Ho, Maromi Nei
We describe a case of ictal asystole in a patient with posterior reversible encephalopathy syndrome (PRES), which has never been described previously. Ictal asystole is rare and has possible serious medical consequences, including syncope, and may be a potential mechanism for sudden unexpected death in epilepsy (SUDEP). Awareness that PRES may be observed with recurrent ictal asystole may aid in the recognition and treatment of seizures in this condition and the prevention of asystole-associated complications...
September 4, 2017: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/28842725/-diagnosis-of-non-epileptic-paroxysmal-disorders-and-epileptic-seizures
#4
REVIEW
S Noachtar, B Güldiken
Non-epileptic paroxysmal disorders may clinically manifest in a similar way to epileptic seizures and have to be considered in the differential diagnosis of epilepsy. Syncope, non-epileptic psychogenic seizures, paroxysmal movement disorders, migraine, transient ischemic attacks and parasomnia constitute the major differential diagnoses. A meticulous history and a third party description are useful for the differential diagnosis. Neurological, psychiatric and cardiological examinations are required for the correct differential diagnosis...
August 25, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28833993/high-fidelity-simulation-in-training-dental-students-for-medical-life-threatening-emergency
#5
E Roy, V E Quinsat, O Bazin, P Lesclous, C Lejus-Bourdeau
INTRODUCTION: Any dental surgeon may be faced with a critical life-threatening emergency situation. In our university, all students in dentistry receive a standard course on emergency first aid. The aim of this prospective, comparative, single-centre study was to determine whether additional training on a high-fidelity patient simulator would improve student performance. METHODS: After approval by an Ethical Committee and written informed consent, the students of the Simulation group (n=42) had full-scale high-fidelity training on a patient simulator SimMan 3G(™) (3 hours by six students)...
August 23, 2017: European Journal of Dental Education: Official Journal of the Association for Dental Education in Europe
https://www.readbyqxmd.com/read/28815953/epilepsy-in-fragile-x-syndrome-mimicking-panayiotopoulos-syndrome-description-of-three-patients
#6
Paolo Bonanni, Susanna Casellato, Franco Fabbro, Susanna Negrin
Fragile-X-syndrome is the most common cause of inherited intellectual disability. Epilepsy is reported to occur in 10-20% of individuals with Fragile-X-syndrome. A frequent seizure/electroencephalogram (EEG) pattern resembles that of benign rolandic epilepsy. We describe the clinical features, EEG findings and evolution in three patients affected by Fragile-X-syndrome and epilepsy mimicking Panayiotopoulos syndrome. Age at seizure onset was between 4 and about 7 years. Seizures pattern comprised a constellation of autonomic symptoms with unilateral deviation of the eyes and ictal syncope...
August 16, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28806632/clinical-utility-of-serum-lactate-levels-for-differential-diagnosis-of-generalized-tonic-clonic-seizures-from-psychogenic-nonepileptic-seizures-and-syncope
#7
Ebru Apaydın Doğan, Ali Ünal, Aslıhan Ünal, Çağla Erdoğan
BACKGROUND: The differential diagnosis of generalized tonic-clonic seizures (GTCS), psychogenic nonepileptic seizures (PNES), and syncope constitutes a major challenge. Misdiagnosis rates up to 20 to 30% are reported in the literature. PURPOSE: To assess the clinical utility of serum lactate levels for differentiation of GTCS, PNES, and syncope based on gender differences. METHODS: Data from 270 patients were evaluated retrospectively. Only patients ≥18 years old with the final diagnosis of GTCS, PNES, or syncope in their chart were recruited...
August 11, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28790826/convulsive-syncope-related-to-a-small-dose-of-quetiapine-in-an-adolescent-with-bipolar-disorder
#8
Jianbo Lai, Qiaoqiao Lu, Tingting Huang, Shaohua Hu, Yi Xu
Quetiapine, an atypical antipsychotic, has been extensively used in patients with bipolar disorder. Overdose of quetiapine can result in severe complications, such as coma, seizure, respiratory depression, arrhythmia, and even death. However, the paucity of toxicological evaluation in adolescence causes more potential risks in this population. Herein, we present a case of hypotension and convulsive syncope after exposure to a small dose of quetiapine in a 16-year-old who was diagnosed with bipolar disorder...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28752154/epidemiology-pathophysiology-clinical-evaluation-and-treatment-of-carbon-monoxide-poisoning-in-child-infant-and-fetus
#9
REVIEW
Atilla Alp Gozubuyuk, Huseyin Dag, Alper Kacar, Yakup Karakurt, Vefik Arica
Carbon monoxide (CO) poisoning is one of the most common types of poisoning causing death worldwide. In our country, it occurs particularly during winter as a result of leak from stove or water heater, or as result of inhalation during a fire. Although most poisonings occur accidentally, some cases are suicide attempt. As CO is a substance that is not visible and has no taste or smell and is therefore difficult to detect, the gas can be a "silent killer" that is not noticed until effects develop. CO reacts with oxygen, creating carboxy hemoglobin (COHb), which leads to tissue hypoxia...
2017: Northern Clinics of Istanbul
https://www.readbyqxmd.com/read/28750691/the-use-of-interpreters-in-medical-triage-during-a-refugee-mass-gathering-incident-in-europe
#10
Lykourgos Christos Alexakis, Anastasia Papachristou, Chiara Baruzzi, Angeliki Konstantinou
Introduction During a refugees' mass-gathering incident in Kos Island, Greece, Médecins Sans Frontières (MSF; Brussels, Belgium) teams provided emergency medical care. A case report of the event focusing on difficulties encountered by the interpreters during triage and emergency response was prepared. METHODS: Data collected during the event were reviewed from the patient's register and qualitative interviews were obtained from the MSF interpreters involved in the response. In addition, a description of the event and a literature review were included...
July 28, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28747444/recurrence-risk-of-ictal-asystole-in-epilepsy
#11
REVIEW
Kevin G Hampel, Roland D Thijs, Christian E Elger, Rainer Surges
OBJECTIVE: To determine the recurrence risk of ictal asystole (IA) and its determining factors in people with epilepsy. METHODS: We performed a systematic review of published cases with IA in 3 databases and additionally searched our local database for patients with multiple seizures simultaneously recorded with ECG and EEG and at least one IA. IA recurrence risk was estimated by including all seizures without knowledge of the chronological order. Various clinical features were assessed by an individual patient data meta-analysis...
August 22, 2017: Neurology
https://www.readbyqxmd.com/read/28728690/contemporary-outcomes-in-patients-with%C3%A2-long-qt-syndrome
#12
Ram K Rohatgi, Alan Sugrue, J Martijn Bos, Bryan C Cannon, Samuel J Asirvatham, Christopher Moir, Heidi J Owen, Katy M Bos, Teresa Kruisselbrink, Michael J Ackerman
BACKGROUND: Long QT syndrome (LQTS) is a potentially lethal cardiac channelopathy with a 1% to 5% annual risk of LQTS-triggered syncope, aborted cardiac arrest, or sudden cardiac death. OBJECTIVES: This study sought to evaluate LQTS outcomes from a single center in the contemporary era. METHODS: The authors conducted a retrospective study comprising the 606 patients with LQTS (LQT1 in 47%, LQT2 in 34%, and LQT3 in 9%) who were evaluated in Mayo Clinic's Genetic Heart Rhythm Clinic from January 1999 to December 2015...
July 25, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28667576/can-syncope-cause-convulsive-seizures-in-adults
#13
Dearbhla M Kelly, Daniel J Costello
PURPOSE: Convulsive epileptic seizures triggered by transient cerebral hypoperfusion 'reflex anoxic seizures' are well-described in children but are not commonly recognized in adults. METHODS: We report a case series of 12 adults who presented acutely after generalized tonic-clonic seizures with a clear syncopal phase before the convulsion. We describe the aetiology, semiology and natural history of these events. RESULTS: Four patients (33...
August 2017: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/28622073/neighborhood-poverty-and-9-1-1-ambulance-contacts
#14
Josh Seim, Joshua English, Karl Sporer
BACKGROUND: Neighborhood poverty is positively associated with frequency of 9-1-1 ambulance utilization, but it is unclear whether this association remains significant when accounting for variations in the severities and types of ambulance contacts. METHODS: We merged EMS ambulance contact records in a single California county (n = 88,027) with data from the American Community Survey at the census tract level (n = 300). Using tract as a proxy for neighborhood and negative binomial regression as an analytical tool, we predicted 16 outcomes: any ambulance contacts, ambulance contacts stratified by three intervention severities, and ambulance contacts varied by 12 primary impression categories...
June 16, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28520630/diagnostic-yield-of-routine-electroencephalography-with-concurrent-video-recording-in-detecting-interictal-epileptiform-discharges-in-relation-to-reasons-for-request-a-prospective-study-of-1-080-video-electroencephalograms
#15
Laia Grau-López, Marta Jiménez, Jordi Ciurans, Sonia Barambio, Alejandra Fumanal, Juan L Becerra
PURPOSE: The aim of this study was to prospectively analyze the sensitivity and specificity of routine electroencephalography with concurrent video recording (vEEG) in relation to the reasons for requesting the test and to investigate when routine vEEG should be requested. METHODS: We prospectively analyzed 1,080 consecutive vEEGs performed between April 2015 and April 2016. The requests for vEEG were classified as requests with a low suspicion of epilepsy (syncope, confusion or delirium, suspicion of psychogenic nonepileptic seizures, and paroxysmal focal neurological deficit) or requests with a high suspicion of epilepsy (first clinical seizure, suspected status epilepticus, follow-up study of a patient with epilepsy, and acute symptomatic seizures)...
May 16, 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28490286/loss-of-consciousness-collapse-and-associated-driving-restrictions-a-retrospective-case-note-review-an-important-reminder-regarding-driving-restrictions
#16
Adam Williamson, Scott Muir
Background and aims National guidelines outlining medical standards for fitness to drive are provided by The Driver and Vehicle Licensing Agency. We aimed to establish whether patients presenting with collapse or loss of consciousness received documented advice regarding driving restrictions, if appropriate for their working diagnosis. Methods and results A retrospective case note review was undertaken over a four-month period for emergency patients clinically coded as seizure/convulsion (R568) and collapse/syncope (R55X); 163 patients had a primary or working diagnosis on discharge that suggested driving status and restrictions could have been reviewed...
January 1, 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28445305/a-case-report-of-painless-type-a-aortic-dissection-with-intermittent-convulsive-syncope-as-initial-presentation
#17
Chun-Hsien Chen, Kuan-Ting Liu
RATIONALE: The initial presenting symptoms and signs of acute aortic dissection are so diverse that it makes early and accurate diagnosis arduous. Painless and convulsive syncope due to cardiac arrhythmia were not typical presentations of acute aortic dissection. PATIENT CONCERNS: A 61-year-old male presenting with transient consciousness loss and suspected seizure attack was sent to emergency room (ER) by ambulance. Consciousness loss accompanying with upward gaze and limb convulsion was noted in ER, and electrocardiogram monitor recorded a transient cardiac asystole then spontaneous recovery of sinus rhythm...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28403704/nursing-management-of-reflex-anoxic-seizures-in-children
#18
Neal Patel, Rowan Kerr-Liddell, Louise Challis, Siba Prosad Paul
Children who present with transient loss of consciousness (T-LOC) are often first seen in emergency departments (EDs). Reflex anoxic seizure (RAS), vasovagal syncope and prolonged respiratory apnoea are benign, syncopal events that can be generally managed by explanation and reassurance. RAS is a short, paroxysmal, self-reverting episode of asystole that is triggered by pain, fear or anxiety and is caused by increased vagal response. It is an important differential diagnosis in pre-school age children who present with T-LOC, but is often underdiagnosed and can sometimes be misdiagnosed as epilepsy...
April 13, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28371670/panic-symptoms-in-transient-loss-of-consciousness-frequency-and-diagnostic-value-in-psychogenic-nonepileptic-seizures-epilepsy-and-syncope
#19
G H Rawlings, J Jamnadas-Khoda, M Broadhurst, R A Grünewald, S J Howell, M Koepp, S W Parry, S M Sisodiya, M C Walker, M Reuber
PURPOSE: Previous studies suggest that ictal panic symptoms are common in patients with psychogenic nonepileptic seizures (PNES). This study investigates the frequency of panic symptoms in PNES and if panic symptoms, just before or during episodes, can help distinguish PNES from the other common causes of transient loss of consciousness (TLOC), syncope and epilepsy. METHODS: Patients with secure diagnoses of PNES (n=98), epilepsy (n=95) and syncope (n=100) were identified using clinical databases from three United Kingdom hospitals...
March 27, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28236737/panayiotopoulos-syndrome-with-a-special-emphasis-of-ictal-semiologic-features
#20
A Destina Yalçın, Hülya Ertaşoğlu Toydemir
PURPOSE: The aim was to identify the demographic, electroencephalographic findings, clinical features, especially ictal semiological symptoms of patients diagnosed with Panayiotopoulos Syndrome. METHOD: The semiologic and EEG findings of 42 patients were reviewed. Statistical analysis was used to determine the frequencies of semiologic features and to define the symptom clusters. RESULTS: The most common clinical features were nausea (54.8%), vomiting (50...
March 2017: Epilepsy Research
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