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https://www.readbyqxmd.com/read/28007363/an-emergency-medicine-focused-review-of-seizure-mimics
#1
James Webb, Brit Long, Alex Koyfman
BACKGROUND: Seizures result in a change in motor, sensory, and behavioral symptoms caused by abnormal neurologic electrical activity. The symptoms share similar presentations of several other conditions, leading to difficulties in diagnosis and frequent improper management. OBJECTIVE: This review evaluates adult patients with suspected seizure, signs and symptoms of seizure, mimics of seizure, and an approach to management of seizure mimics. DISCUSSION: A seizure is caused by abnormal neurologic electrical activity resulting in altered motor, sensory, and behavioral symptoms...
December 19, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27988446/a-novel-variant-in-ryr2-causes-familiar-catecholaminergic-polymorphic-ventricular-tachycardia
#2
Cristina Bosch, Oscar Campuzano, Georgia Sarquella-Brugada, Sergi Cesar, Alexandra Perez-Serra, Monica Coll, Irene Mademont, Jesus Mates, Bernat Del Olmo, Anna Iglesias, Josep Brugada, Volker Petersen, Ramon Brugada
Catecholaminergic polymorphic ventricular tachycardia is a rare familial arrhythmogenic disease. It usually occurs in juvenile patients with a structurally normal heart and causes exercise-emotion triggered syncope and sudden cardiac death. The main gene associated with catecholaminergic polymorphic ventricular tachycardia is RyR2, encoding the cardiac ryanodine receptor protein which is involved in calcium homeostasis. After the identification of a 16 year-old man presenting with exercise-induced sudden cardiac death, clinically diagnosed as catecholaminergic polymorphic ventricular tachycardia, we collected the family information and performed a comprehensive genetic analysis using Next Generation Sequencing technology...
December 9, 2016: Forensic Science International
https://www.readbyqxmd.com/read/27932282/serum-cardiac-troponin-i-in-canine-syncope-and-seizures
#3
E Dutton, J Dukes-McEwan, P J Cripps
OBJECTIVE: To determine if serum cardiac troponin I (cTnI) concentration distinguishes between cardiogenic syncope and collapsing dogs presenting with either generalized epileptic seizures (both with and without cardiac disease) or vasovagal syncope. ANIMALS: Seventy-nine prospectively recruited dogs, grouped according to aetiology of collapse: generalized epileptic seizures (group E), cardiogenic syncope (group C), dogs with both epileptic seizures and cardiac disease (group B), vasovagal syncope (group V) or unclassified (group U)...
December 5, 2016: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
https://www.readbyqxmd.com/read/27869560/syncope-seizure-or-both
#4
Paraskevi Koutrolou-Sotiropoulou, Abhijeet Singh, Mason Leeman-Markowski, Eric J Rashba
Ictal asystole (IA) is a rare phenomenon in patients with seizures with an incidence of 0.27-0.4% and has been proposed as a possible mechanism of sudden unexpected death in epilepsy patients (SUDEP). We present a case of a 53-year-old woman who initially presented with episodes of expressive aphasia and was treated with antiepileptic drugs (AEDs). While on therapy she experienced episodes of syncope. During her hospitalization for tapering of AEDs and 24-hour EEG monitoring, the patient developed a seizure followed by sinus bradycardia and an 18-second sinus pause, resulting in loss of consciousness and slowing of cerebral activity...
November 21, 2016: Acute Cardiac Care
https://www.readbyqxmd.com/read/27868350/an-elderly-jervell-and-lange-nielsen-patient-heterozygous-compound-for-two-new-kcnq1-mutations
#5
Eliecer Coto, Francisco J García-Fernández, David Calvo, Ricardo Salgado-Aranda, Javier Martín-González, Belén Alonso, Sara Iglesias, Juan Gómez
We present the case of a 66-year-old female with early onset deafness and seizures, who was diagnosed with epilepsy at the age of 2 years. She received antiepileptic drugs and was free of syncope episodes for 32 years. After a syncope at the age of 34, the ECG was characteristic of long-QT syndrome and was treated with antiarrhythmic drugs. Sequencing of the KCNQ1 gene identified two novel KCNQ1 variants interpreted to be pathogenic, and the patient was finally diagnosed with Jervell and Lange-Nielsen syndrome...
November 21, 2016: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/27845151/data-fusion-for-paroxysmal-events-classification-from-eeg
#6
Evangelia Pippa, Evangelia I Zacharaki, Michael Koutroumanidis, Vasileios Megalooikonomou
BACKGROUND: Spatiotemporal analysis of electroencephalography is commonly used for classification of events since it allows capturing dependencies across channels. The significant increase of feature vector dimensionality however introduce noise and thus it does not allow the classification models to be trained using a limited number of samples usually available in clinical studies. NEW METHOD: Thus, we investigate the classification of epileptic and non-epileptic events based on temporal and spectral analysis through the application of three different fusion schemes for the combination of information across channels...
January 1, 2017: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/27843098/the-heart-of-epilepsy-current-views-and-future-concepts
#7
S Shmuely, M van der Lende, R J Lamberts, J W Sander, R D Thijs
Cardiovascular (CV) comorbidities are common in people with epilepsy. Several mechanisms explain why these conditions tend to co-exist including causal associations, shared risk factors and those resulting from epilepsy or its treatment. Various arrhythmias occurring during and after seizures have been described. Ictal asystole is the most common cause. The converse phenomenon, arrhythmias causing seizures, appears extremely rare and has only been reported in children following cardioinihibitory syncope. Arrhythmias in epilepsy may not only result from seizure activity but also from a shared genetic susceptibility...
October 26, 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/27798055/exercise-induced-syncope-in-a-22-year-old-man
#8
Colin Yeo, Vern Hsen Tan, Kelvin Ck Wong
A 22-year-old man was referred to us for syncope during a game of Captain's ball. There was no prodrome. His friends did not notice any ictal movements. He was otherwise well prior to passing out. He was not taking any medications or supplements. He was not usually physically active, but was otherwise well with no significant medical history. This is his first episode of syncope. There was no history of cardiac arrest or seizures. There is no family history of premature sudden cardiac death.Physical examination was normal...
October 25, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27780653/clinical-mimics-an-emergency-medicine-focused-review-of-stroke-mimics
#9
Brit Long, Alex Koyfman
BACKGROUND: Stroke is a leading cause of death and disability and most commonly presents with focal neurologic deficit within a specific vascular distribution. Several other conditions may present in a similar manner. OBJECTIVES: This review provides emergency providers with an understanding of stroke mimics, use of thrombolytics in these mimics, and keys to differentiate true stroke from mimic. DISCUSSION: Stroke has significant morbidity and mortality, and the American Heart Association emphasizes rapid recognition and aggressive treatment for patients with possible stroke-like symptoms, including thrombolytics...
October 22, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27762118/fahr-s-disease-with-seizure-presentation
#10
Rangaswamy, V Ranjith, L Vikas, R Santosh
Fahr's disease or Fahr's syndrome is a rare neurodegenerative disorder characterized by abnormal symmetrical calcifications of the basal ganglia, thalami, sub-cortical hemispheric white matter and deep cerebellar nuclei. It can be idiopathic or associated with an endocrinopathy, frequently with parathyroid disorder. Clinical spectrum of the disease is wide ranging from neurological features like seizure, syncope, stroke like events, extra-pyramidal symptoms often combined with frontal sub-cortical pattern of behavioural dysfunction and psychiatric symptoms such as psychosis, mood disorder and dementia...
August 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27719851/psychogenic-nonepileptic-seizures-eeg-and-investigation
#11
R Duncan
In the investigation of psychogenic nonepileptic seizures (PNES), the main differential diagnoses are between convulsive PNES and tonic-clonic seizures, between swoon PNES and syncope, and between pseudoabsence PNES and absence seizures. For the best diagnostic certainty, events must be captured, ideally using video-electroencephalogram (EEG), including an electrocardiographic channel. The "video" part of video-EEG allows EEG changes (or lack of them) to be interpreted in the appropriate clinical context. When the diagnosis is based on less good data (e...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27719848/nonepileptic-seizures-subjective-phenomena
#12
M Reuber, G H Rawlings
Psychogenic nonepileptic seizures (PNES) superficially resemble epileptic seizures or syncope and most patients with PNES are initially misdiagnosed as having one of the latter two types of transient loss of consciousness. However, evidence suggests that the subjective seizure experience of PNES and its main differential diagnoses are as different as the causes of these three disorders. In spite of this, and regardless of the fact that PNES are considered a mental disorder in the current nosologies, research has only given limited attention to the subjective symptomatology of PNES...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27697802/stroke-mimic-diagnoses-presenting-to-a-hyperacute-stroke-unit
#13
Ang Dawson, Geoffrey C Cloud, Anthony C Pereira, Barry J Moynihan
Stroke services have been centralised in several countries in recent years. Diagnosing acute stroke is challenging and a high proportion of patients admitted to stroke units are diagnosed as a non-stroke condition (stroke mimics). This study aims to describe the stroke mimic patient group, including their impact on stroke services. We analysed routine clinical data from 2,305 consecutive admissions to a stroke unit at St George's Hospital, London. Mimic groupings were derived from 335 individual codes into 17 groupings...
October 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27688429/medical-emergencies-in-pediatric-dentistry
#14
REVIEW
Dubravka Negovetić Vranić, Josipa Jurković, Jesenka Jeličić, Antonija Balenović, Gordana Stipančić, Ivana Čuković-Bagić
Medical emergencies that are life threatening can occur in dental practice. Complications may arise because of an underlying disease or a reaction to medication. Reactions to medications may be allergic and toxic. The most common reactions are toxic reactions to local anesthetics, whereas allergies occur mainly as a consequence of the application of antibiotics, usually penicillin. In response to stress, vasovagal syncope typically occurs. Other causes may be related to an underlying disease-specific pathology (such as acute asthma attack, diabetic ketoacidosis, hypoglycemia, or seizures) or accidents (aspiration of a foreign body causing obstruction of the respiratory system)...
March 2016: Acta Stomatologica Croatica
https://www.readbyqxmd.com/read/27549906/seizure-related-modulation-of-systemic-arterial-blood-pressure-in-focal-epilepsy
#15
Kevin G Hampel, Amirhossein Jahanbekam, Christian E Elger, Rainer Surges
OBJECTIVE: Cardiorespiratory function alterations are commonly observed with epileptic seizures and may lead to syncope and sudden unexpected death in epilepsy (SUDEP). Although most previous research has focused on controlling heart rate (HR) and respiration, little is known about seizure-related regulation of systemic blood pressure (BP). Herein, we have investigated whether the periictal modulation of systemic BP and HR depends on seizure characteristics. METHODS: Systemic arterial BP, HR, and peripheral capillary oxygen saturation (SPO2 ) were continuously and noninvasively monitored using the ccNexfin device in those epilepsy patients undergoing video-electroencephalography (EEG) telemetry...
October 2016: Epilepsia
https://www.readbyqxmd.com/read/27510871/-clinical-and-genetic-characteristics-and-detection-of-urinary-pipecolic-acid-in-pyridoxine-dependent-epilepsy
#16
J Xue, Z X Yang, H Li, P Qian, Y Wu, Y W Jiang, X Y Liu
OBJECTIVE: To analyze the clinical and genetic characteristics of patients with pyridoxine dependent epilepsy (PDE), and build a method to detect and analyze the concentration of urinary pipecolic acid in PDE patients receiving pyridoxine treatment. METHOD: Twelve patients (8 were male, 4 were female) were diagnosed as PDE in Peking University First Hospital between April 2012 and September 2015. The clinical manifestations, diagnosis and treatment process, video-electroencephalogram, magnetic resonance imaging were retrospectively analyzed...
August 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/27506513/challenges-in-the-first-seizure-clinic-for-adult-patients-with-epilepsy
#17
Anvesh Jackson, Louise Teo, Udaya Seneviratne
AIMS: (1) To delineate the challenges in seizure diagnosis in the first seizure clinic setting for adult patients of a teaching hospital, and (2) quantify the diagnostic accuracy of the referral source and the yield of routine investigations, including blood tests, EEGs, and neuroimaging. METHODS: We retrospectively reviewed medical records of patients referred by the emergency department to the adult first seizure clinic and seen by the same epilepsy specialist between June 2007 and June 2011...
September 1, 2016: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/27486953/comparison-of-semiologies-between-tilt-induced-psychogenic-nonsyncopal-collapse-and-psychogenic-nonepileptic-seizures
#18
Geoffrey L Heyer, Dara V F Albert, Amanda Weber, Satyanarayana Gedela, Jorge Vidaurre
We sought to characterize the clinical features of tilt-induced psychogenic nonsyncopal collapse (PNSC) from a cohort of young patients and to compare the semiologies between PNSC and EEG-confirmed psychogenic nonepileptic seizures (PNES). A PNSC diagnosis was made if a clinical event occurred during tilt-table testing that the patient regarded as fainting, but neither hypotension nor EEG changes were present. A diagnosis of PNSC was made in 17.6% of all patients referred during the 15-month study period. Cohorts with psychogenic nonsyncopal collapse (n=40) and PNES (n=40) did not differ in age (15...
September 2016: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/27485560/phenotype-guided-characterization-and-molecular-analysis-of-indian-patients-with-long-qt-syndromes
#19
Bijal Vyas, Ratna D Puri, Narayanan Namboodiri, Renu Saxena, Mohan Nair, Prahlad Balakrishnan, M P Jayakrishnan, Ameya Udyavar, Ravi Kishore, Ishwar C Verma
BACKGROUND: Long QT syndromes (LQTS) are characterized by prolonged QTc interval on electrocardiogram (ECG) and manifest with syncope, seizures or sudden cardiac death. Long QT 1-3 constitute about 75% of all inherited LQTS. We classified a cohort of Indian patients for the common LQTS based on T wave morphology and triggering factors to prioritize the gene to be tested. We sought to identify the causative mutations and mutation spectrum, perform genotype-phenotype correlation and screen family members...
January 2016: Indian Pacing and Electrophysiology Journal
https://www.readbyqxmd.com/read/27455832/vagoglossopharyngeal-neuralgia-occurred-concomitantly-with-ipsilateral-hemifacial-spasm-and-versive-seizure-like-movement-a-first-case-report
#20
Peeraphong Thiarawat, Apirath Wangtheraprasert, Jiraporn Jitprapaikulsan
Vagoglossopharyngeal neuralgia (VGPN) is a very rare condition. VGPN with convulsive like attack is even rarer All of the cases had their head turned to the opposite side of facial pain. Hemifacial spasm occurring concurrently with VGPN has never been reported. Herein, we present the first case of VGPN that had ipsilateral hemifacial spasm and versive seizure-like movement to the same side of facial pain. We reported a 71-year-old man presenting with multiple episodes of intermittent sharp shooting pain arising on the right middle neck, followed by hemifacial spasm on right face...
January 2016: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
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