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syncopal seizure

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https://www.readbyqxmd.com/read/29136314/syncope-prognosis-based-on-emergency-department-diagnosis-a-prospective-cohort-study
#1
Cristian Toarta, Muhammad Mukarram, Kirtana Arcot, Soo-Min Kim, Sarah Gaudet, Marco L A Sivilotti, Brian H Rowe, Venkatesh Thiruganasambandamoorthy
OBJECTIVE: Relatively little is known about outcomes after disposition among syncope patients assigned various diagnostic categories during emergency department (ED) evaluation. We sought to measure the outcomes among these groups within 30 days of the initial ED visit. METHODS: We prospectively enrolled adult syncope patients at six EDs and excluded patients with pre-syncope, persistent mental status changes, intoxication, seizure, and major trauma. Patient characteristics, ED management, diagnostic impression (presumed vasovagal, orthostatic, cardiac, or other/unknown) at the end of the ED visit and physicians' confidence in assigning the etiology were collected...
November 14, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29129117/calls-to-poison-centers-for-hookah-smoking-exposures
#2
Sandra S Retzky, Henry A Spiller, Priscilla Callahan-Lyon
Over the past decade, smoking behaviors have changed in the US. Hookah or waterpipe smoking is increasing, especially among youth and young adults. Social media sites describe the "hookah high" or "buzz", which may be related to nicotine, carbon monoxide, or other inhalants in hookah smoke. Most important is the risk of carbon monoxide poisoning. Case reports include a high number of victims presenting with loss of consciousness from either syncope or seizures. Anaphylaxis and a very rare respiratory hypersensitivity reaction, acute eosinophilic pneumonia, have also been reported from hookah smoking in previously healthy young adults...
November 13, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29123835/ambulance-dispatches-to-schools-during-a-5-year-period-in-fukui-prefecture
#3
Yoshikazu Takinami, Shinji Maeda
Aim: To determine the characteristics and trends of medical emergencies during school activities by analyzing information provided by fire departments. Methods: During a 5-year period from January 2009 to December 2013, all nine fire departments in Fukui Prefecture handled 850 emergencies at schools. We investigated the 850 cases with the age range of 0-63 years. Results: It was found that 21.5% of ambulance dispatches to schools were on weekends and there were more dispatches for non-faculty members of all age groups on weekends than on weekdays...
January 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29110977/clinical-mimics-an-emergency-medicine-focused-review-of-syncope-mimics
#4
Diana K Coleman, Brit Long, Alex Koyfman
BACKGROUND: Syncope is an event that causes a transient loss of consciousness (LOC) secondary to global cerebral hypoperfusion. The transient nature of the event can make diagnosis in the emergency department (ED) difficult, as symptoms have often resolved by time of initial presentation. The symptoms and presentation of syncope are similar to many other conditions, which can lead to difficulty in establishing a diagnosis in the ED. OBJECTIVE: This review evaluates patients presenting with a history concerning for possible syncope, mimics of syncope, and approach to managing syncope mimics...
October 27, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29103011/seizure-triggered-by-sick-sinus-syndrome
#5
Nilesh Patel, Faisal Majeed, Anupam Ashutosh Sule
Sick sinus syndrome (SSS) is a dysfunction of sinoatrial node resulting in symptomatic bradycardia or sinus pauses causing decreased cardiac output with cerebral hypoperfusion and usually presents as syncope, presyncope or fatigue. The occurrence of a seizure is very rare. A 69-year-old man suffered two episodes of generalised tonic-clonic seizures. MRI and electroencephalogram failed to reveal the cause of seizures. In the emergency room, he experienced presyncope simultaneous to bradycardia and sinus pauses...
November 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29057193/long-qt-syndrome-unveiled-by-a-fatal-combination-of-medications-and-electrolyte-abnormalities
#6
Pooja Sethi, Jennifer Treece, Vandana Pai, Chidinma Onweni
Long QT syndrome (LQTS) can present with syncope and seizure-like activity in the setting of torsades de pointes (TdP) with hemodynamic instability. Electrolyte abnormalities and medications can predispose to TdP in the setting of latent LQTS. An implantable cardioverter defibrillator (ICD) is needed if patients with TdP continue to be symptomatic despite medical treatment. We report a case of a patient who presented with seizures and was found to have prolonged corrected QT interval (QTc). During her admission, she was treated with ondansetron...
August 18, 2017: Curēus
https://www.readbyqxmd.com/read/29055272/engaging-psychiatrists-in-the-diagnosis-of-psychogenic-nonepileptic-seizures-what-can-they-contribute
#7
Massimiliano Beghi, Giuseppe Erba, Cesare Maria Cornaggia, Giorgia Giussani, Elisa Bianchi, Gianni Porro, Michela Russo, Ettore Beghi
PURPOSE: To investigate if psychiatrists could predict the diagnosis of psychogenic nonepileptic seizures (PNES) by reviewing videos of seizures of various types and to compare the accuracy and the criteria leading to the diagnosis used by psychiatrists with those used by epileptologists. METHODS: Four board-certified psychiatrists were asked to review 23 videos capturing representative events of 21 unselected consecutive patients admitted to an epilepsy center for long-term video-EEG monitoring...
October 16, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29037160/-homozygous-and-compound-heterozygous-mutation-in-3-turkish-family-with-jervell-and-lange-nielsen-syndrome-case-reports
#8
Fahrettin Uysal, Burcu Turkgenc, Guven Toksoy, Ozlem M Bostan, Elif Evke, Oya Uyguner, Cengiz Yakicier, Hulya Kayserili, Ergun Cil, Sehime G Temel
BACKGROUND: Jervell and Lange-Nielsen syndrome (JLNS) isa recessive model of long QT syndrome which might also be related to possible hearing loss. Although the syndrome has been demonstrated to be originated from homozygous or compound heterozygous mutations in either the KCNQ1 or KCNE1 genes, additional mutations in other genetic loci should be considered, particularly in malignant course patients. CASE PRESENTATIONS: Three patients were admitted into hospital due to recurrent seizures/syncope, intrauterine and postnatal bradycardia respectively; moreover all three patients had congenital sensorineural hearing-loss...
October 16, 2017: BMC Medical Genetics
https://www.readbyqxmd.com/read/28926844/atypical-presentation-of-a-pediatric-cerebellar-ganglioglioma
#9
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
#10
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
#11
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 1, 2017: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/28842725/-diagnosis-of-non-epileptic-paroxysmal-disorders-and-epileptic-seizures
#12
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...
October 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28833993/high-fidelity-simulation-in-training-dental-students-for-medical-life-threatening-emergency
#13
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
#14
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
#15
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...
October 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
#16
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
#17
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
#18
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
#19
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
#20
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
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