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Meningitis, Status epilepticus

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https://www.readbyqxmd.com/read/29185625/unusual-warfarin-dose-to-achieve-therapeutic-inr-in-a-4-month-old-child-non-genetics-risk-factors-are-still-a-challenge
#1
Lucas Miyake Okumura, Giovanna Webster Negretto, Clarissa Gutiérrez Carvalho
OBJECTIVE: To report a case of a 4-month old girl that required 0.7 mg/kg/day (5 mg) of warfarin and discuss relevant risk factors for requiring higher doses. CASE DESCRIPTION: In November 2015, a 5 kg female infant (36-week preterm) was admitted to the hospital due to status epilepticus and fever. Diazepam, phenytoin and ceftriaxone were prescribed. Cerebrospinal fluid contained 7 leukocytes, 150 mg/dL proteins, 1 mg/dL glucose and gram positive cocci were observed...
October 2017: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
https://www.readbyqxmd.com/read/28965695/-evaluating-a-child-after-a-febrile-seizure-insights-on-three-important-issues
#2
S Auvin, M Antonios, G Benoist, M-A Dommergues, F Corrard, V Gajdos, C Gras Leguen, E Launay, A Salaün, L Titomanlio, L Vallée, M Milh
Febrile seizures (FS) are the most common seizures seen in the paediatric population in the out-of-hospital and emergency department settings, and they account for the majority of seizures seen in children younger than 5 years old. An FS is a seizure accompanied by fever, without central nervous system infection, occurring in children between 6 months and 5 years old. Five criteria have been used and taught to classify any FS as simple or complex FS. These factors do not bear the same significance for clinical practice, in particular, the decision to perform a lumbar puncture for cerebrospinal fluid analysis to rule out an intracranial infection...
November 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28962814/nosocomial-infections-in-the-neurointensive-care-unit
#3
REVIEW
Katharina Maria Busl
Infectious complications in the neurointensive care unit (neuro-ICU) are common, including pneumonia, urinary tract infection, bloodstream infection, and intracranial infection. The neuro-ICU population poses a specific challenge in the diagnosis of infections, because of the high incidence of fever in acutely brain-injured patients. Furthermore, susceptibility to infections is likely enhanced by brain-injury (induced immune modulation). This article reviews the concept of brain injury-induced immune modulation, and summarizes available data and knowledge on nosocomial meningitis and ventriculitis, and systemic infectious complications in patients with traumatic brain injury, ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, and status epilepticus...
November 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/28762041/neuroinfluenza-evaluation-of-seasonal-influenza-associated-severe-neurological-complications-in-children-a-multicenter-study
#4
Muhammet Sukru Paksu, Kerim Aslan, Tanil Kendirli, Basak Nur Akyildiz, Nazik Yener, Riza Dincer Yildizdas, Mehmet Davutoglu, Ayhan Yaman, Sedat Isikay, Gulnar Sensoy, Haydar Ali Tasdemir
PURPOSE: Although influenza primarily affects the respiratory system, in some cases, it can cause severe neurological complications. Younger children are especially at risk. Pediatric literature is limited on the diagnosis, treatment, and prognosis of influenza-related neurological complications. The aim of the study was to evaluate children who suffered severe neurological manifestation as a result of seasonal influenza infection. METHODS: The medical records of 14 patients from six hospitals in different regions of the country were evaluated...
July 31, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28697163/utility-of-lumbar-puncture-in-children-presenting-with-status-epilepticus
#5
Kenneth A Michelson, Todd W Lyons, Kara B Johnson, Lise E Nigrovic, Marvin B Harper, Amir A Kimia
OBJECTIVES: Because meningitis may trigger seizures, we sought to determine its frequency in children with first-time status epilepticus (SE). METHODS: We performed a retrospective cross-sectional study of children aged 1 month to 21 years who presented to a single pediatric emergency department between 1995 and 2012 with SE and who had a lumbar puncture (LP) performed as part of the diagnostic evaluation. We defined bacterial meningitis as a cerebrospinal fluid (CSF) culture positive for a bacterial pathogen or CSF pleocytosis (CSF white blood cells ≥10 cells/mm) with a blood culture positive for a bacterial pathogen...
August 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28637636/epilepsy-after-cerebral-infection-review-of-the-literature-and-the-potential-for-surgery
#6
Georgia Ramantani, Hans Holthausen
The risk of unprovoked seizures in population-based cohorts of cerebral infection survivors is 7-8% in developed countries, rising to considerably higher rates in resource-poor countries. The main risk factors for epilepsy after cerebral infection, besides acute seizures, are infection-associated brain lesions and status epilepticus during the acute phase. Despite the high prevalence of pharmacoresistant epilepsies after cerebral infections, especially in patients with MRI-identifiable lesions, only a small minority undergoes epilepsy surgery...
June 1, 2017: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/28389055/primary-amebic-meningoencephalitis-in-children-a-report-of%C3%A2-two-fatal-cases-and-review-of-the-literature
#7
Robert C Stowe, Davut Pehlivan, Katie E Friederich, Michael A Lopez, Shannon M DiCarlo, Varina L Boerwinkle
BACKGROUND: Primary amebic meningoencephalitis is a rare, almost uniformly fatal disease of cerebral invasion by Naegleria fowleri, occurring most commonly after swimming in warm fresh water in summer months. Treatment using the experimental medication miltefosine demonstrated improved survival and favorable neurocognitive outcome in a 2013 North American patient. There is little information about the electroencephalographic findings of such patients, and our understanding of factors predicting survival is limited...
May 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28303609/pathological-analysis-of-children-with-childhood-central-nervous-system-infection-based-on-changes-in-chemokines-and-interleukin-17-family-cytokines-in-cerebrospinal-fluid
#8
Shinichiro Morichi, Tomomi Urabe, Natsumi Morishita, Mika Takeshita, Yu Ishida, Shingo Oana, Gaku Yamanaka, Yasuyo Kashiwagi, Hisashi Kawashima
BACKGROUND: In this study, the pathologies of acute meningitis and encephalopathy were investigated, and biomarkers useful as prognostic indices were searched for. METHODS: The subjects were 31 children with meningitis, 30 with encephalopathy, and 12 with convulsions following gastroenteritis. Control group consisted of 24 children with non-central nervous system infection. Cerebrospinal fluid cytokine analysis was performed. RESULTS: Chemokines significantly increased in the bacterial meningitis group compared with those in viral meningitis and encephalopathy groups...
March 17, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28298482/movement-disorder-associated-with-foreign-body-ingestion
#9
Olugbenga Akingbola, Dinesh Singh, Uwe Blecker
We present a case of recurrent bouts of irritability with arching, head extension, and lethargy in a previously healthy 10-month-old girl admitted to the PICU for acute onset of a movement disorder. The patient's vital signs and physical examination were unremarkable but recurrent bouts of abnormal movements persisted for the first 10 hours of admission in the PICU. Possible diagnoses, such as meningitis, status epilepticus, space occupying lesions, and toxic ingestions, were ruled out because of negative cerebrospinal fluid analysis, normal EEG, and negative results of other ancillary tests...
April 2017: Pediatrics
https://www.readbyqxmd.com/read/28028789/isoflurane-use-in-the-treatment-of-super-refractory-status-epilepticus-is-associated-with-hippocampal-changes-on-mri
#10
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...
June 2017: Neurocritical Care
https://www.readbyqxmd.com/read/27904066/erratum-a-case-of-cefepime-encephalopathy-being-difficult-to-distinguish-from-non-convulsive-status-epilepticus-during-the-treatment-of-bacterial-meningitis
#11
(no author information available yet)
No abstract text is available yet for this article.
2016: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/27680224/a-case-of-cefepime-encephalopathy-being-difficult-to-distinguish-from-non-convulsive-status-epilepticus-during-the-treatment-of-bacterial-meningitis
#12
REVIEW
Yusuke Toda, Mineo Yamazaki, Tomohiro Ota, Yosuke Fujisawa, Kazumi Kimura
A 64-year-old man with fever, appetite loss, and pain in the back of the neck visited our hospital. We diagnosed him as having bacterial meningitis because of pleocytosis of the cerebrospinal fluid, and started treatment with antibiotics. Multiple cerebral infarcts were found on brain MRI. We suspected that the origin of the bacterial meningitis was infective endocarditis, and administered Cefepime and Gentamicin according to the guidelines for treatment of infective endocarditis. Three days later, he became drowsy and had myoclonus and flapping of the extremities...
October 28, 2016: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/27606021/refractory-status-epilepticus-due-to-pneumococcal-meningitis-in-an-infant-with-congenital-immunodeficiency
#13
Sudhakaran Prasanth, Velayudhan Cheruvallil Shaji, Chacko Lyla, Vasudevapanicker Jayalakshmi
Pneumococcal meningitis remains a life-threatening infection, with varied presentations. A 3 month-old-baby with pneumococcal meningitis presented with clusters of seizures evolving into refractory status epilepticus despite standard antibiotic and aggressive anticonvulsant therapy. Progressive illness despite antibiotic initially suggested possible antibiotic resistance and resulted in addition of another antibiotic. Nonresponse to standard treatment and previous history of abscess in the back of neck pointed to some underlying congenital immunodeficiency...
April 2016: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/27423594/focal-status-epilepticus-as-a-manifestation-of-idiopathic-hypertrophic-cranial-pachymeningitis
#14
Irene Navalpotro-Gómez, Rosa María Vivanco-Hidalgo, Elisa Cuadrado-Godia, Santiago Medrano-Martorell, Francisco Alameda-Quitllet, Gloria Villalba-Martínez, Jaume Roquer
BACKGROUND: Idiopathic hypertrophic cranial pachymeningitis (IHCP) is an uncommon disease of unknown etiology characterized by thickening of the cerebral dura mater with possible associated inflammation. The most frequently described clinical symptoms include headache, cranial nerve palsy, and cerebellar dysfunction. Epilepsy and/or status epilepticus as main presentation is very uncommon. CASE PRESENTATION: Two consecutive cases are presented of patients manifesting focal status epilepticus secondary to IHCP, with clinical, laboratory [blood test and cerebrospinal fluid (CSF) analysis], neuroradiologic [magnetic resonance imaging (MRI) at 3 Tesla and digital subtraction angiography (DSA)], and therapeutic data...
August 15, 2016: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/27280723/epidemiology-of-pediatric-convulsive-status-epilepticus-with-fever-in-the-emergency-department-a-cohort-study-of-381-consecutive-cases
#15
Itaru Hayakawa, Sahoko Miyama, Nobuaki Inoue, Hiroshi Sakakibara, Hiroshi Hataya, Toshiro Terakawa
Pediatric convulsive status epilepticus with fever is common in the emergency setting but leads to severe neurological sequelae in some patients. To explore the epidemiology of convulsive status epilepticus with fever, a retrospective cohort covering all convulsive status epilepticus cases with fever seen in the emergency department of a tertiary care children's hospital were consecutively collected. Of the 381 consecutive cases gathered, 81.6% were due to prolonged febrile seizure, 6.6% to encephalopathy/encephalitis, 0...
September 2016: Journal of Child Neurology
https://www.readbyqxmd.com/read/26960270/-a-case-of-rhabdomyolysis-after-status-epilepticus-without-stroke-like-episodes-in-mitochondrial-myopathy-encephalopathy-lactic-acidosis-and-stroke-like-episodes
#16
REVIEW
Jun Yokoyama, Hiroo Yamaguchi, Hiroshi Shigeto, Takeshi Uchiumi, Hiroyuki Murai, Jun-ichi Kira
A 24-year-old man was referred to our hospital emergency department due to a sudden onset of convulsions after drinking. On arrival he presented status epilepticus and was managed by artificial ventilation. He had no brainstem signs or meningeal irritation. Head MRI showed an old infarction-like lesion in the left occipital lobe, but no abnormal signals on diffusion-weighted images. The patient showed acute rhabdomyolysis (CK 18,000 IU/l) and renal failure, and hemodialysis was started. On 18 day after admission, he was transferred to our department with mild proximal limb muscle weakness and bilateral sensorineural hearing impairment...
2016: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/26812288/cerebral-salt-wasting-in-pediatric-critical-care-not-just-a-neurosurgical-disorder-anymore
#17
Orkun Tolunay, Tamer Celik, Umit Celik, Mustafa Kömür, Begul Yagci-Kupeli
OBJECTIVE: Cerebral salt-wasting syndrome (CSWS) is a hypovolemic hyponatremia caused by natriuresis and diuresis, of which the exact pathogenesis is unknown. Although CSWS has been more commonly described to be associated with neurosurgical disorders, increasing numbers of patients are diagnosed and new etiological factors are being identified as the awareness of it increases. METHODS: The files of the patients who had been hospitalized and treated with the diagnosis of CSWS at the pediatric critical care unit during the last three years were retrospectively reviewed...
December 2015: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/26664438/refractory-convulsive-status-epilepticus-in-children-etiology-associated-risk-factors-and-outcome
#18
Mohammad Barzegar, Mohammad Mahdavi, Afshin Galegolab Behbehani, Aidin Tabrizi
OBJECTIVE: Refractory status epilepticus (RSE) is a life-threatening disease in children wherein the patient's convulsive seizures do not respond to adequate initial anticonvulsants. RSE is associated with high rate of mortality and morbidity. This study was aimed to survey the risk factors leading status epilepticus (SE) to RSE in children, and their early outcome. MATERIALS & METHODS: Patients with SE hospitalized in Tabriz Children's Hospital, Iran were studied during the years 2007 and 2008 with regard to their clinical profile, etiology, the treatment methods available to them and their outcome upon release from the hospital...
2015: Iranian Journal of Child Neurology
https://www.readbyqxmd.com/read/25551849/what-is-hiding-behind-bubbles-of-air-an-unusual-streptococcus-pyogenes-meningitis
#19
Paolo Gritti, Andrea Luigi Lanterna, Tatyana Sarnecki, Carlo Brembilla, Cristina Agostinis, Marco Rizzi, Ferdinando Luca Lorini
Streptococcus pyogenes is a rare but aggressive cause of meningitis, which often evolves in a poor outcome with fatal consequences. Although lumbar puncture and CT scan of the brain are the gold standard of diagnosis of cerebral infections, they can have some limitations. We report and describe the clinical history and neuroimaging of a 36-year-old woman admitted to the emergency department of our hospital three days after the onset of earache and otorrhoea. When the patient developed an emergent refractory status epilepticus, the CT scan of the brain showed an unusual pneumocephalus...
December 2014: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/25307572/acute-withdrawal-diagnosis-and-treatment
#20
REVIEW
John C M Brust
Symptoms of alcohol withdrawal range in severity from mild "hangover" to fatal delirium tremens (DTs). Tremor, hallucinosis, and seizures usually occur within 48 hours of abstinence. Seizures tend to be generalized without focality, occurring singly or in a brief cluster, but status epilepticus is not unusual. DTs usually appears after 48 hours of abstinence and consists of marked inattentiveness, agitation, hallucinations, fluctuating level of alertness, marked tremulousness, and sympathetic overactivity. The mainstay of treatment for alcohol withdrawal is benzodiazepine pharmacotherapy, which can be used to control mild early symptoms, to prevent progression to DTs, or to treat DTs itself...
2014: Handbook of Clinical Neurology
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