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Status epilepticus protocol

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https://www.readbyqxmd.com/read/29786808/-status-epilepticus-in-children-and-adults
#1
Johan Bjellvi, Niklas Timby, Roland Flink
Status epilepticus, a condition with prolonged or repeated seizures, is a common neurological emergency with significant morbidity and mortality. This text outlines the treatment and initial work-up for convulsive and non-convulsive status epilepticus in adults and children. The most serious form is convulsive (tonic-clonic) status epilepticus, which requires rapid treatment and work-up. Bensodiazepines are the preferred initial treatment, while antiepileptic drugs and anesthetics are added if seizures continue...
May 22, 2018: Läkartidningen
https://www.readbyqxmd.com/read/29702411/towards-acute-pediatric-status-epilepticus-intervention-teams-do-we-need-seizure-codes
#2
REVIEW
Coral M Stredny, Nicholas S Abend, Tobias Loddenkemper
PURPOSE: To identify areas of treatment delay and barriers to care in pediatric status epilepticus, review ongoing quality improvement initiatives, and provide suggestions for further innovations to improve and standardize these patient care processes. METHODS: Narrative review of current status epilepticus management algorithms, anti-seizure medication administration and outcomes associated with delays, and initiatives to improve time to treatment. Articles reviewing or reporting quality improvement initiatives were identified through a PubMed search with keywords "status epilepticus," "quality improvement," "guideline adherence," and/or "protocol;" references of included articles were also reviewed...
April 13, 2018: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29663283/eeg-artifact-versus-subclinical-status-epilepticus-in-a-patient-following-cardiac-arrest
#3
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/29625197/a-single-subconvulsant-dose-of-domoic-acid-at-mid-gestation-does-not-cause-temporal-lobe-epilepsy-in-mice
#4
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/29588971/personalized-safety-measures-reduce-the-adverse-event-rate-of-long-term-video-eeg
#5
Judith Dobesberger, Julia Höfler, Markus Leitinger, Giorgi Kuchukhidze, Georg Zimmermann, Aljoscha Thomschewski, Iris Unterberger, Gerald Walser, Gudrun Kalss, Alexandra Rohracher, Caroline Neuray, Teia Kobulashvili, Yvonne Höller, Eugen Trinka
Objective: Safety in epilepsy monitoring units (EMUs) has become an increasing concern because adverse events occur in up to 10% of patients undergoing long-term video EEG in EMUs. The aim of this study was to assess the effectiveness of a specific safety protocol in an EMU. Methods: We retrospectively assessed the adverse event rates in a group without (group 1, 84-month period, Innsbruck, Austria) and a group with (group 2, 33-month period, Salzburg, Austria) personalized safety measures utilizing a standardized protocol for long-term epilepsy monitoring in high-risk patients...
December 2017: Epilepsia Open
https://www.readbyqxmd.com/read/29572918/status-epilepticus-role-for-etiology-in-determining-response-to-benzodiazepines
#6
Suchitra Joshi, Karthik Rajasekaran, Kyle M Hawk, Stephen J Chester, Howard P Goodkin
OBJECTIVE: Clinical factors contributing to benzodiazepine failure in treating status epilepticus include suboptimal dosing and seizure duration. As many benzodiazepine-refractory episodes of status epilepticus (SE) arise from acute etiologies, we sought to determine whether etiology impacts SE treatment. METHODS: The potency of diazepam to terminate SE induced by lithium-pilocarpine (LiPilo-SE) or kainic acid (KA-SE) in 3-week old rats was studied by video-electroencephalograpy...
March 24, 2018: Annals of Neurology
https://www.readbyqxmd.com/read/29553531/the-pilocarpine-model-of-temporal-lobe-epilepsy-and-eeg-monitoring-using-radiotelemetry-system-in-mice
#7
Ji-Eun Kim, Kyung-Ok Cho
Temporal lobe epilepsy (TLE) is a common neurological disorder in adulthood. For translational studies of chronic epilepsy, pilocarpine-induced status epilepticus (SE) is frequently selected to recapitulate spontaneous recurrent seizures (SRS). Here we present a protocol of SE induction by intraperitoneal (i.p.) injection of pilocarpine and monitoring of chronic recurring seizures in live animals using a wireless telemetry video and electroencephalogram (EEG) system. We demonstrated notable behavioral changes that need attention after pilocarpine injection and their correlation with hippocampal neuronal loss at 7 days and 6 weeks post-pilocarpine...
February 27, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29460429/treatment-outcomes-after-the-introduction-of-a-new-seizure-management-protocol
#8
Lisa Gillinder, Alexander Lehn, Helen Brown, Sasha Dionisio
OBJECTIVE: The present study aims to determine qualitative outcomes of presentations with acute recurrent seizures or status epilepticus to the emergency department of our institution after the introduction of a new seizure management protocol METHODS: We performed a retrospective analysis on two cohorts of patients for all presentation to the emergency department of our institution. Presentations were reviewed from January to July pre protocol introduction and the same period post protocol...
February 20, 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29333566/principles-of-management-of-central-nervous-system-infections
#9
REVIEW
Sunit Singhi, Suresh Kumar Angurana
CNS infections in children are medical emergency and are associated with high mortality and morbidity. For diagnosis, a high index of suspicion is required. Clinical assessment should be supplemented by laboratory investigations including CSF Gram stain and cultures, blood culture, PCR on CSF, serological tests, and imaging. Commonly associated life threatening complications include coma, seizure, raised intracranial pressure (ICP), focal deficits, shock, respiratory failure, and fluid and electrolyte abnormalities...
January 15, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29306558/high-dose-phenobarbitone-coma-in-pediatric-refractory-status-epilepticus-a-retrospective-case-record-analysis-a-proposed-protocol-and-review-of-literature
#10
Sheffali Gulati, Vishal Sondhi, Biswaroop Chakrabarty, Prashant Jauhari, Rakesh Lodha, Jhuma Sankar
BACKGROUND: Ongoing refractory status epilepticus is associated with significant morbidity and mortality. Therapeutic coma induction with midazolam, thiopentone, phenobarbitone or propofol is indicated when conventional antiepileptics fail to abort seizure. Of these, the most extensively studied is midazolam. Amongst the remaining three, phenobarbitone has the most favourable pharmacological profile, but has not been studied adequately, more so in the pediatric age group. The current retrospective case records analysis is an attempt to describe use of phenobarbitone coma in pediatric refractory status epilepticus...
April 2018: Brain & Development
https://www.readbyqxmd.com/read/29306214/the-essence-of-the-first-2-5-h-in-the-treatment-of-generalized-convulsive-status-epilepticus
#11
Leena Kämppi, Harri Mustonen, Kaisa Kotisaari, Seppo Soinila
PURPOSE: This study was designed to find realistic cut-offs of the delays predicting outcome after generalized convulsive status epilepticus (GCSE) and serving protocol streamlining of GCSE patients. METHOD: This retrospective study includes all consecutive adult (>16 years) patients (N = 70) diagnosed with GCSE in Helsinki University Central Hospital emergency department over 2 years. We defined ten specific delay parameters in the management of GCSE and determined functional outcome and mortality at hospital discharge...
February 2018: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29182639/mycophenolate-mofetil-prevents-the-delayed-t-cell-response-after-pilocarpine-induced-status-epilepticus-in-mice
#12
Anne-Marie Neumann, Julia Abele, Timo Kirschstein, Robby Engelmann, Tina Sellmann, Rüdiger Köhling, Brigitte Müller-Hilke
Growing clinical and laboratory evidence corroborates a role for the immune system in the pathophysiology of epilepsy. In order to delineate the immune response following pilocarpine-induced status epilepticus (SE) in the mouse, we monitored the kinetics of leukocyte presence in the hippocampus over the period of four weeks. SE was induced following a ramping protocol of pilocarpine injection into 4-5 weeks old C57BL/6 mice. Brains were removed at days 1-4, 14 or 28 after SE, and the hippocampi were analyzed via flow cytometry, via quantitative reverse transcriptase PCR (qRT-PCR) and via immunohistochemistry...
2017: PloS One
https://www.readbyqxmd.com/read/29171011/stroke-like-migraine-attacks-after-radiation-therapy-a-misnomer
#13
Emily Peien Fan, Gabriel Heiber, Elizabeth E Gerard, Stephan Schuele
OBJECTIVE: To understand the frequency of electrographic and clinical seizures in patients with stroke-like migraine attacks after radiation therapy (SMART), and determine whether SMART warrants comprehensive electroencephalographic (EEG) monitoring and aggressive seizure management. METHODS: We searched our magnetic resonance brain imaging report database for all patients between January 2013 and December 2015 for suspected SMART syndrome. Clinical inclusion criteria were further applied as follows: inpatient adults (>18 years of age) with history of cranial radiation presenting with acute neurologic deficits as primary admission reason who lacked evidence of recurrent or new brain malignancy, stroke, or infectious agents in cerebrospinal fluid...
January 2018: Epilepsia
https://www.readbyqxmd.com/read/29163349/kainic-acid-induced-post-status-epilepticus-models-of-temporal-lobe-epilepsy-with-diverging-seizure-phenotype-and-neuropathology
#14
Daniele Bertoglio, Halima Amhaoul, Annemie Van Eetveldt, Ruben Houbrechts, Sebastiaan Van De Vijver, Idrish Ali, Stefanie Dedeurwaerdere
The aim of epilepsy models is to investigate disease ontogenesis and therapeutic interventions in a consistent and prospective manner. The kainic acid-induced status epilepticus (KASE) rat model is a widely used, well-validated model for temporal lobe epilepsy (TLE). As we noted significant variability within the model between labs potentially related to the rat strain used, we aimed to describe two variants of this model with diverging seizure phenotype and neuropathology. In addition, we evaluated two different protocols to induce status epilepticus (SE)...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29161897/status-epilepticus-and-multiple-sclerosis-a-case-presentation-and-literature-review
#15
Murat Mert Atmaca, Candan Gurses
PURPOSE: To search the literature for the frequency, pathogenesis, prognosis, and treatment of seizures and status epilepticus (SE) in patients with multiple sclerosis (MS). METHODS: We report 2 patients with MS who presented with SE and review the literature. RESULTS: Seizures and SE episodes worsened during MS relapses in the first patient. SE episodes and MS relapses significantly decreased after initiation of natalizumab treatment but she still had seizures and was taking 4 antiepileptic drugs (AEDs)...
January 1, 2017: Clinical EEG and Neuroscience: Official Journal of the EEG and Clinical Neuroscience Society (ENCS)
https://www.readbyqxmd.com/read/29138358/epileptic-pilocarpine-treated-rats-exhibit-aberrant-hippocampal-epsp-spike-potentiation-but-retain-long-term-potentiation
#16
Ezekiel Carpenter-Hyland, Edyta K Bichler, Mathew Smith, Robert S Sloviter, Morris Benveniste
Hippocampal neuron plasticity is strongly associated with learning, memory, and cognition. In addition to modification of synaptic function and connectivity, the capacity of hippocampal neurons to undergo plasticity involves the ability to change nonsynaptic excitability. This includes altering the probability that EPSPs will generate action potentials (E-S plasticity). Epilepsy is a prevalent neurological disorder commonly associated with neuronal hyperexcitability and cognitive dysfunction. We examined E-S plasticity in chronically epileptic Sprague-Dawley rats 3-10 weeks after pilocarpine-induced status epilepticus CA1 neurons in hippocampal slices were assayed by whole-cell current clamp to measure EPSPs evoked by Schaffer collateral stimulation...
November 2017: Physiological Reports
https://www.readbyqxmd.com/read/29137682/cefepime-induced-neurotoxicity-a-systematic-review
#17
Lauren E Payne, David J Gagnon, Richard R Riker, David B Seder, Elizabeth K Glisic, Jane G Morris, Gilles L Fraser
BACKGROUND: Cefepime is a widely used antibiotic with neurotoxicity attributed to its ability to cross the blood-brain barrier and exhibit concentration-dependent ϒ-aminobutyric acid (GABA) antagonism. Neurotoxic symptoms include depressed consciousness, encephalopathy, aphasia, myoclonus, seizures, and coma. Data suggest that up to 15% of ICU patients treated with cefepime may experience these adverse effects. Risk factors include renal dysfunction, excessive dosing, preexisting brain injury, and elevated serum cefepime concentrations...
November 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29043491/the-multifactorial-origin-of-posterior-reversible-encephalopathy-syndrome-in-cyclophosphamide-treated-lupus-patients
#18
REVIEW
Tatjana Zekić, Mirjana Stanić Benić, Ronald Antulov, Igor Antončić, Srđan Novak
The cyclophosphamide as a predisposing factor for Posterior Reversible Encephalopathy Syndrome (PRES) and therapeutic option for systemic lupus erythematosus (SLE) is still confusing. The first and only case of PRES, probably induced by cyclophosphamide, in Croatia followed by the findings of 36 SLE patients diagnosed with PRES after treatment with cyclophosphamide worldwide are described. An 18-year-old Caucasian female patient with a 1-year history of SLE was admitted to the hospital due to lupus nephritis and acute arthritis...
December 2017: Rheumatology International
https://www.readbyqxmd.com/read/29042001/recovery-from-vegetative-state-of-patients-with-a-severe-brain-injury-a-4-year-real-practice-prospective-cohort-study
#19
Alessio Baricich, A de Sire, E Antoniono, F Gozzerino, G Lamberti, C Cisari, M Invernizzi
Patients who have suffered severe traumatic or nontraumatic brain injuries can show a progressive recovery, transitioning through a range of clinical conditions. They may progress from coma to a vegetative state (VS) and/or a minimally conscious state (MCS). A longer duration of the VS is known to be related to a lower probability of emergence from it; furthermore, the literature seems to lack evidence of late improvements in these patients. This real-practice prospective cohort study was conducted in inpatients in a VS following a severe brain injury, consecutively admitted to a vegetative state unit (VSU)...
July 2017: Functional Neurology
https://www.readbyqxmd.com/read/28941387/management-protocols-for-status-epilepticus-in-the-pediatric-emergency-room-systematic-review-article
#20
REVIEW
Cheuk C Au, Ricardo G Branco, Robert C Tasker
OBJECTIVE: This systematic review of national or regional guidelines published in English aimed to better understand variance in pre-hospital and emergency department treatment of status epilepticus. SOURCES: Systematic search of national or regional guidelines (January 2000 to February 2017) contained within PubMed and Google Scholar databases, and article reference lists. The search keywords were status epilepticus, prolonged seizure, treatment, and guideline...
November 2017: Jornal de Pediatria
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