keyword
https://read.qxmd.com/read/37388544/neuromodulation-in-new-onset-refractory-status-epilepticus
#21
Ioannis Stavropoulos, Jin Han Khaw, Antonio Valentin
BACKGROUND: New-onset refractory status epilepticus (NORSE) and its subset of febrile infection-related epilepsy syndrome (FIRES) are devastating clinical presentations with high rates of mortality and morbidity. The recently published consensus on the treatment of these conditions includes anesthetics, antiseizure drugs, antivirals, antibiotics, and immune therapies. Despite the internationally accepted treatment, the outcome remains poor for a significant percentage of patients. METHODS: We conducted a systematic review of the use of neuromodulation techniques in the treatment of the acute phase of NORSE/FIRES using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
2023: Frontiers in Neurology
https://read.qxmd.com/read/37363462/evidence-based-guideline-on-management-of-status-epilepticus-in-adult-intensive-care-unit-in-resource-limited-settings-a-review-article
#22
JOURNAL ARTICLE
Aschalew Besha, Yayeh Adamu, Hailemariam Mulugeta, Abebayehu Zemedkun, Belete Destaw
UNLABELLED: Status epilepticus (SE) is a life-threatening condition associated with at least 5 min of continuous seizures or repeated seizures without regaining consciousness between episodes. It is a medical emergency with significant morbidity and mortality. The most common causes of SE are previous seizures, stroke, trauma, metabolic disorders, and central nervous system tumor. The aim of this review was to systematically review articles and ultimately develop evidence-based guidelines for the management of SE in resource-limited settings...
June 2023: Annals of Medicine and Surgery
https://read.qxmd.com/read/37322738/comparison-of-phenytoin-and-fosphenytoin-in-treatment-of-active-seizures-in-the-emergency-department
#23
JOURNAL ARTICLE
Mamta Madhiyazhagan, Ramgopal Roshan, Sudhakar G Dhanapal, Joshua V Joseph, Priya Ganesan, Vivek Mathew, Paul P A Kundavaram
BACKGROUND AND OBJECTIVE: Ongoing seizure in the Emergency Department is a medical emergency and its aggressive management is essential. Prompt antiepileptic therapy with early cessation of seizure would minimize the morbidity and risk of recurrence. To compare time to seizure control with fosphenytoin to phenytoin protocol in the ED. MATERIALS AND METHODS: We conducted an observational study on patients with active seizure in the Emergency Department comparing phenytoin versus fosphenytoin protocol over one year...
2023: Neurology India
https://read.qxmd.com/read/37292790/sex-and-gonadectomy-modify-behavioral-seizure-susceptibility-and-mortality-in-a-repeated-low-dose-kainic-acid-systemic-injection-paradigm-in-mice
#24
Niraj V Lawande, Elisabeth A Conklin, Catherine A Christian-Hinman
OBJECTIVE: Sex differences in epilepsy appear driven in part due to effects of gonadal steroids, with varying results in experimental models based on species and method of seizure induction. Furthermore, removing a main source of these steroids via gonadectomy may impact seizure characteristics differently in males and females. Repeated low-dose kainic acid (RLDKA) systemic injection paradigms were recently shown to reliably induce status epilepticus (SE) and hippocampal histopathology in C57BL/6J mice...
May 24, 2023: bioRxiv
https://read.qxmd.com/read/37271017/focal-nonconvulsive-status-epilepticus-with-impaired-consciousness-in-older-adults-prognosis-related-variables
#25
JOURNAL ARTICLE
Gloria M A S Tedrus
OBJECTIVE: To assess the prognosis-related clinical-EEG characteristics in older adults with focal nonconvulsive status epilepticus with impaired consciousness (focal NCSE). METHODOLOGY: We prospectively assessed clinical variables and EEG data at diagnosis and after an initial pharmacological protocol (within 24 hours) and their relationship with prognosis in older adults with focal NCSE treated at the emergency room. RESULTS: The clinical presentation of focal NCSE in 45 adults (mean age 73...
June 2, 2023: Epilepsy & Behavior: E&B
https://read.qxmd.com/read/37181195/efficacy-of-a-pre-specified-timeline-based-treatment-protocol-in-children-with-acute-repetitive-seizures-or-seizure-clusters
#26
JOURNAL ARTICLE
Indar Kumar Sharawat, Aparna Ramachandran, Vinod Kumar, Aman Elwadhi, Apurva Tomar, Prateek Kumar Panda
OBJECTIVES: Acute repetitive seizures (ARSs) are one of the few commonly encountered neurological emergencies in children. There is a need for an appropriate timeline-based treatment protocol, which will be shown to be safe and efficacious in a clinical study. MATERIALS AND METHODS: This was a retrospective chart review to determine the efficacy of a pre-specified treatment protocol for the management of ARSs in children aged 1-18 years. The treatment protocol was specifically applied in children with a diagnosis of epilepsy and not critically ill, who met the criteria for ARSs, with the exemption of new onset of ARSs...
2023: Journal of Neurosciences in Rural Practice
https://read.qxmd.com/read/37153661/perspective-vagal-nerve-stimulation-in-the-treatment-of-new-onset-refractory-status-epilepticus
#27
JOURNAL ARTICLE
Laura Mantoan Ritter, Richard Selway
INTRODUCTION: Resistance to drug therapy is a major hurdle in new-onset refractory status epilepticus (NORSE) treatment and there is urgent need to develop new treatment approaches. Non-drug approaches such as neuromodulation offer significant benefits and should be investigated as new adjunct treatment modalities. An important unanswered question is whether desynchronizing networks by vagal nerve stimulation (VNS) may improve seizure control in NORSE patients. MAIN TEXT: We present a summary of published NORSE cases treated with VNS and our own data, discuss possible mechanisms of action, review VNS implantation timing, stimulation setting titration protocols and outcomes...
2023: Frontiers in Neurology
https://read.qxmd.com/read/37016747/a-standardized-3-tiered-seizure-burden-based-protocol-for-the-treatment-of-neonatal-seizures
#28
JOURNAL ARTICLE
Ashley A Moeller, Andrei R Stefanescu, Beatrice M Stefanescu, Meredith R Golomb, Frances A Boyle, William F Buss, Rebecca S Rose, Sarah E Wing
OBJECTIVE: To evaluate use of a standardized, 3-tiered, seizure burden-based protocol for treatment of all electroencephalography (EEG)-confirmed seizures in a level IV neonatal intensive care unit (NICU). STUDY DESIGN: All infants admitted to the NICU with EEG-confirmed seizures over a 25-month period were enrolled in the study. We compared short-term outcomes before and after implementation of a standardized, 3-tiered protocol. RESULTS: A total of 107 infants were enrolled in the study...
March 2023: Journal of Child Neurology
https://read.qxmd.com/read/36860573/sedation-protocols-in-non-traumatic-sah-sprint-sah-a-cross-sectional-survey-among-german-speaking-neurointensivists
#29
JOURNAL ARTICLE
Moritz L Schmidbauer, Hugo Lanz, Andreas Maskos, Timon Putz, Stefan Kunst, Konstantinos Dimitriadis
BACKGROUND: In subarachnoid hemorrhage (SAH), titrating sedation to find a balance between wakefulness with the ability to perform valid clinical examinations on the one hand, and deep sedation to minimize secondary brain damage, on the other hand, is challenging. However, data on this topic are scarce, and current guidelines do not provide recommendations for sedation protocols in SAH. METHODS: We designed a web-based, cross-sectional survey for German-speaking neurointensivists to map current standards for the indication and monitoring of sedation, duration of prolonged sedation, and biomarkers for the withdrawal of sedation...
2023: Frontiers in Neurology
https://read.qxmd.com/read/36807987/phenobarbital-in-status-epilepticus-rediscovery-of-an-effective-drug
#30
REVIEW
Eugen Trinka
Phenobarbital (PB) is one of the oldest Antiseizure Medicines (ASMs), which is in clinical use since 1912. Its value in the treatment of Status epilepticus is currently discussed controversially. Phenobarbital has fallen out of favor in many countries across Europe because of reports of hypotension, arrhythmias, and hypopnea. Phenobarbital has a strong antiseizure effect with remarkably little sedation. It exerts its clinical effects, through the increase of GABE-ergic inhibition and decrease of glutamatergic excitation by inhibition of AMPA receptors...
April 2023: Epilepsy & Behavior: E&B
https://read.qxmd.com/read/36803874/imaging-of-status-epilepticus-making-the-invisible-visible-a-prospective-study-on-206-patients
#31
JOURNAL ARTICLE
Pilar Bosque Varela, Lukas Machegger, Andreas Oellerer, Jürgen Steinbacher, Mark McCoy, Johannes Pfaff, Eugen Trinka, Giorgi Kuchukhidze
BACKGROUND: Peri-ictal MRI abnormalities (PMA) frequently affect the cerebral cortex, hippocampus, pulvinar of the thalamus, corpus callosum, and cerebellum. In this prospective study, we aimed to characterize the spectrum of PMA in a large cohort of patients with status epilepticus. METHODS: We prospectively recruited 206 patients with SE and an acute MRI. The MRI protocol included diffusion weighted imaging (DWI), fluid-attenuated inversion recovery (FLAIR), arterial spin labeling (ASL), and T1-weighted imaging pre-and post-contrast application...
February 17, 2023: Epilepsy & Behavior: E&B
https://read.qxmd.com/read/36792542/ketamine-as-advanced-second-line-treatment-in-benzodiazepine-refractory-convulsive-status-epilepticus-in-children
#32
REVIEW
Silvia Buratti, Emanuele Giacheri, Antonella Palmieri, Jessica Tibaldi, Giacomo Brisca, Antonella Riva, Pasquale Striano, Maria Margherita Mancardi, Lino Nobili, Andrea Moscatelli
Status epilepticus (SE) is one of the most common neurological emergencies in children. To date, there is no definitive evidence to guide treatment of SE refractory to benzodiazepines. The main objectives of treatment protocols are to expedite therapeutic decisions and to use fast- and short-acting medications without significant adverse effects. Protocols differ among institutions, and most frequently valproate, phenytoin, and levetiracetam are used as second-line treatment. After failure of first- and second-line medications, admission to the intensive care unit and continuous infusion of anesthetics are usually indicated...
April 2023: Epilepsia
https://read.qxmd.com/read/36790006/electrolyte-imbalance-and-neurologic-injury
#33
JOURNAL ARTICLE
Jordan Poe, Sai Sriram, Yusuf Mehkri, Brandon Lucke-Wold
Neurologic injury continues to be a debilitating worldwide disease with high morbidity and mortality. The systemic sequelae of a neural insult often lead to prolonged hospital stays and challenging nutritional demands that contribute to poorer prognoses. Clinical management of a given condition should prioritize preserving the homeostatic parameters disrupted by inflammatory response cascades following the primary insult. This focused review examines the reciprocal relationship between electrolyte disturbance and neurologic injury...
February 15, 2023: CNS & Neurological Disorders Drug Targets
https://read.qxmd.com/read/36761344/seizure-burden-and-neuropsychological-outcomes-of-new-onset-refractory-status-epilepticus-systematic-review
#34
REVIEW
Olga Taraschenko, Spriha Pavuluri, Cynthia M Schmidt, Yashwanth Reddy Pulluru, Navnika Gupta
BACKGROUND: Long-term sequelae of the new onset refractory status epilepticus (NORSE) include the development of epilepsy, cognitive deficits, and behavioral disturbances. The prevalence of these complications has been previously highlighted in case reports and case series: however, their full scope has not been comprehensively assessed. METHODS: We conducted a systematic review of the literature (PROSPERO ID CRD42022361142) regarding neurological and functional outcomes of NORSE at 30 days or longer following discharge from the hospital...
2023: Frontiers in Neurology
https://read.qxmd.com/read/36691237/real-time-seizure-detection-in-paediatric-intensive-care-patients-the-reset-child-brain-protocol
#35
JOURNAL ARTICLE
Michaela Waak, Kristen Gibbons, Louise Sparkes, Jane Harnischfeger, Sandra Gurr, Andreas Schibler, Anthony Slater, Stephen Malone
INTRODUCTION: Approximately 20%-40% of comatose children with risk factors in intensive care have electrographic-only seizures; these go unrecognised due to the absence of continuous electroencephalography (EEG) monitoring (cEEG). Utility of cEEG with high-quality assessment is currently limited due to high-resource requirements. New software analysis tools are available to facilitate bedside cEEG assessment using quantitative EEG (QEEG) trends. The primary aim of this study is to describe accuracy of interpretation of QEEG trends by paediatric intensive care unit (PICU) nurses compared with cEEG assessment by neurologist (standard clinical care) in children at risk of seizures and status epilepticus utilising diagnostic test statistics...
June 3, 2022: BMJ Open
https://read.qxmd.com/read/36688794/propofol-versus-sodium-thiopentone-for-the-treatment-of-status-epilepticus-and-refractory-status-epilepticus-in-dogs
#36
JOURNAL ARTICLE
I Espiñeira, D Alzate, J Araos, F Pellegrino, M Tunesi, M Jensen, P A Donati
AIMS: To compare the effect on mortality and length of hospital stay of propofol with that of sodium thiopentone for the management of dogs with status epilepticus (SE) and refractory status epilepticus (RSE). METHODS: In this cohort study, medical records of a veterinary referral clinic in Argentina were retrospectively searched for dogs that were hospitalised and required induction of therapeutic coma (TC) with either propofol or sodium thiopentone for the management of SE or RSE of any cause...
January 23, 2023: New Zealand Veterinary Journal
https://read.qxmd.com/read/36682749/-elderly-onset-epilepsy-and-post-stroke-epilepsy
#37
JOURNAL ARTICLE
Takeharu Kunieda
It has been reported that the incidence of epilepsy in individuals over the age of 75 years is similar to or higher than one year, suggesting that epilepsy is an important clinical condition in older people. The aging rate in Japan, which reached 27.3% in 2017, makes this an issue of increasing concern. Diagnosis begins with the collection of medical history and knowledge of seizure semiology. In the elderly, most seizures are of extratemporal origin with various seizure semiologies. Difficulties in diagnosis lie in the influence of the autonomic nervous system and nonconvulsive status epilepticus(NCSE)...
January 2023: No Shinkei Geka. Neurological Surgery
https://read.qxmd.com/read/36617960/super-refractory-status-epilepticus-during-blinatumomab-initiation-for%C3%A2-b-cell-acute-lymphoblastic-leukemia
#38
JOURNAL ARTICLE
Chethan K Rao, Samuel Kamoroff, Julian Zorrilla, Michael Joyce, Fernando N Galan
Seizures have been reported as an adverse effect of blinatumomab, a bispecific T-cell engager monoclonal antibody, which is mainly used for the treatment of pediatric relapsed/refractory leukemia. Here, we present the first reported case of super-refractory status epilepticus in an 11-year-old boy with B-cell acute lymphoblastic leukemia (B-ALL) while receiving blinatumomab. Our patient had a complete return to baseline despite enduring encephalopathy, refractory subclinical seizures requiring prolonged therapeutic burst suppression and MRI signal changes...
December 2022: Immunotherapy
https://read.qxmd.com/read/36474454/refractory-convulsive-status-epilepticus-provoked-by-intoxication-with-dalfampridine-in-a-patient-with-multiple-sclerosis-and-depression-disorder-a-case-report-and-literature-review
#39
REVIEW
Mehdi Maghbooli, Zahra Jourahmad, Mehrdad Golizadeh
PURPOSE: Dalfampridine (DFP) is used to improve motor functions in patients with multiple sclerosis (MS). Overdose of DFP can occur for a variety of reasons and can lead to a state of epilepsy. CASE REPORT: A 24-year-old woman with MS was admitted to hospital with severe sweating and delirium after attempting suicide by overdosing on DFP. At the time of hospitalization, she developed a tonic-clonic seizure that did not respond to immediate intravenous (IV) diazepam injection, followed by intravenous sodium valproate...
March 30, 2023: Acta Neurologica Taiwanica
https://read.qxmd.com/read/36401982/levetiracetam-versus-phenobarbital-for-neonatal-seizures-a-retrospective-cohort-study
#40
JOURNAL ARTICLE
Linda Bättig, Corinne Dünner, Dorottya Cserpan, Andrea Rüegger, Cornelia Hagmann, Bernhard Schmitt, Francesco Pisani, Georgia Ramantani
BACKGROUND: Although phenobarbital (PB) is commonly used as a first-line antiseizure medication (ASM) for neonatal seizures, in 2015 we chose to replace it with levetiracetam (LEV), a third-generation ASM. Here, we compared the safety and efficacy of LEV and PB as first-line ASM, considering the years before and after modifying our treatment protocol. METHODS: We conducted a retrospective cohort study of 108 neonates with electroencephalography (EEG)-confirmed seizures treated with first-line LEV or PB in 2012 to 2020...
January 2023: Pediatric Neurology
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