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https://www.readbyqxmd.com/read/27894945/successful-treatment-of-refractory-status-epilepticus-using-anterior-thalamic-nuclei-deep-brain-stimulation
#1
Ching-Yi Lee, Siew-Na Lim, Tony Wu, Shih-Tseng Lee
BACKGROUND: Refractory status epilepticus(RSE) is considered a medical emergency in neurology and is related to a high mortality rate. We report a successfully treated case of RSE using deep brain stimulation (DBS) at the anterior thalamic nuclei (ATN). METHOD: Report concerning the resolution of RSE after DBS of the ATN in a 17-year-old woman RESULT: This patient developed RSE due to progressive seizure activity. RSE with generalized tonic-clonic seizures was noted two weeks prior to admission...
November 25, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27893511/continuous-infusion-antiepileptic-medications-for-refractory-status-epilepticus-a-review-for-nurses
#2
Adam L Wiss, Michael Samarin, Jacob Marler, G Morgan Jones
Status epilepticus requires treatment with emergent initial therapy with a benzodiazepine and urgent control therapy with an additional antiepileptic drug (AED) to terminate clinical and/or electrographic seizure activity. However, nearly one-third of patients will prove refractory to the aforementioned therapies and are prone to a higher degree of neuronal injury, resistance to pharmacotherapy, and death. Current guidelines for refractory status epilepticus (RSE) recommend initiating a continuous intravenous (CIV) anesthetic over bolus dosing with a different AED...
January 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27867719/monitoring-cerebral-oxygenation-and-local-field-potential-with-a-variation-of-isoflurane-concentration-in-a-rat-model
#3
Dong-Hyuk Choi, Teo Jeon Shin, Seonghyun Kim, Jayyoung Bae, Dongrae Cho, Jinsil Ham, Ji-Young Park, Hyoung-Ihl Kim, Seongwook Jeong, Boreom Lee, Jae Gwan Kim
We aimed to investigate experimentally how anesthetic levels affect cerebral metabolism measured by near-infrared spectroscopy (NIRS) and to identify a robust marker among NIRS parameters to discriminate various stages of anesthetic depth in rats under isoflurane anesthesia. In order to record the hemodynamic changes and local field potential (LFP) in the brain, fiber-optic cannulae and custom-made microelectrodes were implanted in the frontal cortex of the skull. The NIRS and LFP signals were continuously monitored before, during and after isoflurane anesthesia...
October 1, 2016: Biomedical Optics Express
https://www.readbyqxmd.com/read/27864903/long-term-monitoring-of-cardiorespiratory-patterns-in-drug-resistant-epilepsy
#4
Daniel M Goldenholz, Amanda Kuhn, Alison Austermuehle, Martin Bachler, Christopher Mayer, Siegfried Wassertheurer, Sara K Inati, William H Theodore
OBJECTIVE: Sudden unexplained death in epilepsy (SUDEP) during inpatient electroencephalography (EEG) monitoring has been a rare but potentially preventable event, with associated cardiopulmonary markers. To date, no systematic evaluation of alarm settings for a continuous pulse oximeter (SpO2 ) has been performed. In addition, evaluation of the interrelationship between the ictal and interictal states for cardiopulmonary measures has not been reported. METHODS: Patients with epilepsy were monitored using video-EEG, SpO2 , and electrocardiography (ECG)...
November 16, 2016: Epilepsia
https://www.readbyqxmd.com/read/27856078/not-everything-that-shakes-is-a-seizure%C3%A2-role-of-continuous-eeg-in-the-intensive-care-unit
#5
Thomas Ritzenthaler, Chloé Laurencin, Nathalie André Obadia, Carole Bodonian, Frédéric Dailler
Treatment of status epilepticus often requires highly sedative drugs with risk of side effects. Correct diagnosis is mandatory in order to prevent introduction of usefulness treatments. We report a case of suspected myoclonic status epilepticus. A thalamic lesion secondary to an osmotic demyelination syndrome was found to be the likely etiology of the myoclonus. Electrophysiological data (electroencephalography and electromyography) provided evidence for a subcortical origin of myoclonus and use of continuous EEG allowed monitoring of drug withdrawal...
November 14, 2016: Neurophysiologie Clinique, Clinical Neurophysiology
https://www.readbyqxmd.com/read/27844464/the-safety-and-effectiveness-of-intravenous-lacosamide-for-refractory-status-epilepticus-in-the-critically-ill
#6
C R Newey, N M Le, C Ahrens, P Sahota, S Hantus
BACKGROUND: Status epilepticus (SE) often does not respond to initial treatment. A second-line agent with a less established safety and efficacy profile is then required. This study examined the safety of intravenous (IV) lacosamide (LCM) in a critically ill population and obtained an estimate of effectiveness in patients with refractory SE on continuous video EEG monitoring (cEEG). METHODS: Retrospective review of critically ill patients in SE on cEEG treated with IV LCM from June 2009 to April 2011...
November 14, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27818370/can-diffusion-weighted-imaging-be-used-as-a-tool-to-predict-seizures-in-patients-with-pleds
#7
Jaishree Narayanan
It is unclear which patients with PLEDs will have associated seizures and therefore will need to be treated aggressively with antiepileptic medications. We present a prospective observational study of ten consecutive non-anoxic patients with PLEDs based on continuous 24-hour EEG monitoring. According to the EEG, five of the patients had seizures associated with PLEDs and five had PLEDs but no seizures. The aetiology included: neoplasm (n=1), cortical dysplasia (n=1), acute head trauma (n=1), encephalomalacia related to healed abscess (n=1), intra-parenchymal haemorrhage (n=1), and no structural lesion (n=5)...
November 4, 2016: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/27801943/auditory-n1-reveals-planning-and-monitoring-processes-during-music-performance
#8
Brian Mathias, William J Gehring, Caroline Palmer
The current study investigated the relationship between planning processes and feedback monitoring during music performance, a complex task in which performers prepare upcoming events while monitoring their sensory outcomes. Theories of action planning in auditory-motor production tasks propose that the planning of future events co-occurs with the perception of auditory feedback. This study investigated the neural correlates of planning and feedback monitoring by manipulating the contents of auditory feedback during music performance...
November 1, 2016: Psychophysiology
https://www.readbyqxmd.com/read/27771198/yield-of-repeated-intermittent-eeg-for-seizure-detection-in-critically-ill-adults
#9
Yannick Fogang, Benjamin Legros, Chantal Depondt, Nicolas Mavroudakis, Nicolas Gaspard
INTRODUCTION: Seizures are common in critically ill patients and prevalence can exceed 30% in the neuro-intensive care unit (ICU). Continuous EEG monitoring (cEEG) is the gold standard for seizure detection in critically ill patients. OBJECTIVES: To determine the yield of intermittent EEG (iEEG) to detect critically ill adult patients with seizures and to identify the factors that affect this yield. METHODS: We retrospectively analyzed cEEG data and medical records from 977 consecutive critically ill patients undergoing cEEG...
October 19, 2016: Neurophysiologie Clinique, Clinical Neurophysiology
https://www.readbyqxmd.com/read/27769717/progressive-neuronal-activation-accompanies-epileptogenesis-caused-by-hippocampal-glutamine-synthetase-inhibition
#10
Benjamin Albright, Roni Dhaher, Helen Wang, Roa Harb, Tih-Shih W Lee, Hitten Zaveri, Tore Eid
Loss of glutamine synthetase (GS) in hippocampal astrocytes has been implicated in the causation of human mesial temporal lobe epilepsy (MTLE). However, the mechanism by which the deficiency in GS leads to epilepsy is incompletely understood. Here we ask how hippocampal GS inhibition affects seizure phenotype and neuronal activation during epilepsy development (epileptogenesis). Epileptogenesis was induced by infusing the irreversible GS blocker methionine sulfoximine (MSO) unilaterally into the hippocampal formation of rats...
October 18, 2016: Experimental Neurology
https://www.readbyqxmd.com/read/27755068/clinical-practice-guidelines-for-sustained-neuromuscular-blockade-in-the-adult-critically-ill-patient
#11
Michael J Murray, Heidi DeBlock, Brian Erstad, Anthony Gray, Judi Jacobi, Che Jordan, William McGee, Claire McManus, Maureen Meade, Sean Nix, Andrew Patterson, M Karen Sands, Richard Pino, Ann Tescher, Richard Arbour, Bram Rochwerg, Catherine Friederich Murray, Sangeeta Mehta
OBJECTIVE: To update the 2002 version of "Clinical practice guidelines for sustained neuromuscular blockade in the adult critically ill patient." DESIGN: A Task Force comprising 17 members of the Society of Critical Medicine with particular expertise in the use of neuromuscular-blocking agents; a Grading of Recommendations Assessment, Development, and Evaluation expert; and a medical writer met via teleconference and three face-to-face meetings and communicated via e-mail to examine the evidence and develop these practice guidelines...
November 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27750052/continuous-eeg-monitoring-in-post-cardiac-arrest-patients-further-prognostic-insights
#12
EDITORIAL
G Bryan Young
No abstract text is available yet for this article.
December 2016: Resuscitation
https://www.readbyqxmd.com/read/27749460/utility-of-continuous-eeg-monitoring-in-noncritically-lll-hospitalized-patients
#13
Santoshi Billakota, Saurabh R Sinha
INTRODUCTION: Continuous EEG (cEEG) monitoring is used in the intensive care unit (ICU) setting to detect seizures, especially nonconvulsive seizures and status epilepticus. The utility and impact of such monitoring in non-ICU patients are largely unknown. METHODS: Hospitalized patients who were not in an ICU and underwent cEEG monitoring in the first half of 2011 and 2014 were identified. Reason for admission, admitting service (neurologic and nonneurologic), indication for cEEG, comorbid conditions, duration of recording, EEG findings, whether an event/seizure was recorded, and impact of EEG findings on management were reviewed...
October 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27748723/seizures-and-epileptiform-discharges-in-patients-with-acute-subdural-hematoma
#14
Sebastian Pollandt, Bichun Ouyang, Thomas P Bleck, Katharina M Busl
PURPOSE: Subdural hematomas (SDH) are associated with seizures and epileptiform discharges, but little is known about the prevalence and impact of seizures, status epilepticus and epileptiform discharges on outcomes in patients with isolated acute SDH (aSDH). METHODS: Continuous EEG reports from 76 adult patients admitted to Rush University Medical Center with aSDH between 01/2009 and 03/2012 were reviewed. Clinical and radiographic findings, comorbidities, treatment, and outcome parameters mortality, discharge destination, need for tracheostomy/percutaneous endoscopic gastrostomy (PEG) placement and length of stay (LOS) were assessed...
June 20, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27732916/correlation-of-seizure-frequency-and-medication-down-titration-rate-during-video-eeg-monitoring
#15
Sami Al Kasab, Rachael A Dawson, Jorge L Jaramillo, Jonathan J Halford
OBJECTIVE: The three important questions in video-EEG monitoring are (1) whether it is productive to monitor patients with low outpatient seizure frequency, (2) whether rapid down-titration of antiepileptic drugs (AEDs) during EMU admission helps generate more recorded seizures, and (3) how long a patient who has not yet had a seizure should be monitored in the EMU. This study aimed to answer these three questions. METHODS: Preadmission seizure frequency, times of AED administration, and times of seizure occurrence were collected on all adult patients admitted to the EMU at the Medical University of South Carolina (MUSC) between 2012 and 2014 - a total of 439 patients...
October 9, 2016: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/27709099/preoperative-evaluation-and-surgical-decision-making-in-pediatric-epilepsy-surgery
#16
Katrina Ducis, Jian Guan, Michael Karsy, Robert J Bollo
Epilepsy is a common disease in the pediatric population, and the majority of cases are controlled with medications and lifestyle modification. For the children whose seizures are pharmacoresistant, continued epileptic activity can have a severely detrimental impact on cognitive development. Early referral of children with drug-resistant seizures to a pediatric epilepsy surgery center for evaluation is critical to achieving optimal patient outcomes. There are several components to a thorough presurgical evaluation, including a detailed medical history and physical examination, noninvasive testing including electroencephalogram, magnetic resonance imaging (MRI) of the brain, and often metabolic imaging...
July 2016: Translational pediatrics
https://www.readbyqxmd.com/read/27707438/validation-of-a-wireless-self-application-ambulatory-electroencephalographic-sleep-monitoring-device-in-healthy-volunteers
#17
Patrick H Finan, Jessica M Richards, Charlene E Gamaldo, Dingfen Han, Jeannie Marie Leoutsakos, Rachel Salas, Michael R Irwin, Michael T Smith
STUDY OBJECTIVES: To evaluate the validity of an ambulatory electroencephalographic (EEG) monitor for the estimation of sleep continuity and architecture in healthy adults. METHODS: Healthy, good sleeping participants (n = 14) were fit with both an ambulatory EEG monitor (Sleep Profiler) and a full polysomnography (PSG) montage. EEG recordings were gathered from both devices on the same night, during which sleep was permitted uninterrupted for eight hours. The study was set in an inpatient clinical research suite...
November 15, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/27695597/continuous-qualitative-electroencephalography-as-a-noninvasive-neuromonitor
#18
Zachary D Threlkeld, Mohan Kottapally, Aimee Aysenne, Nerissa Ko
Intracranial pressure (ICP) monitoring frequently guides key decisions in the management of diseases causing intracranial hypertension. Although typically measured by invasive means, contraindications may leave the clinician with little recourse for dynamic ICP evaluation-particularly when the patient's mental status is compromised. We describe here a healthy 18-year-old woman who subacutely progressed to coma due to diffuse cerebral venous sinus thrombosis. Heparinization precluded the use of invasive ICP monitoring, and electroencephalography (EEG) was used novelly as a surrogate ICP monitor...
October 2016: Neurohospitalist
https://www.readbyqxmd.com/read/27679737/early-high-dose-caffeine-increases-seizure-burden-in-extremely-preterm-neonates-a-preliminary-study
#19
Zachary A Vesoulis, Christopher McPherson, Jeffrey J Neil, Amit M Mathur, Terrie E Inder
Background: Although evidence suggests that methylxanthines may lower the seizure threshold, the effect of high-dose caffeine on seizure burden in preterm infants is not known. This study reports a secondary post hoc analysis of a randomized controlled trial of early high-dose caffeine citrate therapy in preterm infants, evaluating the effect of caffeine on the seizure burden using amplitude-integrated electroencephalography (aEEG). Methods: Seventy-four preterm infants (≤30 weeks gestation) were randomized to receive high-dose (n = 37, 80 mg/kg over 36 hours) or standard-dose (n = 37, 30 mg/kg over 36 hours) caffeine citrate over the first 36 hours followed by standard maintenance therapy...
September 1, 2016: Journal of Caffeine Research
https://www.readbyqxmd.com/read/27660746/acute-intermittent-porphyria-presenting-with-posterior-reversible-encephalopathy-syndrome-and-lateralized-periodic-discharges-plus-fast-activity-on-eeg
#20
Diosely C Silveira, Mahrukh Bashir, Joshua Daniel, Michelle H Lucena, Frank Bonpietro
We report on a 20-year-old patient with a 6-month history of recurrent abdominal pain and a 3-day history of vomiting, hypertension, seizures, and encephalopathy. The brain MRI showed posterior reversible encephalopathy syndrome, and continuous EEG (cEEG) monitoring showed lateralized periodic discharges plus fast activity. Comprehensive CSF studies were negative. Because of severe abdominal pain without a definite etiology, we requested urine porphobilinogen and serum and fecal porphyrins, which suggested acute intermittent porphyria (AIP)...
2016: Epilepsy & Behavior Case Reports
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