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Non convulsive status epilepticus

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https://www.readbyqxmd.com/read/29650639/non-convulsive-status-epilepticus-mimics-and-chameleons
#1
REVIEW
Michael Owen Kinney, John J Craig, P W Kaplan
Non-convulsive status epilepticus (NCSE) is an enigmatic condition with protean manifestations. It often goes unrecognised, leading to delays in its diagnosis and treatment. The principal reason for such delay is the failure to consider and request an electroencephalogram (EEG), although occasional presentations have no scalp or surface electroencephalographic correlate. In certain settings with limited EEG availability, particularly out-of-hours, clinicians should consider treating without an EEG. Patients need a careful risk-benefit analysis to assess the risks of neuronal damage and harm versus the risks of adverse effects from various intensities of therapeutic intervention...
April 12, 2018: Practical Neurology
https://www.readbyqxmd.com/read/29643084/factors-associated-with-treatment-delays-in-pediatric-refractory-convulsive-status-epilepticus
#2
I Sánchez Fernández, M Gaínza-Lein, N S Abend, A E Anderson, R Arya, J N Brenton, J L Carpenter, K E Chapman, J Clark, W D Gaillard, T A Glauser, J L Goldstein, H P Goodkin, A R Helseth, M C Jackson, K Kapur, Y-C Lai, T L McDonough, M A Mikati, A Nayak, K Peariso, J J Riviello, R C Tasker, D Tchapyjnikov, A A Topjian, M S Wainwright, A Wilfong, K Williams, T Loddenkemper
OBJECTIVE: To identify factors associated with treatment delays in pediatric patients with convulsive refractory status epilepticus (rSE). METHODS: This prospective, observational study was performed from June 2011 to March 2017 on pediatric patients (1 month to 21 years of age) with rSE. We evaluated potential factors associated with increased treatment delays in a Cox proportional hazards model. RESULTS: We studied 219 patients (53% males) with a median (25th-75th percentiles [p25 -p75 ]) age of 3...
April 11, 2018: Neurology
https://www.readbyqxmd.com/read/29589330/the-use-of-continuous-eeg-monitoring-in-intensive-care-units-in-the-netherlands-a-national-survey
#3
Danny M W Hilkman, Walther N K A van Mook, Werner H Mess, Vivianne H J M van Kranen-Mastenbroek
BACKGROUND: Currently, continuous electroencephalographic monitoring (cEEG) is the only available diagnostic tool for continuous monitoring of brain function in intensive care unit (ICU) patients. Yet, the exact relevance of routinely applied ICU cEEG remains unclear, and information on the implementation of cEEG, especially in Europe, is scarce. This study explores current practices of cEEG in adult Dutch ICU departments focusing on organizational and operational factors, development over time and factors perceived relevant for abstaining its use...
March 27, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29526428/-status-epilepticus-recent-advances
#4
William Szurhaj, Nicolas Engrand
About half of status epilepticus (SE) occur in patients without epilepsy. An EEG has to be performed quickly in any patient who remains unconscious after the end of convulsions with the aim to detect a subtle status. An EEG should be performed as soon as possible in case of suspicion of non-convulsive status epilepticus, or in case of a confusional state whose origin remains unknown. The realization of a cerebral imaging is very often necessary in case of inaugural SE, as soon as the patient's condition allow it...
March 8, 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29462742/refractory-status-epilepticus-impact-of-baseline-comorbidity-and-usefulness-of-stess-and-emse-scoring-systems-in-predicting-mortality-and-functional-outcome
#5
Jordi Ciurans, Laia Grau-López, Marta Jiménez, Alejandra Fumanal, Maite Misis, Juan Luis Becerra
PURPOSE: Little has been published on the prognostic value of the Status Epilepticus Severity Score (STESS) or the Epidemiology-based Mortality score in Status Epilepticus (EMSE) in refractory status epilepticus (RSE). We sought to analyze the prognostic value of STESS and EMSE and the impact of baseline comorbidities in mortality and functional outcome in RSE. METHODS: We designed an observational retrospective study of patients diagnosed with RSE between August 2013 and September 2017...
February 12, 2018: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29459611/non-convulsive-status-epilepticus-in-children-clinical-profile-eeg-characteristics-and-treatment
#6
K Fatema, M M Rahman, S Akhter, N Akter, S Begum
Non-convulsive status epilepticus (NCSE) is a term used to denote a range of conditions in which electrographic seizure activity is prolonged and results in non-convulsive clinical symptoms. This study was done to describe the clinical spectrum, EEG findings and to evaluate the efficacy of different therapeutic agents in children with NCSE in 33 patients from January 2011 to December 2015 period. All patients had EEG before and after treatment. Age range was 6 months to 14 year, 25 were male. Regarding development status, 48% had developmental delay, 21% had normal development, 9% had regression and 21% had both developmental delay and regression...
January 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29455222/encephalopathy-mimicking-non-convulsive-status-epilepticus
#7
Ramachandiran Nandhagopal, Fathiya Al-Murshedi, Mujahid Al-Busaidi, Amna Al-Busaidi
Primary hyperammonemic encephalopathy due to urea cycle disorders (UCD) typically manifests with episodic unresponsiveness and this clinical entity is not often included in the differential diagnosis of presumed non-convulsive status epilepticus (NCSE). However, this diagnostic consideration has therapeutic implications. In this report, we document the therapeutic importance of elucidating the specific cause of hyperammonemic encephalopathy that closely mimicked NCSE through 2 unique illustrative cases.
January 2018: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
https://www.readbyqxmd.com/read/29430560/epilepsy-is-associated-with-ventricular-alterations-following-convulsive-status-epilepticus-in-children
#8
Wail Ali, Beth A Bubolz, Linh Nguyen, Danny Castro, Jorge Coss-Bu, Michael M Quach, Curtis E Kennedy, Anne E Anderson, Yi-Chen Lai
Objective: Convulsive status epilepticus can exert profound cardiovascular effects in adults including ventricular depolarization-repolarization abnormalities. Whether status epilepticus adversely affects ventricular electrical properties in children is less understood. Therefore, we sought to characterize ventricular alterations and the associated clinical factors in children following convulsive status epilepticus. Methods: We conducted a 2-year retrospective, case-control study...
December 2017: Epilepsia Open
https://www.readbyqxmd.com/read/29368126/pharmacotherapy-for-refractory-and-super-refractory-status-epilepticus-in-adults
#9
Martin Holtkamp
Patients with prolonged seizures that do not respond to intravenous benzodiazepines and a second-line anticonvulsant suffer from refractory status epilepticus and those with seizures that do not respond to continuous intravenous anesthetic anticonvulsants suffer from super-refractory status epilepticus. Both conditions are associated with significant morbidity and mortality. A strict pharmacological treatment regimen is urgently required, but the level of evidence for the available drugs is very low. Refractory complex focal status epilepticus generally does not require anesthetics, but all intravenous non-anesthetizing anticonvulsants may be used...
January 24, 2018: Drugs
https://www.readbyqxmd.com/read/29344469/successful-use-of-therapeutic-hypothermia-for-refractory-nonconvulsive-status-epilepticus
#10
Do-Hyung Kim, Hye-Hoon Kang, Minjung Kim, Tae-Won Yang, Oh-Young Kwon, Jung Sook Yeom, Bong Su Kang, Yong Hwan Kim, Young-Soo Kim
Therapeutic hypothermia (TH) has rarely been utilized as an adjunct to anticonvulsants in treating patients with refractory convulsive status epilepticus (CSE). However, determining the effectiveness of TH in CSE is difficult due to the unavoidable use of sedative drugs to manage hypothermia. Additionally, the effectiveness of TH has not been studied in patients with refractory non-convulsive status epilepticus (NCSE). Here, we report the successful use of TH without additional sedative drugs in a patient with temporal lobe epilepsy and refractory NCSE...
December 2017: Journal of Epilepsy Research
https://www.readbyqxmd.com/read/29320603/drug-management-for-acute-tonic-clonic-convulsions-including-convulsive-status-epilepticus-in-children
#11
REVIEW
Amy McTague, Timothy Martland, Richard Appleton
BACKGROUND: Tonic-clonic convulsions and convulsive status epilepticus (currently defined as a tonic-clonic convulsion lasting at least 30 minutes) are medical emergencies and require urgent and appropriate anticonvulsant treatment. International consensus is that an anticonvulsant drug should be administered for any tonic-clonic convulsion that has been continuing for at least five minutes. Benzodiazepines (diazepam, lorazepam, midazolam) are traditionally regarded as first-line drugs and phenobarbital, phenytoin and paraldehyde as second-line drugs...
January 10, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29226310/long-term-behavioural-outcomes-after-paediatric-convulsive-status-epilepticus-a-population-based-cohort-study
#12
Marina M Martinos, Suresh Pujar, Christopher Gillberg, Mario Cortina-Borja, Brian G R Neville, Michelle De Haan, Rod C Scott, Richard F M Chin
AIM: To describe behavioural and psychiatric outcomes of children within 10 years of convulsive status epilepticus (CSE). METHOD: Children originally identified by the population-based North London Convulsive Status Epilepticus in Childhood Surveillance Study were followed-up between July 2009 and February 2013. They were grouped into epilepsy- and non-epilepsy-related CSE, and compared with population norms and healthy controls using the Strengths and Difficulties Questionnaire; the Autism Spectrum Screening Questionnaire; and the Swanson, Nolan, and Pelham questionnaire...
December 10, 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/29197620/role-of-the-fyn-pkc%C3%AE-signaling-in-se-induced-neuroinflammation-and-epileptogenesis-in-experimental-models-of-temporal-lobe-epilepsy
#13
Shaunik Sharma, Steven Carlson, Sreekanth Puttachary, Souvarish Sarkar, Lucas Showman, Marson Putra, Anumantha G Kanthasamy, Thimmasettappa Thippeswamy
Status epilepticus (SE) induces neuroinflammation and epileptogenesis, but the mechanisms are not yet fully delineated. The Fyn, a non-receptor Src family tyrosine kinase (SFK), and its immediate downstream target, PKCδ are emerging as potential mediators of neuroinflammation. In order to first determine the role of Fyn kinase signaling in SE, we tested the efficacy of a SFK inhibitor, saracatinib (25mg/kg, oral) in C57BL/6J mouse kainate model of acute seizures. Saracatinib pretreatment dampened SE severity and completely prevented mortality...
February 2018: Neurobiology of Disease
https://www.readbyqxmd.com/read/29137682/cefepime-induced-neurotoxicity-a-systematic-review
#14
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/29125945/periodic-eeg-patterns-in-sporadic-creutzfeld-jakob-disease-can-be-benzodiazepine-responsive-and-be-difficult-to-distinguish-from-non-convulsive-status-epilepticus
#15
Justus Marquetand, Susanne Knake, Adam Strzelczyk, Bernhard J Steinhoff, Holger Lerche, Matthis Synofzik, Niels K Focke
PURPOSE: Periodic discharges in EEG and a history of rapidly progressive dementia are known to be associated with sporadic Creutzfeld-Jakob Disease (sCJD). Doubts regarding this rare but fatal diagnosis can arise, when episodic symptoms (seizures, psychiatric features, speech disturbances) are present and the EEG shows epileptiform discharges within this periodicity. This scenario may indicate non-convulsive status epilepticus (NCSE), which is - in contrast to sCJD - a treatable and frequent condition...
December 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29123833/clinical-characteristics-of-non-convulsive-status-epilepticus-diagnosed-by-simplified-continuous-electroencephalogram-monitoring-at-an-emergency-intensive-care-unit
#16
Satoshi Egawa, Toru Hifumi, Kenya Kawakita, Arisa Manabe, Ryuta Nakashima, Hikari Matsumura, Tomoya Okazaki, Hideyuki Hamaya, Natsuyo Shinohara, Hajime Shishido, Koshiro Takano, Yuko Abe, Masanobu Hagiike, Yuichi Kubota, Yasuhiro Kuroda
Aim: The present study aimed to elucidate the clinical characteristics of non-convulsive status epilepticus (NCSE) in patients with altered mental status (AMS). Methods: This single-center retrospective study comprised 149 patients who were hospitalized between March 1, 2015 and September 30, 2015 at the emergency intensive care unit (ICU) of the Kagawa University Hospital (Kagawa, Japan). The primary outcome was NCSE incidence. The secondary outcome was the comparison of duration of ICU stay, hospital stay, and a favorable neurological outcome, as assessed using the modified Rankin Scale score, at discharge from our hospital between patients with and without NCSE...
January 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29111005/impact-of-non-guideline-based-treatment-of-status-epilepticus
#17
James Braun, Elizabeth Gau, Stacy Revelle, Laurie Byrne, Abhay Kumar
BACKGROUND: This retrospective study analyzed benzodiazepine usage patterns in relation to guideline recommendations for the treatment of generalized convulsive status epilepticus (GCSE) as practiced by emergency medical services (EMS) and the emergency department (ED) of an inner-city hospital. Secondary outcomes of interest were adverse events and admission/discharge outcomes. METHODS: Records of all patients≥18years old diagnosed with GCSE between June 2012 and September 2015 and transported by EMS to our hospital ED were reviewed...
November 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29108660/usefulness-of-electroencephalography-for-the-management-of-epilepsy-in-emergency-departments
#18
A Viloria Alebesque, A López Bravo, E Bellosta Diago, S Santos Lasaosa, J A Mauri Llerda
INTRODUCTION: Electroencephalography (EEG) is an essential diagnostic tool in epilepsy. Its use in emergency departments (ED) is usually restricted to the diagnosis and management of non-convulsive status epilepticus (NCSE). However, EDs may also benefit from EEG in the context of other situations in epilepsy. METHODS: We conducted a retrospective observational study using the clinical histories of patients treated at our hospital's ED for epileptic seizures and suspicion of NCSE and undergoing EEG studies in 2015 and 2016...
November 3, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/29104261/neurochemical-changes-and-c-fos-mapping-in-the-brain-after-carisbamate-treatment-of-rats-subjected-to-lithium-pilocarpine-induced-status-epilepticus
#19
José Eduardo Marques-Carneiro, Astrid Nehlig, Jean-Christophe Cassel, Eduardo Ferreira Castro-Neto, Julia Julie Litzahn, Anne Pereira de Vasconcelos, Maria da Graça Naffah-Mazacoratti, Maria José da Silva Fernandes
The administration of lithium-pilocarpine (LiPilo) in adult rats is a validated model reproducing the main clinical and neuropathological features of temporal lobe epilepsy (TLE). Previous studies have shown that carisbamate (CRS) has the property of modifying epileptogenesis in this model. When treated with CRS, about 50% of rats undergoing LiPilo status epilepticus (SE) develop non-convulsive seizures (NCS) instead of convulsive ones (commonly observed in TLE). The goal of this work was to determine some of the early changes that occur after CRS administration, as they could be involved in the insult- and epileptogenesis-modifying effects of CRS...
November 1, 2017: Pharmaceuticals
https://www.readbyqxmd.com/read/28963934/factors-associated-with-occurrence-and-outcome-of-super-refractory-status-epilepticus
#20
Dominik Madžar, Ruben U Knappe, Caroline Reindl, Antje Giede-Jeppe, Maximilian I Sprügel, Vanessa Beuscher, Stephanie Gollwitzer, Hajo M Hamer, Hagen B Huttner
PURPOSE: Super-refractory status epilepticus (SRSE) represents a challenging medical condition with high morbidity and mortality. In this study, we aimed to establish variables related to SRSE development and outcome. METHODS: We retrospectively screened our databases for refractory SE (RSE) and SRSE episodes between January 2001 and January 2015. Baseline demographics, SE characteristics, and variables reflecting the clinical course were compared in order to identify factors independently associated with SRSE occurrence...
November 2017: Seizure: the Journal of the British Epilepsy Association
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