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Status epilepticus in children

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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/29786801/-epilepsy-incidens-prevalens-and-causes
#2
Lars Forsgren, Heléne Sundelin, Olafur Sveinsson
Epilepsy affects people in all ages with the highest incidence in small children, particularly before age one year, and in elderly aged 65 years and older. In Sweden, between 4500-5000 persons develop epilepsy annually. Based on studies from North America and Europe, including the Nordic countries, the number of people with active epilepsy in Sweden is between 60000-70000. The lifetime risk for epilepsy up to age 85 years is 4-5 %, i.e. approximately every 25th person. The new epilepsy classification divides etiology into the following groups: structural, genetic, infectious, metabolic, immune and unknown...
May 21, 2018: Läkartidningen
https://www.readbyqxmd.com/read/29778428/status-dystonicus-due-to-missense-variant-in-arx-diagnosis-and-management
#3
Kathleen M Gorman, Heather Cary, Laura Gaffney, Eva Forman, Dympna Waldron, Fowzy Al-Delami, Bryan J Lynch, Mary D King, Nicholas M Allen
Movement disorders are increasingly identified in infantile encephalopathies due to single gene disorders (e.g. SCN2A, CDKL5, ARX). The associated movement disorder can be challenging to recognise and treat. We report a 2 year-old boy with a background history of Ohtahara syndrome due to a missense variant in ARX (the aristaless-related homeobox gene) who subsequently developed status dystonicus. ARX is a transcription factor that plays a critical role in cortical neuronal development and is associated with a range of important neurodevelopmental disorders depending on the site of the pathogenic variant...
May 3, 2018: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/29753573/impact-of-prior-authorization-of-antiepileptic-drugs-in-children-with-epilepsy
#4
Elaine C Wirrell, Alexander J Vanderwiel, Lauren Nickels, Saskia L Vanderwiel, Katherine C Nickels
OBJECTIVE: We assessed how commonly prior authorization results in treatment delay or missed doses in children with epilepsy. METHODS: Parents of 462 children followed in a pediatric epilepsy clinic were surveyed regarding prior authorization in the preceding year. Epilepsy and insurance details were collected. If prior authorization was required, parents were asked whether it resulted in (1) delayed initiation of a newly-prescribed antiepileptic drug, and/or (2) lapse in coverage of a current medication...
April 3, 2018: Pediatric Neurology
https://www.readbyqxmd.com/read/29747930/baseline-and-outcome-assessment-in-pediatric-status-epilepticus
#5
REVIEW
Saba Jafarpour, Coral M Stredny, Juan Piantino, Kevin E Chapman
PURPOSE: To summarize different aspects of short and long-term outcomes associated with SE, including mortality, recurrence, subsequent epilepsy, neurocognitive dysfunction, imaging abnormalities, and health-related quality of life. METHODS: We searched MEDLINE for studies that assessed the short-term and long-term outcome of status epilepticus in pediatric population, including mortality, recurrence of seizure and status epilepticus, neurological, cognitive, or behavioral impairment, and health-related quality of life...
April 27, 2018: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29745347/febrile-infection-related-epilepsy-syndrome-fires-an-overview-of-treatment-and-recent-patents
#6
Kam Lun E Lun Hon, Alexander K C Leung, Alcy R Torres
BACKGROUND: New-onset refractory status epilepticus (NORSE) refers to a clinical presentation in a patient without active epilepsy or other existing relevant neurological disorder, with new onset of refractory status epilepticus in the absence of a clear acute or active structural, metabolic, or toxic cause. Febrile infection-related epilepsy syndrome (FIRES) is a subset of NORSE that requires a febrile infection between 24 hours and 2 weeks prior to the onset of refractory status epilepticus, with or without fever at the onset of status epilepticus, and with no restriction to the age of the patient...
May 8, 2018: Recent Patents on Inflammation & Allergy Drug Discovery
https://www.readbyqxmd.com/read/29702407/generalized-seizures-presurgically-in-a-cohort-of-children-with-hemispherectomy-predictors-and-a-potential-link-to-surgical-outcome
#7
Ming Liu, Taoyun Ji, Qingzhu Liu, Shuang Wang, Ye Wu, Wen Wang, Weike Cheng, Ruofan Wang, Guojing Yu, Xiaoyan Liu, Lixin Cai, Yuwu Jiang
PURPOSE: Generalized seizures were often thought to be contraindications for hemispherectomy. However, few studies had investigated this issue comprehensively, as well as the predictors for generalized seizures in hemispheric lesion. We studied the predictors of generalized seizures and their potential link to seizure outcomes in a cohort of children who underwent hemispherectomy. METHODS: A cohort of 76 children with hemispherectomy were reviewed and dichotomized into two groups with and without generalized seizures confirmed by vEEG presurgically...
March 29, 2018: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29687739/vigabatrin-for-epileptic-spasms-and-tonic-seizures-in-tuberous-sclerosis-complex
#8
Emma A van der Poest Clement, Mustafa Sahin, Jurriaan M Peters
Vigabatrin is recommended as first-line treatment for infantile spasms in tuberous sclerosis complex (TSC), but other indications in children with tuberous sclerosis complex are less known. We retrospectively reviewed 201 children with tuberous sclerosis complex, and identified 21 children older than 1 year started on vigabatrin for any indication and with sufficient follow-up data. The indication for vigabatrin was epileptic spasms (n = 13), tonic seizures (n = 5), both (n = 2), and status epilepticus (n = 1)...
January 1, 2018: Journal of Child Neurology
https://www.readbyqxmd.com/read/29683949/a-rare-case-of-hemophagocytic-lymphohistiocytosis-associated-with-myelodysplastic-syndrome-and-trisomy-8-in-a-pediatric-patient
#9
Seh Hyun Kim, Dae Yong Yi, Na Mi Lee, Sin Weon Yun, Soo Ahn Chae, In Seok Lim
Hemophagocytic lymphohistiocytosis (HLH) is a rare disease resulting in clinical and biochemical manifestations of extreme inflammation. Myelodysplastic syndrome (MDS) represents a heterogenous group of clonal hematopoietic disorders. The development of MDS is common in children with trisomy of chromosome 8. Here, we report a fatal case of 8-year-old girl who was admitted to the emergency department with status epilepticus, and later diagnosed with HLH associated with MDS and trisomy of chromosome 8. We believe this is the first reported case of HLH associated with MDS and trisomy 8 in a pediatric patient...
April 20, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29683201/different-as-night-and-day-patterns-of-isolated-seizures-clusters-and-status-epilepticus
#10
Daniel M Goldenholz, Kshitiz Rakesh, Kush Kapur, Marina Gaínza-Lein, Ryan Hodgeman, Robert Moss, William H Theodore, Tobias Loddenkemper
Using approximations based on presumed U.S. time zones, we characterized day and nighttime seizure patterns in a patient-reported database, Seizure Tracker. A total of 632 995 seizures (9698 patients) were classified into 4 categories: isolated seizure event (ISE), cluster without status epilepticus (CWOS), cluster including status epilepticus (CIS), and status epilepticus (SE). We used a multinomial mixed-effects logistic regression model to calculate odds ratios (ORs) to determine night/day ratios for the difference between seizure patterns: ISE versus SE, ISE versus CWOS, ISE versus CIS, and CWOS versus CIS...
April 23, 2018: Epilepsia
https://www.readbyqxmd.com/read/29588985/ketogenic-parenteral-nutrition-in-17-pediatric-patients-with-epilepsy
#11
Anastasia Dressler, Nadja Haiden, Petra Trimmel-Schwahofer, Franz Benninger, Sharon Samueli, Gudrun Gröppel, Sina Spatzierer, Angelika Mühlebner, Klaus Abraham, Martha Feucht
Objective: Ketogenic parenteral nutrition (kPN) is indicated when enteral intake is temporarily limited or impossible, but evidence-based prescriptions are lacking. Objective was to evaluate the efficacy and safety of kPN in children with epileptic encephalopathies using a new computer-based algorithm for accurate component calculating. Methods: Children with epilepsy receiving kPN were included. A computer-based algorithm was established on the basis of guidelines of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN): fat intake not exceeding 4 g/kg/day, age-adequate supply of protein, electrolytes, vitamins, and trace elements, but reduced carbohydrates...
March 2018: Epilepsia open
https://www.readbyqxmd.com/read/29587188/nonconvulsive-status-epilepticus-after-cessation-of-convulsive-status-epilepticus-in-pediatric-intensive-care-unit-patients
#12
Jin Chen, Lingling Xie, Yue Hu, Xinghui Lan, Li Jiang
Little is known about pediatric patients suffering from nonconvulsive status epilepticus (NCSE) after convulsive status epilepticus (CSE) cessation. The aim of this study was to identify in pediatric patients the clinical characteristics of NCSE after CSE cessation and the factors that contribute to patient outcomes. Data from clinical features, electroencephalography (EEG) characteristics, neuroimaging findings, treatments, and prognosis were systematically summarized, and the associations between clinical characteristics and prognosis were quantified...
March 24, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29582225/outcomes-in-children-treated-with-pentobarbital-infusion-for-refractory-and-super-refractory-status-epilepticus
#13
Jennifer Erklauer, Jeanine Graf, Mona McPherson, Anne Anderson, Angus Wilfong, Charles G Minard, Laura Loftis
BACKGROUND: Functional neurologic outcome for children with refractory and super-refractory status epilepticus has not been well defined. METHODS: Retrospective chart review including children age 0-17 years who received pentobarbital infusion from 2003 to 2016 for status epilepticus. Outcomes were defined in terms of mortality, need for new medical technology assistance at hospital discharge and functional neurologic outcome determined by pediatric cerebral performance category score (PCPC)...
March 26, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29492661/mortality-in-robin-sequence-identification-of-risk-factors
#14
Robrecht J H Logjes, Maartje Haasnoot, Petra M A Lemmers, Mike F A Nicolaije, Marie-José H van den Boogaard, Aebele B Mink van der Molen, Corstiaan C Breugem
Although Robin sequence (RS) is a well-known phenomenon, it is still associated with considerable morbidity and even mortality. The purposes of this study were to gain greater insight into the mortality rate and identify risk factors associated with mortality in RS. We retrospectively reviewed all RS infants followed at the Wilhelmina Children's Hospital from 1995 to 2016. Outcome measurements were death and causes of death. The authors identified 103 consecutive RS infants with a median follow-up of 8.6 years (range 0...
May 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29474272/an-update-in-the-initial-management-of-paediatric-status-epilepticus
#15
Ben Lawton, Tessa Davis, Henry Goldstein, Andrew Tagg
PURPOSE OF REVIEW: Over the last 2 years, algorithms for the optimal management of status epilepticus have changed, as the medical community has recognized the need to terminate seizures in status in a timely manner. Recent research has evaluated the different choices of benzodiazepine and has given consideration to second-line treatment options. RECENT FINDINGS: There has been a move to examine alternatives to phenytoin (such as levetiracetam and lacosamide) as second-line agents...
June 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29467308/comparing-the-antiseizure-and-neuroprotective-efficacy-of-ly293558-diazepam-caramiphen-and-ly293558-caramiphen-combination-against-soman-in-a-rat-model-relevant-to-the-pediatric-population
#16
James P Apland, Vassiliki Aroniadou-Anderjaska, Taiza H Figueiredo, Volodymyr I Pidoplichko, Katia Rossetti, Maria F M Braga
The currently Food and Drug Administration-approved anticonvulsant for the treatment of status epilepticus (SE) induced by nerve agents is the benzodiazepine diazepam; however, diazepam does not appear to offer neuroprotective benefits. This is of particular concern with respect to the protection of children because, in the developing brain, synaptic transmission mediated via GABAA receptors, the target of diazepam, is weak. In the present study, we exposed 21-day-old male rats to 1.2 × LD50 soman and compared the antiseizure, antilethality, and neuroprotective efficacy of diazepam (10 mg/kg), LY293558 (an AMPA/GluK1 receptor antagonist; 15 mg/kg), caramiphen (CRM, an antimuscarinic with NMDA receptor-antagonistic properties; 50 mg/kg), and LY293558 (15 mg/kg) + CRM (50 mg/kg), administered 1 hour after exposure...
May 2018: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/29461450/utility-of-the-performance-of-lumbar-puncture-for-febrile-children-with-status-epilepticus-in-the-bacterial-conjugate-vaccine-era
#17
Haro Kaoru, Ryota Igarashi, Takayuki Hoshina, Masumi Kojiro, Koichi Kusuhara
BACKGROUND: The necessity of lumbar puncture for the differentiation of central nervous system (CNS) infection in children with febrile status epilepticus (FSE) remains controversial. The aim of the present study is to investigate the diagnostic necessity of lumbar puncture for children with FSE after the introduction of bacterial conjugate vaccines into the infant immunization program. METHODS: Our retrospective cohort study was performed in children aged 6 to 60 months who were admitted to the pediatric ward at Kitakyushu General Hospital from January 1, 2011 to December 31, 2015 for seizures with fever...
February 15, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29459611/non-convulsive-status-epilepticus-in-children-clinical-profile-eeg-characteristics-and-treatment
#18
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/29454756/outcomes-after-acute-symptomatic-seizures-in-neonates
#19
REVIEW
Hannah C Glass, Zachary M Grinspan, Renée A Shellhaas
Acute symptomatic seizures are a common sign of neurological dysfunction and brain injury in neonates and occur in approximately one to three per 1000 live births. Seizures in neonates are usually a sign of underlying brain injury and, as such, are commonly associated with adverse outcomes. Neurological morbidities in survivors often co-occur; epilepsy, cerebral palsy, and intellectual disability often occur together in the most severely affected children. Risk factors for adverse outcome include prematurity, low Apgar scores, low pH on the first day of life, seizure onset <24 or >72 h after birth, abnormal neonatal neurological examination, abnormal neonatal electroencephalographic background, status epilepticus, and presence and pattern of brain injury (particularly deep gray or brainstem injury)...
February 6, 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29430560/epilepsy-is-associated-with-ventricular-alterations-following-convulsive-status-epilepticus-in-children
#20
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
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