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Status epilepticus in children

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https://www.readbyqxmd.com/read/28211248/anesthetic-considerations-for-pediatric-electroconvulsive-therapy
#1
REVIEW
Andrew D Franklin, Jenna H Sobey, Eric T Stickles
Electroconvulsive therapy is being used more frequently in the treatment of many chronic and acute psychiatric illnesses in children. The most common psychiatric indications for pediatric electroconvulsive therapy are refractory depression, bipolar disorder, schizophrenia, catatonia, and autism. In addition, a relatively new indication is the treatment of pediatric refractory status epilepticus. The anesthesiologist may be called upon to assist in the care of this challenging and vulnerable patient population...
February 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28207570/international-survey-of-critically-ill-children-with-acute-neurologic-insults-the-prevalence-of-acute-critical-neurological-disease-in-children-a-global-epidemiological-assessment-study
#2
Ericka L Fink, Patrick M Kochanek, Robert C Tasker, John Beca, Michael J Bell, Robert S B Clark, Jamie Hutchison, Monica S Vavilala, Anthony Fabio, Derek C Angus, R Scott Watson
OBJECTIVE: The international scope of critical neurologic insults in children is unknown. Our objective was to assess the prevalence and outcomes of children admitted to PICUs with acute neurologic insults. DESIGN: Prospective study. SETTING: Multicenter (n = 107 PICUs) and multinational (23 countries, 79% in North America and Europe). PATIENTS: Children 7 days to 17 years old admitted to the ICU with new traumatic brain injury, stroke, cardiac arrest, CNS infection or inflammation, status epilepticus, spinal cord injury, hydrocephalus, or brain mass...
February 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28202703/investigations-in-gabaa-receptor-antibody-associated-encephalitis
#3
Marianna Spatola, Mar Petit-Pedrol, Mateus Mistieri Simabukuro, Thaís Armangue, Fernanda J Castro, Maria I Barcelo Artigues, Maria R Julià Benique, Leslie Benson, Mark Gorman, Ana Felipe, Ruben L Caparó Oblitas, Myrna R Rosenfeld, Francesc Graus, Josep Dalmau
OBJECTIVE: To report the clinical features, comorbidities, receptor subunit targets, and outcome in patients with anti-GABAA receptor (GABAAR) encephalitis. METHODS: Clinical study of 26 patients, including 17 new (April 2013-January 2016) and 9 previously reported patients. Antibodies to α1, β3, and γ2 subunits of the GABAAR were determined using reported techniques. RESULTS: Patients' median age was 40.5 years (interquartile range 48...
February 15, 2017: Neurology
https://www.readbyqxmd.com/read/28193596/vegf-regulates-hippocampal-neurogenesis-and-reverses-cognitive-deficits-in-immature-rats-after-status-epilepticus-through-the-vegf-r2-signaling-pathway
#4
Wei Han, Xiaojie Song, Rong He, Tianyi Li, Li Cheng, Lingling Xie, Hengsheng Chen, Li Jiang
Epilepsy is the most common chronic disease in children, who exhibit a higher risk for status epilepticus (SE) than adults. Hippocampal neurogenesis is altered by epilepsy, particularly in the immature brain, which may influence cognitive development. Vascular endothelial growth factor (VEGF) represents an attractive target to modulate brain function at the neurovascular interface and is a double-edged sword in seizures. We used the lithium-pilocarpine-induced epilepsy model in immature Sprague-Dawley rats to study the effects of VEGF on hippocampal neurogenesis in the acute phase and on long-term cognitive behaviors in immature rats following status epilepticus (SE)...
February 10, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28130784/time-to-electroencephalography-is-independently-associated-with-outcome-in-critically-ill-neonates-and-children
#5
Iván Sánchez Fernández, Arnold J Sansevere, Rejean M Guerriero, Ersida Buraniqi, Phillip L Pearl, Robert C Tasker, Tobias Loddenkemper
OBJECTIVE: To identify factors associated with in-hospital mortality in neonates and children undergoing continuous electroencephalography (cEEG) monitoring in the intensive care unit (ICU). METHODS: We performed a retrospective observational study in patients from birth to 21 years of age who underwent clinically indicated cEEG in the ICU from 2011 to 2013. The main outcome measure was in-hospital mortality. RESULTS: Six-hundred and twenty-five patients (54...
January 28, 2017: Epilepsia
https://www.readbyqxmd.com/read/28118303/outcomes-following-electrographic-seizures-and-electrographic-status-epilepticus-in-the-pediatric-and-neonatal-icus
#6
Elana F Pinchefsky, Cecil D Hahn
PURPOSE OF REVIEW: Increasing recognition of electrographic seizures and electrographic status epilepticus in critically ill neonates and children has highlighted the importance of identifying their potential contributions to neurological outcomes to guide optimal management. RECENT FINDINGS: Recent studies in children and neonates have found an independent association between increasing seizure burden and worse short-term and long-term outcomes, even after adjusting for other important contributors to outcome such as seizure cause and illness severity...
January 21, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28099234/electrographic-seizures-in-children-and-neonates-undergoing-extracorporeal-membrane-oxygenation
#7
Jainn-Jim Lin, Brenda L Banwell, Robert A Berg, Dennis J Dlugos, Rebecca N Ichord, Todd J Kilbaugh, Roxanne E Kirsch, Matthew P Kirschen, Daniel J Licht, Shavonne L Massey, Maryam Y Naim, Natalie E Rintoul, Alexis A Topjian, Nicholas S Abend
OBJECTIVE: We aimed to determine the prevalence and risk factors for electrographic seizures in neonates and children requiring extracorporeal membrane oxygenation support. DESIGN: Prospective quality improvement project. SETTING: Quaternary care pediatric institution. PATIENTS: Consistent with American Clinical Neurophysiology Society electroencephalographic monitoring recommendations, neonates and children requiring extracorporeal membrane oxygenation support underwent clinically indicated electroencephalographic monitoring...
January 17, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28099181/adverse-events-and-risk-factors-during-emergency-intubation-in-a-tertiary-paediatric-emergency-department
#8
Ruth M C Löllgen, Jennifer Pontin, Matthew Gow, Mary E McCaskill
BACKGROUND: Rapid sequence intubation and emergency intubation in the emergency department (ED) can be life-saving procedures, but require the appropriate skills, experience and preparation to avoid complications ranging from simple trauma to life-threatening desaturation. Only scarce data exist in the published literature on complications following emergency intubation in children and most guidelines are extrapolated from the adult population. PATIENTS AND METHODS: We reviewed all emergency intubations of patients in our tertiary paediatric ED within a 2-year period to estimate the incidence of complications and to analyse the risk factors associated with this procedure...
January 17, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28095390/hydrogen-sulfide-promotes-learning-and-memory-and-suppresses-proinflammatory-cytokines-in-repetitive-febrile-seizures
#9
Fei Zhuang, Xuhong Zhou, Hong Li, Xiaochun Yang, Zewu Dong, Wendi Zhou, Jian Chen
OBJECTIVE: Hydrogen sulfide (H2S), as a novel gasotransmitter, plays important roles in a number of physiological and pathological processes. Its effectiveness has been demonstrated in different types of brain disorders but not in repetitive febrile seizure (febrile status epilepticus; FSE) models. This study aims to test whether a donor of H2S sodium sulfhydrate (NaHS) is also effective for FSE in rats. METHODS: FSE was induced in rat pups on postnatal day 10 in water at 45...
January 18, 2017: Neuroimmunomodulation
https://www.readbyqxmd.com/read/28087260/seizure-recurrence-in-children-after-stopping-antiepileptic-medication-5-year-follow-up
#10
Inn-Chi Lee, Shuan-Yow Li, Yung-Jung Chen
BACKGROUND: We wanted to identify in children with epilepsy the factors associated with seizure control and recurrence after a 2-year remission. METHODS: We did a 5-year follow-up of epileptic children whose antiepileptic medication had been stopped. Bivariate and multivariate analyses were used to compare features of electroencephalograms (EEGs) and clinical findings. In this study, 43 patients with and 64 without a seizure recurrence (SR) were enrolled. RESULTS: Clinical features strongly associated with SR in the univariate analysis included a symptomatic etiology for seizures, a history of status epilepticus, treatment duration before stopping antiepileptic drugs, and abnormal EEG findings at the time of stopping antiepileptic drugs...
December 18, 2016: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28079314/scn1a-gene-mutation-and-adaptive-functioning-in-18-vietnamese-children-with-dravet-syndrome
#11
Thi Thu Hang Do, Diem My Vu, Thi Thuy Kieu Huynh, Thi Khanh Van Le, Eun Hwa Sohn, Thieu Mai Thao Le, Huu Hao Ha, Chi Bao Bui
BACKGROUND AND PURPOSE: Dravet syndrome is a rare and severe type of epilepsy in infants. The heterogeneity in the overall intellectual disability that these patients suffer from has been attributed to differences in genetic background and epilepsy severity. METHODS: Eighteen Vietnamese children diagnosed with Dravet syndrome were included in this study. SCN1A variants were screened by direct sequencing and multiplex ligation-dependent probe amplification. Adaptive functioning was assessed in all patients using the Vietnamese version of the Vineland Adaptive Behavior Scales, and the results were analyzed relative to the SCN1A variants and epilepsy severity...
January 2017: Journal of Clinical Neurology
https://www.readbyqxmd.com/read/28062149/prediction-of-neonatal-seizures-in-hypoxic-ischemic-encephalopathy-using-electroencephalograph-power-analyses
#12
Siddharth V Jain, Amit Mathur, Preethi Srinivasakumar, Michael Wallendorf, Joseph P Culver, John M Zempel
BACKGROUND: The severity of the initial encephalopathy in neonatal hypoxic-ischemic encephalopathy correlates with seizure burden. Early electroencephalograph (EEG) background activity reflects the severity of encephalopathy. Thus, we hypothesized that early EEG background would be predictive of subsequent seizures in neonatal hypoxic-ischemic encephalopathy. METHODS: This study included infants undergoing therapeutic hypothermia at St. Louis Children's Hospital between January 2009 and April 2013...
November 11, 2016: Pediatric Neurology
https://www.readbyqxmd.com/read/28042096/different-response-to-antiepileptic-drugs-according-to-the-type-of-epileptic-events-in-a-neonatal-ischemia-reperfusion-model
#13
Luc Morin, Julie Enderlin, Pierre-Louis Leger, Gaëtan Perrotte, Philippe Bonnin, Nina Dupuis, Olivier Baud, Christiane Charriaut-Marlangue, Stéphane Auvin
Perinatal arterial stroke is the most frequent form of cerebral infarction in children. Neonatal seizures are the most frequent symptom during the neonatal period. The current management of perinatal stroke is based on supportive care. It is currently unknown if treatment of the seizures modifies the outcome, and no clinical studies have focused on seizures during neonatal stroke. We studied the effect of phenobarbital and levetiracetam on an ischemic-reperfusion stroke model in P7 rats using prolonged electroencephalographic recordings and a histologic analysis of the brain (24h after injury)...
December 30, 2016: Neurobiology of Disease
https://www.readbyqxmd.com/read/28011930/refractory-status-epilepticus-in-children-with-and-without-prior-epilepsy-or-status-epilepticus
#14
Iván Sánchez Fernández, Michele C Jackson, Nicholas S Abend, Ravindra Arya, James N Brenton, Jessica L Carpenter, Kevin E Chapman, William D Gaillard, Marina Gaínza-Lein, Tracy A Glauser, Joshua L Goldstein, Howard P Goodkin, Ashley Helseth, Kush Kapur, Tiffani L McDonough, Mohamad A Mikati, Katrina Peariso, James Riviello, Robert C Tasker, Alexis A Topjian, Mark S Wainwright, Angus Wilfong, Korwyn Williams, Tobias Loddenkemper
OBJECTIVE: To compare refractory convulsive status epilepticus (rSE) management and outcome in children with and without a prior diagnosis of epilepsy and with and without a history of status epilepticus (SE). METHODS: This was a prospective observational descriptive study performed from June 2011 to May 2016 on pediatric patients (1 month-21 years of age) with rSE. RESULTS: We enrolled 189 participants (53% male) with a median (25th-75th percentile) age of 4...
January 24, 2017: Neurology
https://www.readbyqxmd.com/read/27988968/premature-mortality-of-epilepsy-in-low-and-middle-income-countries-a-systematic-review-from-the-mortality-task-force-of-the-international-league-against-epilepsy
#15
REVIEW
Francis Levira, David J Thurman, Josemir W Sander, W Allen Hauser, Dale C Hesdorffer, Honorati Masanja, Peter Odermatt, Giancarlo Logroscino, Charles R Newton
To determine the magnitude of risk factors and causes of premature mortality associated with epilepsy in low- and middle-income countries (LMICs). We conducted a systematic search of the literature reporting mortality and epilepsy in the World Bank-defined LMICs. We assessed the quality of the studies based on representativeness; ascertainment of cases, diagnosis, and mortality; and extracted data on standardized mortality ratios (SMRs) and mortality rates in people with epilepsy. We examined risk factors and causes of death...
January 2017: Epilepsia
https://www.readbyqxmd.com/read/27943220/population-pharmacokinetics-and-exploratory-pharmacodynamics-of-lorazepam-in-pediatric-status-epilepticus
#16
Daniel Gonzalez, James M Chamberlain, Jeffrey T Guptill, Michael Cohen-Wolkowiez, Barrie Harper, Jian Zhao, Edmund V Capparelli
BACKGROUND: Lorazepam is one of the preferred agents used for intravenous treatment of status epilepticus (SE). We combined data from two pediatric clinical trials to characterize the population pharmacokinetics of intravenous lorazepam in infants and children aged 3 months to 17 years with active SE or a history of SE. METHODS: We developed a population pharmacokinetic model for lorazepam using the NONMEM software. We then assessed exploratory exposure-response relationships using the overall efficacy and safety study endpoints, and performed dosing simulations...
December 9, 2016: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/27943132/new-non-intravenous-routes-for-benzodiazepines-in-epilepsy-a-clinician-perspective
#17
Marco Mula
Benzodiazepines represent the first-line treatment for the acute management of epileptic seizures and status epilepticus. The emergency use of benzodiazepines must be timely, and because most seizures occur outside of the hospital environment, there is a significant need for delivery methods that are easy for nonclinical caregivers to use and administer quickly and safely. In addition, the ideal route of administration should be reliable in terms of absorption. Rectal diazepam is the only licensed formulation in the USA, whereas rectal diazepam and buccal midazolam are currently licensed in the EU...
December 9, 2016: CNS Drugs
https://www.readbyqxmd.com/read/27930967/epidemiology-and-diagnostic-and-therapeutic-management-of-febrile-seizures-in-the-italian-pediatric-emergency-departments-a-prospective-observational-study
#18
Giovanna Vitaliti, Emanuele Castagno, Fulvio Ricceri, Antonio Urbino, Alberto Verrotti Di Pianella, Riccardo Lubrano, Elisa Caramaschi, Maurizio Prota, Rita Maria Pulvirenti, Patrizia Ajovalasit, Giuseppe Signorile, Carla Navone, Maria Rosaria La Bianca, Alberto Villani, Giovanni Corsello, Raffaele Falsaperla
AIM: Febrile seizures (FS) involve 2-5% of the paediatric population, among which Complex FS (CFS) account for one third of accesses for FS in Emergency Departments (EDs). The aim of our study was to define the epidemiology, the clinical, diagnostic and therapeutic approach to FS and CFSs in the Italian EDs. METHODS: A multicenter prospective observational study was performed between April 2014 and March 2015. Patients between 1 and 60 months of age, randomly accessing to ED for ongoing FS or reported FS at home were included...
January 2017: Epilepsy Research
https://www.readbyqxmd.com/read/27907953/management-of-the-pediatric-neurocritical-care-patient
#19
Christopher M Horvat, Haifa Mtaweh, Michael J Bell
Pediatric neurocritical care is a growing subspecialty of pediatric intensive care that focuses on the management of acute neurological diseases in children. A brief history of the field of pediatric neurocritical care is provided. Neuromonitoring strategies for children are reviewed. Management of major categories of acute childhood central neurologic diseases are reviewed, including treatment of diseases associated with intracranial hypertension, seizures and status epilepticus, stroke, central nervous system infection and inflammation, and hypoxic-ischemic injury...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27890484/25-years-of-advances-in-definition-classification-and-treatment-of-status-epilepticus
#20
Eugen Trinka, Reetta Kälviäinen
PURPOSE: Status epilepticus (SE) requires not only urgent symptomatic treatment with antiepileptic drugs but also rapid identification and treatment of its cause. This narrative review summarizes the most important advances in classification and treatment of SE. METHOD: Data sources included MEDLINE, EMBASE, ClinicalTrials.gov, and back tracking of references in pertinent studies, reviews, and books. RESULTS: SE is now defined as "a condition resulting either from the failure of the mechanisms responsible for seizure termination or from the initiation of mechanisms, which lead to abnormally, prolonged seizures (after time point t1)...
November 14, 2016: Seizure: the Journal of the British Epilepsy Association
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