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Postictal generalized EEG suppression

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https://www.readbyqxmd.com/read/27809868/efficacy-of-naloxone-in-reducing-postictal-central-respiratory-dysfunction-in-patients-with-epilepsy-study-protocol-for-a-double-blind-randomized-placebo-controlled-trial
#1
Sylvain Rheims, Luc Valton, Véronique Michel, Louis Maillard, Vincent Navarro, Philippe Convers, Fabrice Bartolomei, Arnaud Biraben, Arielle Crespel, Philippe Derambure, Bertrand de Toffol, Edouard Hirsch, Philippe Kahane, Martine Lemesle Martin, Didier Tourniaire, Sébastien Boulogne, Catherine Mercier, Pascal Roy, Philippe Ryvlin
BACKGROUND: Generalized tonic-clonic seizures (GTCSs) are the main risk factor for sudden unexpected death in epilepsy (SUDEP). Experimental and clinical data strongly suggest that the majority of SUDEP results from a postictal respiratory dysfunction progressing to terminal apnea. Postictal apnea could partly derive from a seizure-induced massive release of endogenous opioids. The main objective of this study is to evaluate the efficacy of an opioid antagonist, naloxone, administered in the immediate aftermath of a GTCS, in reducing the severity of the postictal central respiratory dysfunction...
November 3, 2016: Trials
https://www.readbyqxmd.com/read/27494359/local-brain-activity-persists-during-apparently-generalized-postictal-eeg-suppression
#2
Dirk-Matthias Altenmüller, Andreas Schulze-Bonhage, Christian E Elger, Rainer Surges
OBJECTIVES: Postictal generalized EEG suppression (PGES) frequently occurs after generalized convulsive seizures (GCS) and may be involved in the pathophysiology of sudden unexpected death in epilepsy (SUDEP). It is usually determined using conventional scalp EEG which is likely to miss cerebral activity in deeper brain structures. Here, we examined intracranial EEG activity after GCS to unravel the pattern and extent of local brain activity during apparent PGES on scalp EEG (s-PGES)...
September 2016: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/27357326/automated-video-detection-of-epileptic-convulsion-slowing-as-a-precursor-for-post-seizure-neuronal-collapse
#3
Stiliyan N Kalitzin, Prisca R Bauer, Robert J Lamberts, Demetrios N Velis, Roland D Thijs, Fernando H Lopes Da Silva
Automated monitoring and alerting for adverse events in people with epilepsy can provide higher security and quality of life for those who suffer from this debilitating condition. Recently, we found a relation between clonic slowing at the end of a convulsive seizure (CS) and the occurrence and duration of a subsequent period of postictal generalized EEG suppression (PGES). Prolonged periods of PGES can be predicted by the amount of progressive increase of interclonic intervals (ICIs) during the seizure. The purpose of the present study is to develop an automated, remote video sensing-based algorithm for real-time detection of significant clonic slowing that can be used to alert for PGES...
April 4, 2016: International Journal of Neural Systems
https://www.readbyqxmd.com/read/27221596/nonseizure-sudep-sudden-unexpected-death-in-epilepsy-without-preceding-epileptic-seizures
#4
Samden D Lhatoo, Maromi Nei, Manoj Raghavan, Michael Sperling, Bilal Zonjy, Nuria Lacuey, Orrin Devinsky
OBJECTIVE: To describe the phenomenology of monitored sudden unexpected death in epilepsy (SUDEP) occurring in the interictal period where death occurs without a seizure preceding it. METHODS: We report a case series of monitored definite and probable SUDEP where no electroclinical evidence of underlying seizures was found preceding death. RESULTS: Three patients (two definite and one probable) had SUDEP. They had a typical high SUDEP risk profile with longstanding intractable epilepsy and frequent generalized tonic-clonic seizures (GTCS)...
July 2016: Epilepsia
https://www.readbyqxmd.com/read/27073342/generalized-convulsive-seizure-type-oxygen-administration-postictal-generalized-eeg-suppression-and-sudep-risk-are-they-related
#5
Alison M Pack
No abstract text is available yet for this article.
March 2016: Epilepsy Currents
https://www.readbyqxmd.com/read/27001990/risk-factors-of-postictal-generalized-eeg-suppression-in-generalized-convulsive-seizures
#6
LETTER
James X Tao
No abstract text is available yet for this article.
March 22, 2016: Neurology
https://www.readbyqxmd.com/read/26994879/impact-of-periictal-nurse-interventions-on-postictal-generalized-eeg-suppression-in-generalized-convulsive-seizures
#7
Shasha Wu, Naoum P Issa, Sandra L Rose, Ahmer Ali, James X Tao
OBJECTIVES: The objective of this study was to determine the impact of periictal nurse interventions on postictal generalized EEG suppression (PGES) in generalized convulsive seizures (GCS). METHODS: We retrospectively reviewed the video-EEG recordings of patients during long-term video-EEG monitoring. We compared the duration of seizures, seizure phases (tonic, clonic, and tonic-clonic phases), and the occurrence and duration of postictal generalized EEG suppression (PGES) in patients with and without periictal interventions (e...
May 2016: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/26851982/postictal-generalized-eeg-suppression-after-generalized-convulsive-seizures-a-double-edged-sword
#8
MULTICENTER STUDY
Jiahui Xu, Bo Jin, Jianwei Yan, Jing Wang, Jingying Hu, Zhongjin Wang, Zhong Chen, Meiping Ding, Shuhua Chen, Shuang Wang
OBJECTIVE: The aim of this study is to investigate the key facilitating factors for postictal generalized EEG suppression (PGES) in a large cohort of patients with generalized convulsive seizures (GCSs). METHODS: We retrospectively reviewed the data of consecutive patients who had GCSs in the epilepsy monitoring units of two epilepsy centers. Statistical analysis was performed to assess specific variables as potential risk factors for PGES. RESULTS: Among the 208 enrolled patients with 366 seizures, PGES was observed in 109 (51...
April 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/26763069/postictal-immobility-and-generalized-eeg-suppression-are-associated-with-the-severity-of-respiratory-dysfunction
#9
Jonathan Kuo, Wenjie Zhao, Chin-Shang Li, Jeffrey D Kennedy, Masud Seyal
OBJECTIVE: The pathophysiology of sudden unexpected death in epilepsy (SUDEP) remains undetermined. Seizures are accompanied by respiratory dysfunction (RD). Postictal generalized electroencephalography (EEG) suppression (PGES) may follow generalized tonic-clonic seizures (GTCS). Following GTCS patients have impaired arousal and may be motionless. Patients with SUDEP are usually prone. Postictal immobility (PI) may contribute to SUDEP by not permitting repositioning of the head to allow unimpeded ventilation...
March 2016: Epilepsia
https://www.readbyqxmd.com/read/26425830/the-sudep-risk-inventory-association-with-postictal-generalized-eeg-suppression
#10
Brian D Moseley, Christopher M DeGiorgio
To help identify patients at greatest risk for sudden unexpected death in epilepsy (SUDEP), screening inventories like the SUDEP-7 Inventory can be useful. In this study, we examined the strength of association between this inventory's risk factors and postictal generalized EEG suppression (PGES), a biomarker of SUDEP risk. We reanalyzed data from an epilepsy monitoring unit study of 37 children. We performed a 2 by 2 contingency table analysis to determine the association between "yes" responses on the inventory questions and PGES following >=1 seizure...
November 2015: Epilepsy Research
https://www.readbyqxmd.com/read/26333799/risk-factors-of-postictal-generalized-eeg-suppression-in-generalized-convulsive-seizures
#11
MULTICENTER STUDY
Veriano Alexandre, Blanca Mercedes, Luc Valton, Louis Maillard, Fabrice Bartolomei, William Szurhaj, Edouard Hirsch, Cécile Marchal, Francine Chassoux, Jérôme Petit, Arielle Crespel, Anca Nica, Vincent Navarro, Philippe Kahane, Bertrand De Toffol, Pierre Thomas, Sarah Rosenberg, Marie Denuelle, Jacques Jonas, Philippe Ryvlin, Sylvain Rheims
OBJECTIVE: To identify the clinical determinants of occurrence of postictal generalized EEG suppression (PGES) after generalized convulsive seizures (GCS). METHODS: We reviewed the video-EEG recordings of 417 patients included in the REPO2MSE study, a multicenter prospective cohort study of patients with drug-resistant focal epilepsy. According to ictal semiology, we classified GCS into 3 types: tonic-clonic GCS with bilateral and symmetric tonic arm extension (type 1), clonic GCS without tonic arm extension or flexion (type 2), and GCS with unilateral or asymmetric tonic arm extension or flexion (type 3)...
November 3, 2015: Neurology
https://www.readbyqxmd.com/read/25844030/pulmonary-edema-following-generalized-tonic-clonic-seizures-is-directly-associated-with-seizure-duration
#12
Jeffrey D Kennedy, Kimberly A Hardin, Palak Parikh, Chin-Shang Li, Masud Seyal
PURPOSE: Postictal pulmonary edema (PPE) is almost invariably present in human and animal cases of sudden unexpected death in epilepsy (SUDEP) coming to autopsy. PPE may be a contributing factor in SUDEP. The incidence of postictal PPE is unknown. We retrospectively investigated PPE following generalized tonic clonic seizures (GTCS) in the epilepsy monitoring unit. METHODS: Chest X-Rays (CXR) following each GTCS were obtained in 24 consecutive patients. Relationship of CXR abnormality to seizure duration, ictal/postictal oxygen desaturation (SpO2), apnea and presence of postictal generalized EEG suppression (PGES) was investigated using logistic regression...
April 2015: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/25647769/postictal-generalized-eeg-suppression-and-sudep-a-review
#13
REVIEW
Sanjeev Rajakulendran, Lina Nashef
Sudden unexpected death in epilepsy (SUDEP) remains a leading cause of epilepsy-related death, and yet, its pathogenic mechanisms remain ill-defined. Although epidemiological studies of SUDEP in heterogenous populations have established a number of clinical associations, evaluation and stratification of individual risk remains difficult. Thus, potential markers as predictors of risk of SUDEP are important not only clinically but also for research on SUDEP prevention. Recordings from rare monitored cases of SUDEP demonstrate postictal generalized EEG suppression after terminal seizures, raising expectations that postictal generalized EEG suppression may identify individuals at higher risk...
February 2015: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/25647767/seizure-related-autonomic-changes-in-children
#14
REVIEW
Brian D Moseley
Although sudden unexpected death in epilepsy is encountered less frequently in children versus adults, it is still an important direct epilepsy-related cause of death in this population. Just as in adults, the pathophysiology of sudden unexpected death in epilepsy in children is believed to involve seizure-related autonomic dysfunction. Seizures that develop during the pediatric period can be marked by some of the most dramatic alterations in autonomic functions seen at any age. This article reviews such seizure-related autonomic changes, including ictal nausea/emesis, hypersalivation, hypoxemia, apnea, tachycardia, bradycardia, cardiac repolarization anomalies, reduced heart rate variability, and postictal generalized EEG suppression...
February 2015: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/25300988/sudden-infant-death-syndrome-sleep-and-seizures
#15
Toke Hoppenbrouwers
benign febrile seizures seen in 7% of infants before 6 months play a role in the terminal pathway in a subset of sudden infant death syndrome victims. Supporting evidence: (1) lack of 5-hydroxitryptamine, one consistent finding in sudden infant death syndrome that Kinney et al coined a developmental serotonopathy, is consistent with risk for seizures. (2) Non-rapid eye movement sleep increasing during the age of highest risk for sudden infant death syndrome facilitates some seizures (seizure gate). (3) Sudden unexpected death in epilepsy is associated with severe hypoxemia and hypercapnia during postictal generalized electroencephalographic (EEG) suppression...
June 2015: Journal of Child Neurology
https://www.readbyqxmd.com/read/25046982/ictal-ontogeny-in-dravet-syndrome
#16
Se Hee Kim, Douglas R Nordli, Anne T Berg, Sookyong Koh, Linda Laux
OBJECTIVE: To define seizure characteristics of Dravet syndrome (DS) with video-electroencephalographic (EEG) recording in different age groups. METHODS: We reviewed 23 patients with 63 seizures in different age groups: group 1 (0-5years old); group 2 (6-10years old); and group 3 (11 or above). RESULTS: We included 7, 11 and 5 patients in groups 1, 2, and 3 respectively. Younger children had seizures while awake (p=0.005), provoked seizures (p=0...
March 2015: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/24731583/selective-serotonin-reuptake-inhibitors-prolong-seizures-preliminary-results-from-an-observational-study
#17
Judith Dobesberger, Aleksandar J Ristic, Gerald Walser, Julia Höfler, Iris Unterberger, Eugen Trinka
OBJECTIVE: Selective serotonin reuptake inhibitors (SSRIs) are often used in the treatment of depressive disorders in patients with epilepsy. Pro- and anti-convulsive effects of SSRIs are discussed controversially. The aim of this study was to investigate a possible impact of SSRIs-treatment on duration of EEG and clinical features in epilepsy patients. METHODS: We studied video-EEG data from 162 patients with focal epilepsies between January 2006 and March 2008 using a case-control study design...
May 2014: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/24701979/heart-rate-variability-analysis-indicates-preictal-parasympathetic-overdrive-preceding-seizure-induced-cardiac-dysrhythmias-leading-to-sudden-unexpected-death-in-a-patient-with-epilepsy
#18
REVIEW
Jesper Jeppesen, Anders Fuglsang-Frederiksen, Ramon Brugada, Birthe Pedersen, Guido Rubboli, Peter Johansen, Sándor Beniczky
Evidence for seizure-induced cardiac dysrhythmia leading to sudden unexpected death in epilepsy (SUDEP) has been elusive. We present a patient with focal cortical dysplasia who has had epilepsy for 19 years and was undergoing presurgical evaluation. The patient did not have any cardiologic antecedents. During long-term video-electroencephalography (EEG) monitoring, following a cluster of secondarily generalized tonic-clonic seizures (GTCS), the patient had prolonged postictal generalized EEG suppression, asystole, followed by arrhythmia, and the patient died despite cardiopulmonary resuscitation...
July 2014: Epilepsia
https://www.readbyqxmd.com/read/24140516/comparison-of-cardiorespiratory-and-eeg-abnormalities-with-seizures-in-adults-and-children
#19
COMPARATIVE STUDY
Milena Pavlova, Kanwaljit Singh, Myriam Abdennadher, Eliot S Katz, Barbara A Dworetzky, David P White, Nichelle Llewellyn, Sanjeev V Kothare
Cardiopulmonary dysfunction and postictal generalized EEG suppression (PGES) are proposed as possible risk factors for the occurrence of SUDEP. The evolution of cardiorespiratory abnormalities with seizures has not been systematically studied for any age-related findings. Additionally, not many studies have looked into the possible effect of age-related brain maturation on PGES. The purpose of this study was to compare these SUDEP risk factors in adults versus children. We prospectively recorded cardiopulmonary abnormalities during seizures using pulse oximetry, EKG, and respiratory inductance plethysmography...
December 2013: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/24011708/age-specific-periictal-electroclinical-features-of-generalized-tonic-clonic-seizures-and-potential-risk-of-sudden-unexpected-death-in-epilepsy-sudep
#20
Joel Freitas, Gurmeen Kaur, Guadalupe Baca-Vaca Fernandez, Curtis Tatsuoka, Farhad Kaffashi, Kenneth A Loparo, Shyam Rao, Jakrin Loplumlert, Kitti Kaiboriboon, Shahram Amina, Ingrid Tuxhorn, Samden D Lhatoo
Generalized tonic-clonic seizure (GTCS) is the commonest seizure type associated with sudden unexpected death in epilepsy (SUDEP). This study examined the semiological and electroencephalographic differences (EEG) in the GTCSs of adults as compared with those of children. The rationale lies on epidemiological observations that have noted a tenfold higher incidence of SUDEP in adults. We analyzed the video-EEG data of 105 GTCS events in 61 consecutive patients (12 children, 23 seizure events and 49 adults, 82 seizure events) recruited from the Epilepsy Monitoring Unit...
November 2013: Epilepsy & Behavior: E&B
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