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Seizure management

Rumana Ahmad, Tahmeena Khan, Bilal Ahmad, Aparna Misra, Anil K Balapure
Tapeworms (cestodes) are segmented flatworms responsible for causing diseases that may prove fatal and difficult to treat in the absence of proper treatment and efficient drugs. Neurocysticercosis (NCC) is a common parasitic infection of the central nervous system and a major contributor to epilepsy caused by the metacestode (larva) of the human tapeworm Taenia solium, characterized by a range of pathological symptoms including epileptic seizures, headaches, and hydrocephalus. Cysticercosis is considered as a "biological imprint" of the socioeconomic development of a community in general and a country in particular...
October 24, 2016: Parasitology Research
Jocelyn Y Cheng
INTRODUCTION: Status epilepticus (SE) is a life-threatening neurologic emergency. Despite advances in management, in-hospital mortality remains unchanged. This is partly due to the pharmacoresistance which develops the longer that seizures persist. Therefore, rapid antiseizure medication (ASM) administration may represent a beneficial treatment option. The purpose of this study was to determine: 1) whether in-hospital mortality is reduced with shorter latencies to initial treatment of SE with an ASM (LTSE); and 2) the critical time frame during which LTSE is associated with reduced in-hospital mortality...
November 15, 2016: Journal of the Neurological Sciences
Muhammad I Naseer, Adeel G Chaudhary, Mahmood Rasool, Gauthaman Kalamegam, Fai T Ashgan, Mourad Assidi, Farid Ahmed, Shakeel A Ansari, Syed Kashif Zaidi, Mohammed M Jan, Mohammad H Al-Qahtani
BACKGROUND: Epilepsy is genetically complex but common brain disorder of the world affecting millions of people with almost of all age groups. Novel Copy number variations (CNVs) are considered as important reason for the numerous neurodevelopmental disorders along with intellectual disability and epilepsy. DNA array based studies contribute to explain a more severe clinical presentation of the disease but interoperation of many detected CNVs are still challenging. RESULTS: In order to study novel CNVs with epilepsy related genes in Saudi family with six affected and two normal individuals with several forms of epileptic seizures, intellectual disability (ID), and minor dysmorphism, we performed the high density whole genome Agilent sure print G3 Hmn CGH 2x 400 K array-CGH chips analysis...
October 17, 2016: BMC Genomics
Shery Jacob, Anroop B Nair
Given the distinctive characteristics of both epilepsy and antiepileptic drugs (AEDs), therapeutic drug monitoring (TDM) can make a significant contribution to the field of epilepsy. The measurement and interpretation of serum drug concentrations can be of benefit in the treatment of uncontrollable seizures and in cases of clinical toxicity; it can aid in the individualization of therapy and in adjusting for variable or nonlinear pharmacokinetics; and can be useful in special populations such as pregnancy. This review examines the potential for TDM of newer AEDs such as eslicarbazepine acetate, felbamate, gabapentin, lacosamide, lamotrigine, levetiracetam, perampanel, pregabalin, rufinamide, retigabine, stiripentol, tiagabine, topiramate, vigabatrin, and zonisamide...
October 20, 2016: Drugs in R&D
Joseph S Hudson, Kingsley Abode-Iyamah, Yasunori Nagahama, Chandan G Reddy
BACKGROUND: Ionic contrast, if accidentally injected into the intrathecal space during routine imaging studies or interventional procedures, may significantly interfere with neuronal activity, potentially causing ascending tonic-clonic seizure syndrome and even death. As a result, ionic contrast is strictly contraindicated for intrathecal use. Rapid recognition of the condition followed by prompt management, typically involving aggressive cerebrospinal fluid (CSF) drainage, is critical to improving patient outcome...
October 17, 2016: World Neurosurgery
James X Tao, Andrew M Davis
No abstract text is available yet for this article.
October 18, 2016: JAMA: the Journal of the American Medical Association
Theresa Scholl, Angelika Mühlebner, Gerda Ricken, Victoria Gruber, Anna Fabing, Sharon Samueli, Gudrun Gröppel, Christian Dorfer, Thomas Czech, Johannes A Hainfellner, Avanita S Prabowo, Roy J Reinten, Lisette Hoogendijk, Jasper J Anink, Eleonora Aronica, Martha Feucht
Conventional antiepileptic drugs suppress the excessive firing of neurons during seizures. In drug-resistant patients, treatment failure indicates an alternative important epileptogenic trigger. Two epilepsy-associated pathologies show myelin deficiencies in seizure-related brain regions: Focal Cortical Dysplasia IIB (FCD) and cortical tubers in Tuberous Sclerosis Complex (TSC). Studies uncovering white matter-pathology mechanisms are therefore urgently needed to gain more insight into epileptogenesis, the propensity to maintain seizures, and their associated comorbidities such as cognitive defects...
October 17, 2016: Brain Pathology
Adriana Yock-Corrales, Flory Varela-Bulgarelli, Cary Barboza, Alfonso Gutierrez-Mata, Mark T Mackay, Franz Babl
OBJECTIVES: The aim was to describe clinical presentation, management, and outcomes of stroke in a tertiary emergency department (ED) of a developing country. METHODOLOGY: Retrospective case series of patients aged 1 month to 18 years presenting to an ED with radiological confirmed acute stroke during a 7-year period were studied. RESULTS: Ninety-five patients were identified. Twenty-five patients were excluded because of incomplete records (8) or not presenting via ED (17)...
October 4, 2016: Pediatric Emergency Care
A Venkatraman, A Khawaja, A K Bag, M Mirza, J P Szaflarski, S Pati
Lateralized Periodic Discharges (LPDs) are commonly seen on EEG in critically-ill patients. They are often associated with seizures, but some patients may have them without seizures. Therefore, they are considered to lie in the ictal-interictal continuum. When ictal, they require multiple antiepileptic drugs to treat effectively, which can expose the patient to iatrogenic complications. Therefore, optimal management is controversial. We present here two cases where perfusion-weighted Magnetic Resonance Imaging (pMRI) was useful in distinguishing ictal from interictal LPDs...
October 5, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
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
Awanish Mishra, Rajesh Kumar Goel
Our previous studies have suggested a strong involvement of serotonergic innervations in epileptogenesis and associated memory impairment. Several studies have suggested that the modulation of 5-HT3 receptors could serve as a promising tool for the management of epilepsy and memory deficit. The present study was envisaged to confirm this hypothesis. In this study, kindling was induced in male Swiss Albino mice by using a subconvulsive dose of pentylenetetrazole (PTZ) (35 mg/kg at 48±2 h). Once the animals were kindled, they were treated with a vehicle, ondansetron (0...
October 13, 2016: Neuroscience
Basil M Jan, Mohammed M Jan
Cerebral palsy (CP) is a common chronic motor disorder with associated cognitive, communicative, and seizure disorders. Children with CP have a higher risk of dental problems creating significant morbidity that can further affect their wellbeing and negatively impact their quality of life. Screening for dental disease should be part of the initial assessment of any child with CP. The objective of this article is to present an updated overview of dental health issues in children with CP and outline important preventative and practical strategies to the management of this common comorbidity...
October 2016: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
Martha Sajatovic, Curtis Tatsuoka, Elisabeth Welter, Adam T Perzynski, Kari Colon-Zimmermann, Jamie R Van Doren, Ashley Bukach, Mary Ellen Lawless, Eleanor R Ryan, Katherine Sturniolo, Samden Lhatoo
OBJECTIVES: Serious mental illness is disproportionately common in people with epilepsy and contributes to complications and mortality. Few care approaches specifically target individuals who have epilepsy and severe mental illness. We used an iterative process to refine an existing intervention and tested the novel intervention, Targeted Self-Management for Epilepsy and Mental Illness (TIME) in individuals with epilepsy and comorbid mental illness (E-MI). METHODS: The TIME intervention was developed with input from a community advisory board and then tested for feasibility, acceptability, and preliminary efficacy in people with E-MI, using a 16-week prospective, randomized controlled design comparing TIME (N=22) vs...
October 12, 2016: Epilepsy & Behavior: E&B
Maria Vittoria De Angelis, Roberta Di Giacomo, Antonio Di Muzio, Marco Onofrj, Laura Bonanni
BACKGROUND: Movement disorder emergencies include any movement disorder which develops over hours to days, in which failure to appropriately diagnose and manage can result in patient morbidity or mortality.Movement disorder emergencies include acute dystonia: sustained or intermittent muscle contractions causing abnormal, often repetitive, movements. Acute dystonia is a serious challenge for emergency room doctors and neurologists, because of the high probability of misdiagnosis, due to the presence of several mimickers including partial seizures, meningitis, localized tetanus, serum electrolyte level abnormalities, strychnine poisoning, angioedema, malingering, catatonia, and conversion...
October 2016: Medicine (Baltimore)
Rongshuai Wang, Luo Zhuo, Yunyun Wang, Liang Ren, Qian Liu, Liang Liu
BACKGROUND: Tetramine (tetramethylene disulphotetramine, TETS) and fluoroacetamide (FAA) are known as illegal rodenticides with high toxicity to animal species and human beings, which could lead to severe clinical features, including reduction of consciousness, convulsions, coma, and even death. METHODS AND RESULTS: We presented 2 cases that involved rodenticides poisoning. Even though the patients showed severe manifestations, they were initially misdiagnosed, resulting in 2 persons finally died from TETS and FAA poisoning in homicide cases...
October 2016: Medicine (Baltimore)
Jens Henrichs, Viki Verfaille, Laura Viester, Myrte Westerneng, Bert Molewijk, Arie Franx, Henriette van der Horst, Judith E Bosmans, Ank de Jonge, Petra Jellema
BACKGROUND: Intrauterine growth retardation (IUGR) is a major risk factor for perinatal mortality and morbidity. Thus, there is a compelling need to introduce sensitive measures to detect IUGR fetuses. Routine third trimester ultrasonography is increasingly used to detect IUGR. However, we lack evidence for its clinical effectiveness and cost-effectiveness and information on ethical considerations of additional third trimester ultrasonography. This nationwide stepped wedge cluster-randomized trial examines the (cost-)effectiveness of routine third trimester ultrasonography in reducing severe adverse perinatal outcome through subsequent protocolized management...
October 13, 2016: BMC Pregnancy and Childbirth
Silvana E Mengoni, Bob Gates, Georgina Parkes, David Wellsted, Garry Barton, Howard Ring, Mary Ellen Khoo, Deela Monji-Patel, Karin Friedli, Asif Zia, Marie-Anne Durand
PURPOSE: Epilepsy affects 1 in 5 people with an intellectual disability (ID), but little is known about their experiences of living with epilepsy. A qualitative study was conducted to investigate the impact and management of epilepsy in people with ID. MATERIALS AND METHODS: People with epilepsy and ID and their carers were invited to take part in semi-structured interviews. Eleven participants with ID and their carers were interviewed together, one participant with ID and their carer were interviewed separately, two interviews took place with the participant with ID only, and one interview took place with the carer only...
October 10, 2016: Epilepsy & Behavior: E&B
Leslie Citrome, Joseph P McEvoy, Stephen R Saklad
Clozapine is a highly effective antipsychotic medication, which provides a range of significant benefits for patients with schizophrenia, and is the standard of care for treatment-resistant schizophrenia as well as for reducing the risk of suicidal behaviors in schizophrenia and schizoaffective disorder. However, clozapine is widely underutilized, largely because prescribing clinicians lack experience in prescribing it and managing its adverse events (AEs). Clozapine is associated with three uncommon but immediately dangerous AEs-agranulocytosis, myocarditis/cardiomyopathy, and seizures-as well as AEs that may become dangerous if neglected, including weight gain, metabolic syndrome and constipation, and others that are annoying or distressing such as sedation, nighttime enuresis and hypersalivation...
2016: Clinical Schizophrenia & related Psychoses
A Shea, L De Risio, H Carruthers, A Ekiri, E Beltran
To describe the development of clinical signs (CS) and outcome of L-2-hydroxyglutaric aciduria (L-2-HGA), owners of 119 Staffordshire bull terriers positive for the known L-2-hydroxyglutarate dehydrogenase autosomal-recessive mutations were requested to complete a questionnaire regarding their pet's CS. Questionnaires were returned for 27 dogs, all with neurological abnormalities-not all questions were answered in all cases. The mean age of CS onset was 12 months (range 2.5-60). Gait dysfunction was reported in 26/26 dogs, with stiffness of all four limbs the most common (24/26) and earliest recognised abnormality...
October 11, 2016: Veterinary Record
Zhiliang Hu, Yongfeng Yang, Jian Cheng, Cong Cheng, Yun Chi, Hongxia Wei
Cryptococcal meningitis (CM) is a common opportunistic infection with a high mortality rate in human immunodeficiency virus (HIV)-infected patients. It is unclear whether mannitol could be used to manage neurological symptoms in HIV-associated CM. Here, we retrospectively analyzed the clinical data of 33 patients with HIV-associated symptomatic CM at our hospital where mannitol was used to relieve neurologic symptoms. With the empirical mannitol therapy, patients had a median of 2 episodes (range, 1-6 episodes) of headaches the day at the starting of anti-cryptococcal therapy...
October 11, 2016: Drug Discoveries & Therapeutics
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