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https://www.readbyqxmd.com/read/29333566/principles-of-management-of-central-nervous-system-infections
#1
REVIEW
Sunit Singhi, Suresh Kumar Angurana
CNS infections in children are medical emergency and are associated with high mortality and morbidity. For diagnosis, a high index of suspicion is required. Clinical assessment should be supplemented by laboratory investigations including CSF Gram stain and cultures, blood culture, PCR on CSF, serological tests, and imaging. Commonly associated life threatening complications include coma, seizure, raised intracranial pressure (ICP), focal deficits, shock, respiratory failure, and fluid and electrolyte abnormalities...
January 15, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29331007/anaesthetic-management-of-nesidioblastosis-in-two-infants
#2
Muhammad Saad Yousuf, Mohsin Nazir Butt, Fauzia Anis Khan
Nesidioblastosis is the most common cause of non-transient, recurrent and persistent hypoglycaemia in neonates and infants. It is a disorder of diffuse proliferation of beta cells of the pancreas leading to hyperinsulinemia and hypoglycaemia. The main aim is to prevent the severe episodes of hypoglycaemia which can cause damage to the brain and/or mental retardation. In this case report we present two cases of nesidioblastosis and their perioperative anaesthetic course for near-total pancreatectomy. First case was a 7 months old female who had repeated episodes of convulsions since birth...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29324507/determining-when-to-stop-antiepileptic-drug-treatment
#3
Steven C Schachter
PURPOSE OF REVIEW: As the number of patients diagnosed with epilepsy continues to rise and the pharmacological and device-based treatment options for epilepsy increase, determining when to stop antiepileptic drug (AED) treatment continues to be an important issue for patient management and counseling. RECENT FINDINGS: This review focuses on outcomes following AED withdrawal in seizure-free adults with epilepsy. Practical considerations are also discussed because, despite the importance of this topic, relatively little progress has been made in the past year regarding the identification of patients whose risk for recurrent seizures after AED withdrawal is no higher than that of the general population...
January 10, 2018: Current Opinion in Neurology
https://www.readbyqxmd.com/read/29322489/measurement-in-pediatric-epilepsy-self-management-a-critical-review
#4
REVIEW
Gigi Smith, Avani C Modi, Erica K Johnson, Ross Shegog, Joan K Austin, Janelle L Wagner
Given the paucity of information available regarding self-management, the aims of this paper are to synthesize the literature on factors associated with and measures to assess self-management in pediatric epilepsy. INCLUSION CRITERIA: youth birth to 18 years with a seizure disorder or an epilepsy diagnosis and/or their caregivers, published 1985-2014 in English, and conducted in countries with a very high human development index. The review was conducted in 6 phases: (1) identification of bibliographical search criteria and databases; (2) abstract assessment; (3) full article review; (4) organization of final citations into categories; (5) identification of predictors, potential mediators/moderators, and outcomes associated with self-management factors and categorization of factors as influences, processes, or behaviors across individual, family, community, and health care domains; and (6) critique of self-management instrument studies...
January 11, 2018: Epilepsia
https://www.readbyqxmd.com/read/29320603/drug-management-for-acute-tonic-clonic-convulsions-including-convulsive-status-epilepticus-in-children
#5
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/29317153/should-patients-with-complex-febrile-seizure-be-admitted-for-further-management
#6
Heather Olson, Tiffany Rudloe, Tobias Loddenkemper, Marvin B Harper, Amir A Kimia
BACKGROUND AND AIMS: Children with first complex febrile seizure (CFS) are often admitted for observation. The goals of this study were 1) to assess the risk of seizure recurrence during admission, 2) to determine whether early EEG affects acute management. DESIGN/METHODS: We retrospectively reviewed a cohort of children 6-60months of age admitted from a Pediatric Emergency Department for first CFS over a 15year period. We excluded children admitted for supportive care of their febrile illness...
December 28, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29313881/stiripentol-for-the-treatment-of-super-refractory-status-epilepticus-with-cross-sensitivity
#7
Y Uchida, K Terada, Y Madokoro, T Fujioka, M Mizuno, T Toyoda, D Kato, N Matsukawa
BACKGROUND: Cross-sensitivity of rash has been reported between various antiepileptic drugs (AEDs). However, few studies have determined the frequency and management of cross-sensitivity in patients with super-refractory status epilepticus (SRSE). AIMS OF THE STUDY: To examine the optimal AED for treating SRSE with cross-sensitivity. METHODS: We performed a retrospective review of adult patients with SRSE treated at Nagoya City University Hospital, in which we investigated the frequency of cross-sensitivity among patients with SRSE and their clinical and medical profiles...
January 3, 2018: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/29307023/successful-microsurgical-treatment-of-intracranial-aneurysms-in-infants-a-retrospective-study-and-literature-review
#8
Yanming Ren, Shuzhen Zhao, Lunxin Liu, Hong Sun, Yi Liu, Hao Li, Lu Ma, Min He, Chao You, Jin Li
OBJECTIVE: Intracranial aneurysms are extremely rare in infants, especially less than 1 year old. This study aimed to analyze the frequency of infantile intracranial aneurysm in our department and investigate the clinical characteristics, treatment strategies, and outcomes of this disease. METHODS: Six infants under 1 year old in 4350 patients with intracranial aneurysms were retrospectively analyzed from January 2010 to December 2016. RESULTS: The patients (5 females and 1 male) ranged in age from 2 to 11 (mean age, 4...
January 6, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29304841/paediatric-medical-emergency-calls-to-a-danish-emergency-medical-dispatch-centre-a-retrospective-observational-study
#9
Kasper Andersen, Søren Mikkelsen, Gitte Jørgensen, Stine Thorhauge Zwisler
BACKGROUND: Little is known regarding paediatric medical emergency calls to Danish Emergency Medical Dispatch Centres (EMDC). This study aimed to investigate these calls, specifically the medical issues leading to them and the pre-hospital units dispatched to the paediatric emergencies. METHODS: We performed a retrospective, observational study on paediatric medical emergency calls managed by the EMDC in the Region of Southern Denmark in February 2016. We reviewed audio recordings of emergency calls and ambulance records to identify calls concerning patients ≤ 15 years...
January 5, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29303925/local-anesthetic-systemic-toxicity-a-review-of-recent-case-reports-and-registries
#10
Marina Gitman, Michael J Barrington
This review summarizes presenting features, management, and outcomes of local anesthetic systemic toxicity (LAST) from published cases and those submitted to online registries capturing use of intravenous lipid emulsion (ILE) therapy. The results of single-center and multicenter registries and epidemiologic studies complement this information. Between March 2014 and November 2016, 47 separate cases of LAST were described in 35 peer-reviewed articles. Local anesthetic systemic toxicity events occurred as a result of penile blocks (23%), local infiltration (17%), and upper/lower extremity, torso, and neuraxial blockade...
January 5, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29300374/clinical-history-and-management-recommendations-of-the-smooth-muscle-dysfunction-syndrome-due-to-acta2-arginine-179-alterations
#11
Ellen S Regalado, Lauren Mellor-Crummey, Julie De Backer, Alan C Braverman, Lesley Ades, Susan Benedict, Timothy J Bradley, M Elizabeth Brickner, Kathryn C Chatfield, Anne Child, Cori Feist, Kathryn W Holmes, Glen Iannucci, Birgit Lorenz, Paul Mark, Takayuki Morisaki, Hiroko Morisaki, Shaine A Morris, Anna L Mitchell, John R Ostergaard, Julie Richer, Denver Sallee, Sherene Shalhub, Mustafa Tekin, Anthony Estrera, Patricia Musolino, Anji Yetman, Reed Pyeritz, Dianna M Milewicz
PurposeSmooth muscle dysfunction syndrome (SMDS) due to heterozygous ACTA2 arginine 179 alterations is characterized by patent ductus arteriosus, vasculopathy (aneurysm and occlusive lesions), pulmonary arterial hypertension, and other complications in smooth muscle-dependent organs. We sought to define the clinical history of SMDS to develop recommendations for evaluation and management.MethodsMedical records of 33 patients with SMDS (median age 12 years) were abstracted and analyzed.ResultsAll patients had congenital mydriasis and related pupillary abnormalities at birth and presented in infancy with a patent ductus arteriosus or aortopulmonary window...
January 4, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/29299677/compression-of-a-giant-pseudomeningocele-causing-transient-anoxic-seizures-a-case-report
#12
Alhafidz Hamdan, A Saxena, G Rao, M Ivanov
Transient anoxic seizure upon application of pressure on a giant pseudomeningocele has never been reported in the literature; such abrupt changes in intracranial pressure due to large volume of cerebrospinal fluid (CSF) translocation, if left untreated may lead to permanent cerebral hypoxic injury and death. Here we describe a case of a 26-year-old woman who had undergone lumbar disc surgery in another unit few months ago and developed a large lump around her back. Any pressure on the lump resulted in headaches and at times episodes of seizures...
January 3, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29297840/management-of-a-reeve-s-muntjac-muntiacus-reevesi-with-seizures-using-levetiracetam
#13
Emily R Blatt, Kathryn E Seeley, Mathew C Lovett, Randall E Junge
This report describes the diagnosis and management of idiopathic epilepsy in a 4-yr-old intact female Reeve's muntjac ( Muntiacus reevesi). The patient was initially witnessed to have isolated paroxysmal events consistent with epileptic seizures (altered consciousness, lateral recumbency, tonic/clonic movement of limbs) lasting less than 3 min with an immediate return to normal consciousness. The seizure frequency increased to >3 seizures within 24 hr and phenobarbital 3 mg/kg orally every 12 hr was started...
December 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/29295578/devices-for-ambulatory-monitoring-of-sleep-associated-disorders-in-children-with-neurological-diseases
#14
Adriana Ulate-Campos, Melissa Tsuboyama, Tobias Loddenkemper
Good sleep quality is essential for a child's wellbeing. Early sleep problems have been linked to the later development of emotional and behavioral disorders and can negatively impact the quality of life of the child and his or her family. Sleep-associated conditions are frequent in the pediatric population, and even more so in children with neurological problems. Monitoring devices can help to better characterize sleep efficiency and sleep quality. They can also be helpful to better characterize paroxysmal nocturnal events and differentiate between nocturnal seizures, parasomnias, and obstructive sleep apnea, each of which has a different management...
December 25, 2017: Children
https://www.readbyqxmd.com/read/29295522/comparison-between-scalp-eeg-and-behind-the-ear-eeg-for-development-of-a-wearable-seizure-detection-system-for-patients-with-focal-epilepsy
#15
Ying Gu, Evy Cleeren, Jonathan Dan, Kasper Claes, Wim Van Paesschen, Sabine Van Huffel, Borbála Hunyadi
A wearable electroencephalogram (EEG) device for continuous monitoring of patients suffering from epilepsy would provide valuable information for the management of the disease. Currently no EEG setup is small and unobtrusive enough to be used in daily life. Recording behind the ear could prove to be a solution to a wearable EEG setup. This article examines the feasibility of recording epileptic EEG from behind the ear. It is achieved by comparison with scalp EEG recordings. Traditional scalp EEG and behind-the-ear EEG were simultaneously acquired from 12 patients with temporal, parietal, or occipital lobe epilepsy...
December 23, 2017: Sensors
https://www.readbyqxmd.com/read/29291457/diagnosis-of-epileptic-seizures-by-community-health-workers-using-a-mobile-app-a-comparison-with-physicians-and-a-neurologist
#16
Victor Patterson, Shruti Samant, Mamta Bhushan Singh, Priya Jain, Vaibhav Agavane, Yogesh Jain
PURPOSE: The World Health Organisation (WHO) strategy for non-physician health workers (NPHWs) to diagnose and manage people with untreated epilepsy depends on them having access to suitable tools. We have devised and validated an app on a tablet computer to diagnose epileptic episodes and now examine how its use by NPHWs compares with diagnosis by local physicians and a neurologist. METHODS: Fifteen NPHWs at Jan Swasthya Sahyog (JSS) a hospital with community outreach in Chhattisgarh, India were trained in the use of an epilepsy diagnosis app on a tablet computer...
December 26, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29290532/thrombolysis-alert-in-hassan-ii-university-teaching-hospital-of-fez-morocco-a-prospective-study-of-2-years
#17
Moussa Toudou Daouda, Siham Bouchal, Naima Chtaou, Aouatef Midaoui, Zouahyr Souirti, Faouzi Belahsen
BACKGROUND: Thrombolysis alert (TA) is a procedure triggered every time a patient consults for sudden focal neurological deficit within 4.5 hours. OBJECTIVE: We aimed to determine firstly the etiological profile of TA and secondly to evaluate the delays in the management not only of thrombolyzed patients but also of nonthrombolyzed patients to determine the intrahospital delays to optimize. METHODS: Patients aged over 18 years who consulted for sudden focal neurological deficit within 4...
December 29, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29289522/effect-of-rescue-medication-on-seizure-duration-in-non-institutionalized-children-with-epilepsy
#18
Federico Vigevano, Fenella J Kirkham, Bernd Wilken, Miquel Raspall-Chaure, Regina Grebla, Dawn Lee, Tamara Werner-Kiechle, Lieven Lagae
OBJECTIVES: Characterize the real-world management of and outcomes for children with epilepsy receiving rescue medication for prolonged acute convulsive seizures (PACS) in the community. METHODS: PERFECT-3 (Practices in Emergency and Rescue medication For Epilepsy managed with Community-administered Therapy 3) was a European, retrospective observational study. Eligible patients were non-institutionalized children with epilepsy aged 3-16 years who had experienced ≥1 PACS in the past year and had ≥1 currently prescribed PACS rescue medication...
August 2, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/29288902/diagnostic-evaluation-and-surgical-management-of-pediatric-insular-epilepsy-utilizing-magnetoencephalography-and-invasive-eeg-monitoring
#19
Raheel Ahmed, Hiroshi Otsubo, Carter Snead, Elizabeth Donner, Elysa Widjaja, Ayako Ochi, James M Drake, James T Rutka
INTRODUCTION: The diagnosis and surgical management of pediatric patients with insular epilepsy is challenging due to variable and indistinct seizure semiology arising within the insular cortex. In addition, surgical approaches are associated with potential morbidity given the regional neurosurgical and vascular anatomy. Our institutional experience in evaluation and surgical management of insular epilepsy patients is presented. Diagnostic evaluation, surgical treatment and seizures outcomes are highlighted...
December 20, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/29285339/medium-chain-acyl-coa-dehydrogenase-deficiency-in-a-premature-infant
#20
Steven F Dobrowolski, Lina Ghaloul-Gonzalez, Jerry Vockley
Medium-chain acyl-CoA dehydrogenase deficiency (MCADD) is identified by newborn screening (NBS). The natural history of MCADD includes metabolic decompensation with hypoglycemia, hyperammonemia, seizures, coma, and death. NBS enables expectant management thus severe symptoms are rare in managed patients. We report premature birth of an MCADD affected infant and resultant management challenges. Nutritional support advanced from parenteral nutrition at 24 hours to enteral feeds. A NBS sample was collected day 2, positive results for MCADD was reported day six, and diagnostic tests were performed day seven...
November 21, 2017: Pediatric Reports
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