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La Fauci, Giovanna, Melodie O. Aricò, Amedeo Bonelli, Elena Cazzato, and Giuseppe Pagano. "Lo stato di male epilettico in pronto soccorso." QUADERNI ACP 29, no. 3 (2022): 121. http://dx.doi.org/10.53141/qacp.2022.121-127.
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Convulsive status epilepticus is a relatively frequent event that requires a quick picture of the situation and an early and appropriate treatment with subsequent levels of intervention. It is important that the pediatrician, as well as the emergency room physician or the resuscitator are well aware of the early stages of crisis management, both at the local and hospital level. The final outcome of the event will depend above all on the timeliness and appropriateness of the decisions taken, without forgetting that, sometimes, status epilepticus can originate from acute events that, if present, must also be identified and treated appropriately.
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Duara, R. "Convulsive syncope after bidirectional Glenn shunts: physiological implications for a neurological event." Interactive CardioVascular and Thoracic Surgery 5, no. 5 (July 10, 2006): 594–98. http://dx.doi.org/10.1510/icvts.2005.124503.
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Poag, C. Wylie. "The Chesapeake Bay bolide impact: a convulsive event in Atlantic Coastal Plain evolution." Sedimentary Geology 108, no. 1-4 (February 1997): 45–90. http://dx.doi.org/10.1016/s0037-0738(96)00048-6.
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Lu, Xi-Chun M., Yuanzheng Si, Anthony J. Williams, Jed A. Hartings, Divina Gryder, and Frank C. Tortella. "NNZ-2566, a Glypromate Analog, Attenuates Brain Ischemia-Induced Non-Convulsive Seizures in Rats." Journal of Cerebral Blood Flow & Metabolism 29, no. 12 (July 29, 2009): 1924–32. http://dx.doi.org/10.1038/jcbfm.2009.109.
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Ischemic and traumatic brain injuries often induce non-convulsive seizures (NCSs), which likely contribute to the worsening of neurological outcomes. Here, we evaluated the effect of glycyl-l-methylprolyl-l-glutamic acid (NNZ-2566) to lessen the severity of NCSs caused by permanent middle cerebral artery occlusion (pMCAo). Continuous electroencephalographic recordings were performed in rats during pMCAo. Glycyl-l-methylprolyl-l-glutamic acid (3, 10, or 100 mg/kg bolus followed by an infusion of a fixed dose of 3 mg/kg per hour for 12 h) was delivered at 20 mins after pMCAo (before the first NCS event) or delayed until immediately after the first NCS event occurred. Control rats received pMCAo and saline treatment. The results revealed that 91% of the saline-treated animals had NCSs (23 episodes per rat and 1238 secs per rat) with an onset latency of 35 mins after injury. When NNZ-2566 was administered before the NCS events, it dose-dependently reduced the NCS incidence to 36%–80%, decreased NCS frequency to 5–16 episodes per rat, and shortened the total duration of NCS to 251–706 secs per rat. The two high doses significantly reduced the infarct volume by 28%–30%. Delayed treatment also attenuated NCS duration but had no effect on the infarct volume. Results indicate that NNZ-2566 possesses a unique therapeutic potential as a safe prophylactic agent that synergistically provides neuroprotection and reduces injury-induced seizures.
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Hermelin, Michel, Oscar Mejia, and R. Elkin Velasquez. "Erosional and depositional features produced by a convulsive event, San Carlos, Colombia, September 21, 1990." Bulletin of the International Association of Engineering Geology 45, no. 1 (April 1992): 89–95. http://dx.doi.org/10.1007/bf02594908.
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Bonhoeffer, Jan, John Menkes, Michael S. Gold, Glacus de Souza-Brito, Margaret C. Fisher, Neal Halsey, and Patricia Vermeer. "Generalized convulsive seizure as an adverse event following immunization: case definition and guidelines for data collection, analysis, and presentation." Vaccine 22, no. 5-6 (January 2004): 557–62. http://dx.doi.org/10.1016/j.vaccine.2003.09.008.
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Needle, Alan R., and John W. Mackall. "Convulsive Adverse Event in a Nonpredisposed Individual During Single-Pulse Transcranial Magnetic Stimulation Over the Lower Extremity Motor Cortex." Journal of ECT 35, no. 2 (June 2019): e13-e14. http://dx.doi.org/10.1097/yct.0000000000000553.
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Revilla Zúñiga, Joseph, José Revilla Urquizo, and Carolina Dávalos Luque. "Convulsiones asociadas con clozapina." Revista Médica Basadrina 14, no. 2 (December 30, 2020): 59–63. http://dx.doi.org/10.33326/26176068.2020.2.1015.
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Objetivo: Los antipsicóticos son medicamentos que pueden disminuir el umbral convulsivo. La clozapina es un antipsicótico atípico usado en el tratamiento de la esquizofrenia resistente a los antipsicóticos convencionales y está asociado a convulsiones como efecto adverso. Caso clínico: Varón de 28 años con diagnóstico de esquizofrenia paranoide que ingresó a un servicio de psiquiatría de un hospital general por síntomas psicóticos de difícil manejo. Por la persistencia de los síntomas psicóticos a pesar del uso de medicación antipsicótica, y la ideación suicida, se decidió el inicio de clozapina. Presentó dos crisis convulsivas, la primera con 700 mg/d de clozapina y la segunda con 600 mg/d, que remitieron tras la suspensión de este antipsicótico. Debido a este evento adverso, no se reinició la clozapina y se inició la terapia electroconvulsiva, con una respuesta clínica favorable. Resultados: La clozapina es uno de los antipsicóticos que más se asocia a la disminución del umbral convulsivo y que no contraindica su uso. Conclusiones: Si bien en el caso presentado se suspendió la clozapina por la aparición de dos eventos convulsivos, y se decidió el uso de la terapia electroconvulsiva con una respuesta clínica favorable, existen otras estrategias que pueden utilizarse para el manejo de este efecto adverso.
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Gomes, Rui A., Silvana Kesrouani, Jenner Cruz, Alexandre L. Silva, Tânia M. G. Henriques, Marly de Albuquerque, Ricardo M. Arida, et al. "Is there something special about cardiovascular abnormalities and sudden unexpected death in epilepsy among patients with chronic renal insufficiency in regular hemodialysis program?" Arquivos de Neuro-Psiquiatria 67, no. 2a (June 2009): 209–13. http://dx.doi.org/10.1590/s0004-282x2009000200007.
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Of the many risk factors suggested for sudden unexpected death in epilepsy (SUDEP), higher frequency of seizures is a very consistent issue. Following this reasoning, it has been established that hemodialysis-associated seizure is a complication of dialysis procedure. Based on these facts, this study investigated a possible association between cardiovascular abnormalities and SUDEP among patients with chronic renal insufficiency in regular hemodialysis program. For that, a retrospective medical history of 209 patients was reviewed to investigate the occurrence of convulsive seizures and EKG abnormalities during dialytic program. Three patients presented generalized tonic-clonic seizures, one had partial seizure with secondary generalization, and one presented unclassified seizure. Any EKG abnormalities and SUDEP event were found in all patients evaluated. In conclusion, the present findings demonstrated uncommon the occurrence of seizures and also SUDEP. Probably, the main justification to not allow us to demonstrated a direct relation between SUDEP and cardiovascular diseases in hemodialysis are the reduced number of cases examined.
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Lee, John, Ling Obrand, and Janet Campion. "January 2021 Critical Care Case of the Month: A 35-Year-Old Man Found Down on the Street." Southwest Journal of Pulmonary and Critical Care 22, no. 1 (January 1, 2021): 1–7. http://dx.doi.org/10.13175/swjpcc051-20.
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No abstract available. Article truncated after 150 words. History of Present Illness A 35-year-old African-American man with a history of alcohol abuse presented to Emergency Department after he was found down. He was seen by a passerby on the street who witnessed the patient fall with a possible convulsive event. He was brought in by ambulance and was unconscious and unresponsive. PMH, SH, and FH The patient had a history of prior ICU admission in Yuma with septic shock secondary to a dental procedure requiring a tracheostomy in 2018. He also had a history of alcohol intoxication requiring an ED visit about 10 years ago and history of sickle cell trait. Per chart review, the patient took no home medications. Further history was unable to be obtained due to the patient's condition. Physical Examination On arrival the patient had a core temperature of 41°C, systolic blood pressure in the 70s-80s, heart rate of 185, respiratory rate of 19 …
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AArthi, M., Kannan Dhasaradharaman, and Gokila Raj. "A Comparative Study of Unilateral Strength Training Versus Mirror Therapy with Unilateral Strength Training for Upper Extremity in Hemiplegia." International Journal of Health Sciences and Research 13, no. 1 (January 11, 2023): 29–32. http://dx.doi.org/10.52403/ijhsr.20230105.
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Introduction: A stroke is a sudden, non convulsive loss of neurological function due to an ischemic or hemorrhagic event in the brain (WHO2006). Our study aims to compare the effect of unilateral strength training versus mirror therapy with unilateral strength training for upper extremity in hemiplegia. Methodology: A sample of 30 patients within the age group of 35-65 years with hemiplegia were randomly divided into two groups, Group a (n= 15)and group b (n= 15). The subjects in group A is treated with Unilateral strength training and the subjects in group B is treated with mirror therapy with unilateral strength training. The patients improvement on ROM and reduced spasticity is assessed by Modified Ashworth Scale and ABILHAND Questionnaires. The pre and Post test results were tabulated and assessed. Results: The study concludes that there was statistically significant improvement on ROM and reduced spasticity in group B compared to group A in response to treatment. Conclusion: Based on the result, this study concluded that mirror therapy with unilateral strength training is effective than unilateral strength training for upper extremity in hemiplegia. Key words: Unilateral Strength Training, Mirror Therapy, Modified Ashworth Scale, ABILHAND Questionnaire.
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Mizuma, Atsushi, Yoshiaki Goto, Wakoh Takahashi, Shunya Takizawa, and Shigeharu Takagi. "A Patient with Hashimoto's Encephalopathy Presenting with Convulsive Seizure Alone as the Initial Symptom." Clinical Medicine Insights: Case Reports 6 (January 2013): CCRep.S10390. http://dx.doi.org/10.4137/ccrep.s10390.
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A 71-year-old Japanese woman with Sjögren syndrome, Hashimoto's disease and a 6-month history of cognitive impairment was admitted to our hospital because of consciousness disturbance and convulsion. Her convulsive seizure disappeared by intravenous administration of diazepam following carbamazepine, and conscious level became alert the next day. But, her cognitive function was persistently deteriorated, and a score of mini-mental state examination (MMSE) was 17/30 points. Magnetic resonance imaging (MRI) and single photon emission computed tomography (SPECT) of the brain did not show any abnormal findings. The electroencephalogram showed increased slow waves in bilateral parieto-occipital regions. Serum anti-thyroglobulin antibodies were elevated (1780 U/ml), but thyroid function was within the normal range. In addition, anti-NAE (NH2-terminal of α-enolase) antibodies were positive. We diagnosed Hashimoto's encephalopathy, and started steroid therapy. Her cognitive function gradually improved after steroid therapy, and convulsive seizure did not recur until 3 months later. We emphasize that Hashimoto's encephalopathy should be considered even in patients with convulsive seizure of adult onset without thyroid dysfunction.
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Navas Piedra, Gabriela Dayanara, and Verónica Elizabeth Padilla-Vinueza. "Revisión bibliográfica sobre el diagnóstico y manejo de primera crisis convulsiva en pacientes de tercera edad." Ciencia Latina Revista Científica Multidisciplinar 6, no. 5 (October 31, 2022): 2482–92. http://dx.doi.org/10.37811/cl_rcm.v6i5.3258.
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La OMS para el 2017 ha publicado que cada año se diagnostican un estimado de 2.4 millones de casos de epilepsia, señalando que los grupos de 60-65 años y mayores de 80 años son los más afectados, presentando 140 casos por cada 100.000 personas; demostrando que la incidencia de aparición de epilepsia aumenta con la edad. Por tal motivo, realizamos una revisión actualizada con el fin de poder obtener una guía acerca del diagnóstico y el manejo de las crisis convulsivas en los pacientes de tercera edad que acuden al servicio de emergencia. Recalcando que en las personas de tercera edad la mayoría de las crisis convulsivas se originan en los lóbulos frontal y parietal, por consiguiente, los episodios convulsivos se pueden acompañar de auras. Su diagnóstico se basa en la descripción del evento convulsivo, las manifestaciones en el electroencefalograma, apoyo en los exámenes de imagen como tomografía o resonancia. Se realizó una búsqueda en las bases de datos como: PubMed, DynaMed, Up to Date, Scielo, Scopus, etc, la información se tomo en el límite de tiempo de los últimos 5 años, seleccionando 20 artículos para su análisis. Llegando a la conclusión que el diagnóstico exacto en pacientes de tercera representa un desafío enorme para los médicos debido a las limitaciones en la historia clínica, los síntomas atípicos y las comorbilidades médicas que presentan. Los medicamentos anticrisis son: valproato, carbamacepina, fenitoína, lamotrigina, gabapentina, oxcarbacepina, topiramato, levetiracetam y lacosamida. La elección de un medicamento anticonvulsivo ideal no solo debe basarse en la eficacia, sino también en los efectos adversos, la farmacodinámica alterada en adultos mayores y las comorbilidades.
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Kundu, Gopen Kumar, F. Rabin, ER Nandi, Naveen Sheikh, and Shaheen Akhter. "Etiology and Risk Factors of Febrile Seizure An Update." Bangladesh Journal of Child Health 34, no. 3 (April 16, 2012): 103–12. http://dx.doi.org/10.3329/bjch.v34i3.10361.
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Febrile seizures (FS) are the most common convulsive event in children. This condition has been described since the time of Hippocrates. The etiology of the febrile seizures are still unclear. In FS, there is a strong familial predisposition. This does not exclude infections as a causative factor because subtle genetic polymorphisms have been demonstrated to affect the course of infections. In an earlier review of the world literature (1924-1964), except for roseola infantum, viral infections as a cause of febrile seizures were rarely diagnosed. Reports of viral infections in the etiology of febrile seizures have increased in number in the past decade. In the first half of the twentieth century, infections identified with febrile seizures were mainly upper respiratory in type and the etiologic agent was unknown or bacterial. We review i) the role of infection viral and bacterial; ii) the role of genetic and environmental factors; iii) the role of electrolyte and metabolic factors; and iv) the role of cytokines. With the help of new diagnostic tools such as PCR, the viral agents are detected in CSF far more often than previously thought, even in the absence of pleocytosis of the CSF. This makes it difficult to distinguish FS from acute encephalitis. FS may be caused by neuroinvasion or intracerebral activation of viruses. By reviewing etiology and risk factors of FS we can identify the points to be focused in therapeutic interventions and trials and also the fields of future studies will be explored. DOI: http://dx.doi.org/10.3329/bjch.v34i3.10361 BJCH 2010; 34(3): 103-112
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Nahid, Fauzia, Farhana Rahman, Md Mahbubul Hoque, Md Ruhul Amin, Tahmina Yasmin, and Rawshan Ara. "Risk Factors of First Febrile Seizures Admitted in a Tertiary Care Hospital." Ibrahim Cardiac Medical Journal 6, no. 1-2 (March 20, 2018): 56–61. http://dx.doi.org/10.3329/icmj.v6i1-2.53761.
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Background & objective: Febrile seizure (FS) is the most common convulsive event in children. It is the most common type of seizure that every pediatrician has to deal with. However, the etiology of febrile seizure is still unclear. The present study was intended to identify the risk factors of first febrile convulsion among 6 months to 5 years old children.
Materials & Methods: A case-control study was carried out on a total of 200 children-100 cases (children with febrile convulsion) & 100 controls (without febrile convulsion) selected from the In-patient Department of Dhaka Shishu Hospital over a period of six months between May 2012 to October 2012. Data were collected on variables of interest using a semi-structured research instrument. The Chi-square test and Odd Ratio were employed to compare the risk factors between case and control groups.
Result: There was no association of febrile seizure with age of the children, but males were more often associated with FS than the females with risk of developing febrile seizures in boys was 3.5-fold (95% CI=1.8 -6.8) higher than that in girls (p<0.001). The risk of having FS in children with prematurity and caesarean delivery was 2.8 times (95% CI=1.5-5.0) and 2-times (95% CI=1.4-2.6) greater than those in children without having these conditions (p=0.001 and p<0.001 respectively). The children with family history of febrile seizure tends to be associated with first febrile seizures and the odds of having the condition is 36.4 (95% CI=15.4-85.7). There was no significant relationship between family history of epilepsy and first febrile seizure (p=0.061). The children with shorter duration of breast feeding (6-12 months) carry 2.9(95% CI=2.0-4.0) times higher risk of having first febrile seizure than those with longer duration of breast-feeding (p<0.001). Exclusively breast-fed children were less susceptible to develop febrile seizures (OR=0.149, 95% CI: 0.08-0.23). Twelve cases developed perinatal asphyxia as opposed to only 2 of the control group and the risk of having FS in children with perinatal asphyxia was 1.8(95% CI=1.4-2.3) times higher than those without having the history ofperinatal asphyxia (p<0.001). Three-quarters of the children presented with FS had viral fever whereas only 4% of the controls had viral fever indicating that viral fever triggers the development of FS much more frequently than any other childhood illness (p<0.001).
Conclusion: The study concluded that male sex, preterm baby, positive family history of febrile seizures, less than 6 months of exclusive breast feeding, not continuing the breast-feeding beyond 12 months, perinatal asphyxia and viral infections are the predictors of first febrile seizure. Preventive measures in removing these risk factors can go a long way to a decrease the incidence of febrile seizures.
Ibrahim Card Med J 2016; 6 (1&2): 56-61
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Poudel, Sumita, Sudhir Adhikari, Rohit Thapa, Biraj Parajuli, Shanti Regmi, and Prajjwal Kunwar. "Febrile Seizures among Children Admitted to the Department of Paediatrics of a Tertiary Care Centre: A Descriptive Cross-sectional Study." Journal of Nepal Medical Association 60, no. 248 (April 15, 2022): 348–51. http://dx.doi.org/10.31729/jnma.7197.
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Introduction: Febrile seizure is the most common convulsive event in children younger than 60 months. Fever plays an important role in causing disturbances in fluid and electrolyte balance, also hyponatremia has been thought to enhance the susceptibility to seizures. The objective of this study is to find out the prevalence of febrile seizures among children admitted to the Department of Paediatrics of a tertiary care centre. Methods: A descriptive cross-sectional study among children admitted to the Department of Paediatrics was done at a tertiary care centre between December, 2020 to September, 2021. Ethical approval was taken from the Institutional Review Committee (Reference number: 077/078-098). A total of 1052 children were included in this study. A convenience sampling technique was used. Statistical Package for the Social Sciences version 25.0 was used for data analysis. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 1052 children, the prevalence of febrile seizure was 100 (9.50%) (7.73-11.27 at 95% Confidence Interval). Among these 100 patients, 68 (68%) had simple febrile seizures while 32 (32%) had recurrent febrile seizures. Conclusions: The prevalence of febrile seizures was found to be higher than in other studies conducted in similar settings. This knowledge may be of practical value in advising parents or caregivers of the risk of a febrile seizure and its recurrence.
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Barrett, Matthew J., and Ivan S. Login. "Gemifloxacin-Associated Neurotoxicity Presenting as Encephalopathy." Annals of Pharmacotherapy 43, no. 4 (March 31, 2009): 782–84. http://dx.doi.org/10.1345/aph.1l621.
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Objective: To report a case of acute encephalopathy associated with ingestion of gemifloxacin, a fluoroquinolone. Case Summary: A 67-year-old woman presented to the emergency department with an acute alteration in mental status. Twenty-four hours earlier she had taken one 320-mg tablet of her husband's gemifloxacirt prescription to treat symptoms of a mild upper respiratory infection. During her initial evaluation at our institution, the woman was dysphasia, unable to follow commands, and agitated, suggesting encephalopathy. A thorough diagnostic investigation did not reveal any structural, metabolic, or infectious etiology. Her mental status returned to normal within 2 days without any definitive treatment. Discussion: Fluoroquinolone-associated neurotoxicity may manifest as encephalopathy, seizures, confusion, or toxic psychosis. To date, none of these adverse effects, specifically encephalopathy, has been reported with gemifloxacin. An objective causality assessment revealed that encephalopathy was probably associated with gemifloxacin use. Seizures, either convulsive or nonconvulsive, may have contributed to our patient's presentation, but she denied seizures prior to this event and did not suffer a seizure in the 18 months following her discharge, However, her second electroencephalograph revealed an underlying predisposition to seizures, which gemifioxacin may have unmasked. Conclusions: This report illustrates that severe central nervous system adverse effects associated with some fluoroquinolones may also occur with gemifloxacin. Gemifloxacin and other fluoroquinolones should be considered in the etiologic evaluation of patients with acute encephalopathy.
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Shenoy, Shanti, Hai Chen, and Elias Karroum. "835 Ictal Central Apneic Events Detected on Polysomnogram: An Educational Case Report." Sleep 44, Supplement_2 (May 1, 2021): A325. http://dx.doi.org/10.1093/sleep/zsab072.832.
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Abstract Introduction Ictal central apneas (ICA) are frequently observed in focal epilepsy, mostly with temporal lobe seizures, and have been considered as potential biomarkers of sudden unexpected death in epilepsy (SUDEP), particularly when they are prolonged and associated with significant hypoxemia. We present an interesting educational case report of occurrence of such ictal apneic events as recorded during a nocturnal diagnostic polysomnogram (PSG). Report of case(s) A 39-year-old woman with history of left focal epilepsy, hypertension, and headaches was referred to the sleep clinic for loud snoring, witnessed apneic events, and excessive daytime sleepiness. She subsequently underwent a diagnostic (PSG) that demonstrated severe obstructive sleep apnea (apnea-hypopnea index of 63.1) associated with significant hypoxemia (nadir SpO2 of 58%). In addition, the patient had one ictal discharge detected on the PSG’s limited electroencephalogram that occurred in N2 sleep and lasted for almost three minutes with a focal onset and progression in the left hemisphere. The ictal discharge was briefly preceded by central apneic events that continued to occur during and shortly after the termination of the ictal discharge. These ICA events were associated with severe oxygen desaturations down to an SpO2 of 62%. The only time during the PSG recording that the patient had central apneic events was around the ictal event. There were no behavior changes on the video during the seizure, but the ictal discharge was associated with a sustained increase in the mentalis muscles activity and a brief tachycardia. The patient’s neurologist was alerted about the above findings on PSG. The patient was taking a lower dose then prescribed of her anti-epileptic medication (topiramate) that was adjusted, and the patient was counseled on the risks associated with the above findings and positive airway pressure therapy was recommended for her severe sleep apnea. Conclusion The above case report illustrates the importance of polysomnography (specifically the recording of respiratory variables rarely performed in epilepsy monitoring units) in the evaluation of patients with epilepsy given that central apneic events (ICA and post-convulsive central apneas) potentially underlie SUDEP, the most common cause of mortality in refractory epilepsy patients and usually occurring during sleep. Support (if any) None
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AA, Kassem. "Reservoir Description, Diagenesis and Reservoir Quality of the Deep Marine Sediments in the Propagation Stage of Rift Basin." Petroleum & Petrochemical Engineering Journal 6, no. 4 (October 20, 2022): 1–15. http://dx.doi.org/10.23880/ppej-16000316.
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The exploration and exploitation of the downthrown side of the productive upthrown Pre-rifting reservoirs at the Gulf of Suez marked bring a renaissance to the rift basin Exploration. This work documents the reservoir performance, trap geometry, and structural style of the downthrown deep marine stratigraphic entrapment. In addition, it outlines the requirements necessary beyond the production mitigations and limits. To gain better understanding of Asl Formation (deep marine) reservoir characteristics early in the exploration program, Asl Formation was cored in the north October J-5 well. A continuous 366- foot (112m) core was recovered including the main reservoir interval, which is producing over 12,000 barrel of oil per day. The J-5 Asl Formation has been interpreted as a synthetic, mixed clastic-carbonate turbidity deposit. Three major lithofacies described are recognizable on electric log. These are sandstone, shale and carbonates. The sandstones dominate the lower portion of the core and are the main oil producing section. Sandstone porosity and permeability range from 17 to 27% and 30 millidarcies to 3 darcies, respectively. Compared to the sandstone, the carbonate turbidites have poorer reservoir quality. They dominate the upper portion of the core and are composed of coarse fossil debris, silica framework grains and rock fragments. Horizontal and vertical permeabilities with rock types. Both the sandstone and carbonate sections of the J-5 core have experienced a complex diagenetic history. Deposition of the cored interval was initiated by a convulsive geological event such as flashflood or earthquake. These events would likely generate sufficient energy for mobilization of onshore and/or near shore sediments into multiple gravity flows having regional extent. The reservoir quality is controlled by a combination of primary depositional fabric and subsequent diagenetic modification. This research work can guide future exploration of reservoir-prone deep marine deposits in the Red Sea Rift and provide a reference for the subsurface deep-water reservoir quality analysis in the propagation stage in the Rift Basins.
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Powell, Kerry K., Wei Wang, Kelly J. Kelleher, and Sarah H. O’Brien. "Use of SSRIs Not Associated with Increased Bleeding Events in Children: An Analysis of the Michigan Medicaid Database from 2000–2003." Blood 112, no. 11 (November 16, 2008): 2389. http://dx.doi.org/10.1182/blood.v112.11.2389.2389.
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Abstract Background and Aim : Serotonin reuptake inhibitors (SSRIs) have been used in children for a variety of psychiatric illnesses including depression, anxiety and eating disorders. In adults, there have been several studies demonstrating an association between SSRIs and increased bleeding events, particularly gastrointestinal bleeds. It is thought that SSRIs affect platelet aggregation by inhibiting serotonin uptake by platelets, resulting in decreased intra-platelet serotonin concentration. To date there are no pediatric studies evaluating bleeding risk in children taking SSRIs. The objective of this study was to evaluate the incidence of bleeding events in children who are prescribed SSRIs Methods : We performed a review of the Michigan Medicaid database from 2000–2003 and identified all children ages 0–18 years prescribed six commonly used SSRIs: citalopram, escitalopram, fluvoxamine, fluoxetine, paroxetine and sertraline. Children prescribed Attention deficit hyperactivity disorder (ADHD) or antipsychotic medications were used as comparison groups. We obtained demographic data including age, gender and race for individuals with both SSRI prescriptions and bleeding events. Bleeding events were defined according to previously published definitions for major and minor bleeding using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9 CM) diagnostic codes. Bleeding events must have occurred within 90 days of an SSRI prescription. For individuals with bleeding events, we evaluated all inpatient, outpatient and long term records during the 6 months before and after the event. We compared the incidence of bleeding events in the SSRI, ADHD, and antipsychotic medication groups by using Proc GENMOD in SAS 9.1.3. This accounted for the fact that there were patients on multiple medications. We found no statistical difference in the total number of bleeding events between the three medication categories. Results : Of 20,631 children prescribed SSRIs in the study population, six children experienced bleeding events (Table 1). The incidence of bleeding was 29 in 100,000 persons. Two events were associated with traumatic injuries and one was observed in a critically ill patient. There were 52,050 children on ADHD medication and 17,340 on atypical antipsychotics. The incidence of bleeding events in these groups was 13 in 100,000 and 40 in 100,000 respectively. Of note, two of six children in the SSRI group with bleeding events were also prescribed ADHD medication. TABLE 1 Patient Age (years) Gender Race Bleeding Event Associated Diagnosis 1 11.3 Male Black Intracerebral hemorrhage Subdural hemorrhage Lymphoid leukemia Sepsis Aspergillosis Acute respiratory failure Acute renal failure Perforation of intestine Adjustment disorder 2 12.3 Male White Hematoma-complication of procedure Femur fracture Closed reduction of fracture ADHD with hyperactivity Depressive disorder 3 13.4 Female White Subarachnoid hemorrhage Extradural hemorrhage Closed fracture base of skull Convulsive disorder Developmental delay 4 17.7 Female White Subdural hemorrhage ADHD with hyperactivity Intracranial injury 5 17.5 Female White Hemorrhage complicating a procedure Acute pharyngitis and tonsillitis Tonsillectomy 6 15.4 Female White Subdural hemorrhage Cerebral palsy Spastic hemiplegia Discussion : We found that the incidence of bleeding events in children taking SSRIs is not increased as compared to those taking ADHD and antipsychotic medication. The majority of bleeding events that occurred in the 6 children prescribed SSRIs were either associated with trauma or a known complication of a surgical procedure. There were no gastrointestinal bleeding events in the SSRI group. Our study suggests that the use of SSRIs does not confer an increased risk of abnormal bleeding events in children.
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Haque, M. Sanaul, Shahida Yeasmin, Poly Dutta, PK Chandan Kumar, and Pijush Kumar Kundu. "Role of Lumbar Puncture for First Simple Febrile Seizure Among Children 6 to 18 Months of Age." TAJ: Journal of Teachers Association 24, no. 2 (November 28, 2018): 65–69. http://dx.doi.org/10.3329/taj.v24i2.37505.
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Introduction: Fever with seizure is a common childhood emergency. This may be due to febrile seizure or CNS infection like meningitis. Febrile seizure makes up the most common convulsive event in children 6 months to 5 years of age. Despite the commonness of this clinical problem, the need for routine lumbar puncture following a first simple febrile seizure below 18 months of age to exclude meningitis continues to be debated.Objectives: To evaluate the role of lumbar puncture for first simple febrile seizure among children 6 to 18 months of age and to determine the causes of fever of the patient presented with fever with simple seizure in this age group.Methodology: This cross-sectional type of descriptive study was conducted at Paediatric department of Rajshahi Medical College from January 2013 to December 2014.A total of 73 children ages 6 months to 18 months with first simple febrile seizure were enrolled by purposive sampling technique. Lumbar puncture was performed in all patients to evaluate occult meningitis.Results: A total of 73 children ages 6 months to 18 months with first simple febrile seizure were included in the study. 37% (n = 27) were < 12 months of age and 63% (n = 46) were ≥12 months of age with a mean age 13±3.575 months. 43.8% of our study population had family history of febrile seizure. CSF findings of all children > 12 months of age group 63% (n = 46) were normal but in case of age group <12 months, out of 37% (n = 27) cases, only one case showed abnormal CSF finding.Conclusion: It is concluded that lumbar puncture following first simple febrile seizure without any other features of meningitis may be done in children < 12 months of age.TAJ 2011; 24(2): 65-69
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Miani, Alessandro, Anders Sune Pedersen, Charlotte Ulrikka Rask, Lori Uber-Zak, Paul J. Zak, and Michael Winterdahl. "Predicting psychogenic non-epileptic seizures from serum levels of neuropeptide Y and adrenocorticotropic hormone." Acta Neuropsychiatrica 31, no. 03 (April 1, 2019): 167–71. http://dx.doi.org/10.1017/neu.2019.3.
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AbstractObjectivePatients with psychogenic non-epileptic seizures (PNES) may present with convulsive events that are not accompanied by epileptiform brain activity. Video-electroencephalography (EEG) monitoring is the gold standard for diagnosis, yet not all patients experience convulsive episodes during video-EEG sessions. Hence, we aimed to construct a predictive model in order to detect PNES from serum hormone levels, detached from an evaluation of patients’ convulsive episodes.MethodsFifteen female patients with PNES and 60 healthy female controls participated in the study, providing blood samples for hormone analysis. A binomial logistic regression model and the leave-one-out cross-validation were employed.ResultsWe found that levels of neuropeptide Y and adrenocorticotropic hormone were the optimal combination of predictors, with over 90% accuracy (area under the curve=0.980).ConclusionsThe ability to diagnose PNES irrespective of convulsive events would represent an important step considering its feasibility and affordability in daily clinical practice.
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Kuzminov, V. "The convulsive syndrome in the structure of alcohol withdrawal syndrome with delirium." European Psychiatry 64, S1 (April 2021): S362. http://dx.doi.org/10.1192/j.eurpsy.2021.969.
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IntroductionWithdrawal states with delirium, having convulsive syndrome in their structure, are one of the most severe emergency conditions in psychiatry.ObjectivesA total of 160 patients were examined with delirium alcohol withdrawal. Prognostic factors of occurrence of convulsive syndrome in the withdrawal syndrome of alcohol were studied.MethodsClinical, psychopathological, electrophysiological.ResultsIt was found that the most significant prognostic factors seizures were: severe bloating condition, the duration of hard drinking, the total dose of drinking alcohol before the breakdown of consumption alcohol. Convulsive syndrome not always correlated with marked vegetative disorders in the state of withdrawal of alcohol. Convulsive syndrome that appeared after the development of delirious syndrome often indicated a more serious conditionIt is suggested that the convulsive pattern of response to the severe condition of alcohol withdrawal is formed in some young patients under the influence of endogenous factors, but is realized under certain situational conditions - long binge drinking, massive consumption o alcohol before the break of the reception of alcohol, the use of psychoactive drugs with stimulating effect. In the electrophysiological examination, there were significant differences in the group of patients with convulsive syndrome in the current admission from the group of patients with convulsive syndrome in the past and the group without convulsive syndrome in the state of abolition of alcohol.ConclusionsIt is emphasized that when indicating the seizures in the state of abolition of alcohol in the past, the beginning of treatment is necessary to begin even in a state of binge drinking.
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Walker, M. C., O. C. Cockerell, and J. W. A. S. Sander. "Non-Convulsive Status Epilepticus Presenting as a Psychiatric Condition." Journal of the Royal Society of Medicine 89, no. 2 (February 1996): 91–92. http://dx.doi.org/10.1177/014107689608900209.
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Non-convulsive status epilepticus may present as confusion, behavioural disturbances and psychiatric conditions. We present the case of a 17-year-old man who had episodes of non-convulsive status epilepticus as his only manifestation of epilepsy which was mis-diagnosed as a psychiatric condition for over 10 years. He has had almost complete resolution of his symptoms with the introduction of carbamazepine. Non-convulsive status epilepticus is probably commoner than previously thought, and should be considered as a possible diagnosis in all patients presenting with prolonged episodes of altered consciousness even without other manifestations of epilepsy.
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Strati, Paolo, Sudhakar Tummala, Loretta J. Nastoupil, Jason R. Westin, Luis Fayad, Sairah Ahmed, Nathan H. Fowler, et al. "Clinical and Radiological Correlates of Neurotoxicity after Standard of Care Axicabtagene Ciloleucel in Patients with Relapsed/Refractory Large B-Cell Lymphoma." Blood 134, Supplement_1 (November 13, 2019): 765. http://dx.doi.org/10.1182/blood-2019-125769.
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Introduction. Cytokine release syndrome (CRS) and neurotoxicity (NT)(also known as immune effector cell-associated neurotoxicity syndrome or ICANS) are commonly observed after chimeric antigen receptor (CAR) T-cell therapy. While the clinical features of CRS have been extensively described, limited data exists for NT. Here, we report clinical and radiological features of NT after standard of care (SOC) axicabtagene ciloleucel (axi-cel) in patients (pts) with relapsed or refractory (r/r) large B-cell lymphoma (LBCL). Methods. Pts with r/r LBCL treated with SOC axi-cel at MD Anderson Cancer Center between 01/2018 and 04/2019 were included in the study. All pts received anti-seizure prophylaxis with levetiracetam starting on the day of axi-cel infusion for 30 days. CRS and NT were prospectively graded according to CARTOX criteria (Neelapu et al, Nat Rev Clin Oncol, 2018). Association between continuous variables were assessed using the bivariate Pearson correlation. Results. Ninety-five pts were included in the study, 72 (76%) with diffuse LBCL, 17 (18%) with transformed follicular lymphoma, and 6 (6%) with primary mediastinal LBCL. Median age was 60 (range, 18-85), 71 (75%) were male. Median number of previous therapies was 4 (range, 2-15), 26 (27%) had a previous autologous stem cell transplant (SCT), and 1 (1%) a previous allogeneic SCT. Eight (8%) pts had prior central nervous system lymphomatous involvement (parenchymal in 5), and 39 (41%) had prior neurological and/or psychiatric medical history. After axi-cel infusion, NT of any grade was observed in 65 (68%) pts, grade ³3 in 46 (48%)(Table). No significant association was observed between above outlined baseline characteristics and development of NT. Median time from axi-cel infusion to NT onset was 5 days (range, 0-25 days) and median duration was 6 days (range, 1-52 days); no new onset/recurrent NT was observed beyond day 30. Among the 65 pts who developed NT, a CT head without contrast was performed in 48, and was not evaluable in 2 because of motion artifacts. Among the 46 evaluable scans, 1 (4%) was abnormal as compared to baseline, and showed new onset cortical edema (non-diffuse but symmetrical). An MRI brain with contrast was performed in 36 pts, but was not evaluable in 10 because of lack of baseline, motion artifacts or differences in imaging sequences. Among the 26 evaluable scans, 15 (58%) showed abnormal findings, including autoimmune encephalitis-like, characterized by symmetric white matter changes of the pons and hippocampus (6; Fig. A), stroke-like (4; Fig. B), LMD-like (3; Fig. C) and PRES-like (2; Fig. D), with concomitant cortical edema in 5. EEGs were performed in 52 pts (>1/pt, for a total of 116 EEGs) and were abnormal in 47 (90%). Focal and/or diffuse slowing was the most common abnormality (isolated finding in 35 [73%] pts), while epileptiform discharges and/or non-convulsive status epilepticus (NCSE) were observed 12 (27%) pts. A lumbar puncture was performed in 12 pts: median white blood cell count was 2 cells/µL (range, 0-6), median protein 47 mg/dL (range, 13-600), median glucose 69 mg/dL (range, 30-111), and cytology was positive for malignant cells in 2 (7%) pts. Convulsive seizure was observed in 4 (6%) pts and 10 (15%) received additional anti-seizure therapy for convulsive or non-convulsive seizures. Among the 65 pts with NT, dexamethasone up to 20 mg IV Q6H was given to 42 (65%) pts, methylprednisolone 1000 mg IV daily to 12 (18%), and tocilizumab to 64 (98%; during CRS or CRS with concurrent NT). Overall, 93 (98%) pts developed CRS, grade >3 in 27 (28%). A significantly higher rate of NT of any grade (96% vs 57%, p<0.001) or grade >3 (81% vs 35%, p<0.001) was observed among pts with grade >3 CRS. After a median follow-up of 4 months, 6-month progression-free (PFS) and overall survival (OS) rates were 60% and 65%, respectively. Significantly shorter 6-month PFS (46% vs 80%, p=0.02) and OS rates (56% vs 83%, p=0.01) were observed among pts developing NT of any grade. Conclusions. Our results suggest that multiple radiological patterns of NT after axi-cel are possible in r/r LBCL pts, MRI being more sensitive than CT scan for their detection. NCSE is a common event, supporting the use of seizure prophylaxis and EEGs for evaluation of these pts. Pts with NT experience a worse outcome, and additional clinical and biological predictors of NT will be analyzed and presented at the meeting. Figure Disclosures Nastoupil: Spectrum: Honoraria; Janssen: Honoraria, Research Funding; Bayer: Honoraria; Celgene: Honoraria, Research Funding; Genentech, Inc.: Honoraria, Research Funding; Gilead: Honoraria; TG Therapeutics: Honoraria, Research Funding; Novartis: Honoraria. Westin:47 Inc: Research Funding; Novartis: Other: Advisory Board, Research Funding; Juno: Other: Advisory Board; MorphoSys: Other: Advisory Board; Unum: Research Funding; Curis: Other: Advisory Board, Research Funding; Genentech: Other: Advisory Board, Research Funding; Celgene: Other: Advisory Board, Research Funding; Kite: Other: Advisory Board, Research Funding; Janssen: Other: Advisory Board, Research Funding. Fowler:Celgene: Membership on an entity's Board of Directors or advisory committees, Research Funding; Roche: Membership on an entity's Board of Directors or advisory committees, Research Funding; Janssen: Membership on an entity's Board of Directors or advisory committees, Research Funding; Abbvie: Membership on an entity's Board of Directors or advisory committees, Research Funding; TG Therapeutics: Membership on an entity's Board of Directors or advisory committees, Research Funding. Lee:Seattle Genetics, Inc.: Research Funding. Parmar:Cellenkos Inc.: Equity Ownership, Membership on an entity's Board of Directors or advisory committees, Research Funding. Wang:Guidepoint Global: Consultancy; BioInvent: Consultancy, Research Funding; Janssen: Consultancy, Honoraria, Research Funding, Speakers Bureau; Pharmacyclics: Honoraria, Research Funding; AstraZeneca: Consultancy, Honoraria, Research Funding, Speakers Bureau; MoreHealth: Consultancy, Equity Ownership; Acerta Pharma: Consultancy, Research Funding; Kite Pharma: Consultancy, Research Funding; VelosBio: Research Funding; Loxo Oncology: Research Funding; Celgene: Honoraria, Research Funding; Juno Therapeutics: Research Funding; Aviara: Research Funding; Dava Oncology: Honoraria. Pinnix:Merck: Research Funding. Hawkins:Novartis Pharmaceuticals: Other: advisory panels. Neelapu:Precision Biosciences: Consultancy; Novartis: Consultancy; Allogene: Consultancy; Incyte: Consultancy; BMS: Research Funding; Cellectis: Research Funding; Poseida: Research Funding; Karus: Research Funding; Acerta: Research Funding; Celgene: Consultancy, Research Funding; Kite, a Gilead Company: Consultancy, Research Funding; Merck: Consultancy, Research Funding; Cell Medica: Consultancy; Unum Therapeutics: Consultancy, Research Funding; Pfizer: Consultancy. Chi:Kite, A Gilead Company: Consultancy, Honoraria, Other: Kite Patient Management Advisory Board.
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KHAN, FARRUKH HAYAT, and KHALID HAYAT KHAN. "ELECTRO CONVULSIVE THERAPY." Professional Medical Journal 13, no. 04 (December 16, 2006): 481–87. http://dx.doi.org/10.29309/tpmj/2006.13.04.4908.
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Objective: To compare the efficacy of ECT with those of pharmacologicaltreatment modalities, and to bring to light the continuing usefulness of ECT despite the availability of a number of newerand better medicines. Design: A prospective comparative study. Setting: Department of psychiatry, Combined MilitaryHospital Pano Aqil Cantt Period From Jan 2003 to March 2004. Subjects and Methods: Patients suffering from MajorDepression, Mania, Puerperal Psychosis, and Schizophrenia, were included in the study. Two groups were made. I.e.patients treated with medicines only (group I), and patients treated with ECT alone as first line therapy(Group II). Eachgroup comprised 50 patients. Patients belong to two groups were matched closely regarding their age, sex durationor illness, clinical picture and previous treatment etc. Response to treatment was judged with the help of HDRS in caseof depressed patients and clinically only in rest of the patients. Results of the treatment were recorded and comparisonmade for two groups. SPSS was utilized to obtain statistical significance. Results: ECT proved to be a superiortreatment in the achievement of quick remission, especially in those depressed patients with acute onset, psychomotorretardation, psychotic features, and severe disabling anxiety associated with primary illness. Very excited manicpatients quickly responded to ECT and calmed down. Catatonic Schizophrenics showed dramatic response, and sodid patients with puerperal Psychosis, in achieving early remission. Conclusion: In-spite of misinformation by media,and misconceptions in the minds of lay people, as well as, those related to medical profession, ECT remains a veryeffective and safe treatment even today. It should be used without hesitation wherever indicated. Limitations of presentstudy need improvement in future studies, in order to achieve more scientifically oriented results.
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Smith, Zachariah Z., Alexander M. Benison, Florencia M. Bercum, F. Edward Dudek, and Daniel S. Barth. "Progression of convulsive and nonconvulsive seizures during epileptogenesis after pilocarpine-induced status epilepticus." Journal of Neurophysiology 119, no. 5 (May 1, 2018): 1818–35. http://dx.doi.org/10.1152/jn.00721.2017.
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Although convulsive seizures occurring during pilocarpine-induced epileptogenesis have received considerable attention, nonconvulsive seizures have not been closely examined, even though they may reflect the earliest signs of epileptogenesis and potentially guide research on antiepileptogenic interventions. The definition of nonconvulsive seizures based on brain electrical activity alone has been controversial. Here we define and quantify electrographic properties of convulsive and nonconvulsive seizures in the context of the acquired epileptogenesis that occurs after pilocarpine-induced status epilepticus (SE). Lithium-pilocarpine was used to induce the prolonged repetitive seizures characteristic of SE; when SE was terminated with paraldehyde, seizures returned during the 2-day period after pilocarpine treatment. A distinct latent period ranging from several days to >2 wk was then measured with continuous, long-term video-EEG. Nonconvulsive seizures dominated the onset of epileptogenesis and consistently preceded the first convulsive seizures but were still present later. Convulsive and nonconvulsive seizures had similar durations. Postictal depression (background suppression of the EEG) lasted for >100 s after both convulsive and nonconvulsive seizures. Principal component analysis was used to quantify the spectral evolution of electrical activity that characterized both types of spontaneous recurrent seizures. These studies demonstrate that spontaneous nonconvulsive seizures have electrographic properties similar to convulsive seizures and confirm that nonconvulsive seizures link the latent period and the onset of convulsive seizures during post-SE epileptogenesis in an animal model. Nonconvulsive seizures may also reflect the earliest signs of epileptogenesis in human acquired epilepsy, when intervention could be most effective. NEW & NOTEWORTHY Nonconvulsive seizures usually represent the first bona fide seizure following a latent period, dominate the early stages of epileptogenesis, and change in severity in a manner consistent with the progressive nature of epileptogenesis. This analysis demonstrates that nonconvulsive and convulsive seizures have different behavioral outcomes but similar electrographic signatures. Alternatively, epileptiform spike-wave discharges fail to recapitulate several key seizure features and represent a category of electrical activity separate from nonconvulsive seizures in this model.
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Eta, Enow V. A., and Aymle N. N. Gaelle. "Knowledge, Attitudes and Practices of Parents Regarding Convulsion in Children Under Five Years in Muea Community, Cameroon." Pediatrics and Neonatal Nursing – Open Journal 7, no. 1 (December 31, 2021): 13–20. http://dx.doi.org/10.17140/pnnoj-7-133.
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Background Convulsion is an event that can emotionally traumatise most parents. Inadequate knowledge regarding convulsion can cause parental anxiety. Aim This research sought to investigate the knowledge, attitudes, concerns and practices of parents regarding convulsion in children under five-years. Methods The study employed a community based cross-sectional survey design. Purposive, convenient and snowball samplings were used to select the study site and enroll participants to the study. The study was conducted in Muea Community, Buea Health District in Fako Division, South West Region of Cameroon. The study participants were made up of parents of children under 5-years of age and who had witnessed convulsion in a child. Respondents who met the inclusion criteria and gave their consent to participate in the study were selected. Data was collected using a semi-structured questionnaire made up of both open and closed-ended questions. Data was collected on the knowledge, attitudes, concerns and practices of parents regarding convulsions in children. Data collected was entered using a pre-designed EpiData version 3.1 and data from open-ended questions were analysed using systematic process of thematic analysis. Results A total of 100 respondents participated in the study. The study revealed that more than half of the respondents 53.7% had good knowledge on convulsion, 61.9% of the respondents had positive attitudes towards convulsion and 51.4% of parents had good practices regarding convulsion. This study also revealed that knowledge of convulsion had an association (p=0.05) with gender and marital status but was not dependent (p>0.05) on age and level of school attained. Conclusion The study concluded that even though more than half of the respondents were knowledgeable on convulsion, there is still need for proper parental education as inappropriate attitudes and practices like putting the child’s head in the toilet pit, which can lead to complications are still being practiced.
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Park, Kyung-Soon, Jae-Young Moon, Chang-Seon Oh, and Taek-Rim Yoon. "Acetabular Central Fracture Dislocation after Generalized Seizure during Lumbar Myelography with Iohexol." Case Reports in Orthopedics 2013 (2013): 1–3. http://dx.doi.org/10.1155/2013/190917.
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Fracture is a less common complication in seizure patients, and fractures as a consequence of convulsive seizures without direct trauma occur in 0.3% of cases. Acetabular fractures after convulsions are even more rare, and only a few cases of acetabular fracture dislocations, purely caused by convulsive activity, have been reported. Therefore, we report a case of unilateral acetabular central fracture dislocation after a seizure episode, with relevant literature review. The seizure attack occurred after contrast media (Iohexol) injection for checking the myelography.
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Edwards, Amy, Kevin Percival, Louisa Zouita, Jan Arevalo, and John Philip O'Dwyer. "ANALYSIS OF CONVULSIVE SEIZURES AT A DGH EMERGENCY DEPARTMENT." Journal of Neurology, Neurosurgery & Psychiatry 86, no. 11 (October 14, 2015): e4.129-e4. http://dx.doi.org/10.1136/jnnp-2015-312379.4.
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IntroductionSeizures represent 3% of all emergency department attendances.MethodsA list of all possible seizure mimics was generated from ED computerized triage systems from 1/1/12 to 31/12/13. Data was extracted manually from review of ED notes and analyzed.Results905 seizure attendances by 636 patients were examined over 2 years. 340 men and 296 women accounted for them, with average age 33±28 years. 245 patients had a history of epilepsy and were taking at least one AED. >2 AEDs were used by 32 patients. 22 had known Non-Epileptic Attacks (NEAD). Convulsive seizures occurred in 429 and Status Epilepticus in 13. The mode for the number of convulsive events in ED was 2 for NEAD patients and 1 for others. Lactate and neutrophils in NEAD were 1.3±0.3 mM and 4.4±1.2×10^9/L respectively. In other patients with convulsive seizures, they were 3.2 ±3.2 mM (median 2.1) and 6.6±3.1×10^9/L (median 6.1). 73 had neuroimaging acutely. Few patients with NEAD were admitted. 1/3 of convulsive seizures were admitted.ConclusionThis retrospective service audit indicates the burden of epilepsy attendance in a busy hospital. There is a potential role for more acute neurology input to prevent unnecessary admissions, and a pathway for non-epileptic attack sufferers.
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Baklushinskiy, Ivan D. "K. M. Tanashev. Paradoxical movements of the upper eyelid with paralysis of the oculomotor nerve (PseudoGraefe symptom).Proceedings and duct. Imp. Kavk. total April-October 1910." Neurology Bulletin XVIII, no. 1 (July 6, 2021): 201. http://dx.doi.org/10.17816/nb70851.
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The symptom of Graefe is that the eyelid drops unsatisfactorily when the gaze is lowered, sometimes even a convulsive, continuing moment is observed, an upward movement, when raising the gaze, it rises with exaggerated vigor.
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Obese, Ernest, Elvis Ofori Ameyaw, Robert Peter Biney, Emmanuel Awintiig Adakudugu, and Eric Woode. "Neuropharmacological Assessment of the Hydroethanolic Leaf Extract of Calotropis procera (Ait). R. Br. (Apocynaceae) in Mice." Scientifica 2021 (July 1, 2021): 1–10. http://dx.doi.org/10.1155/2021/5551380.
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Background. Calotropis procera has been widely used traditionally for its analgesic and anti-inflammatory effects. It is also reportedly used in ethnomedicine for mental health disorders including epilepsy even in the absence of supporting scientific data. Thus, the potential of the plant to affect neurological functions was evaluated. Methods. Irwin’s test was performed to determine the effect of the oral administration of the extract (30–3000 mg kg−1) on gross behaviour and physiological function. The activity meter, rotarod, pentylenetetrazol- (PTZ-) induced convulsion, pentobarbitone-induced sleep test, and the tail immersion tests were used to evaluate the spontaneous activity, neuromuscular function, convulsive threshold, sedation, and analgesic effects of the Calotropis procera extract (30–1000 mg/kg), respectively, in mice. Results. Calotropis procera extract (CPE) exhibited significant ( p < 0.0001 ) anticonvulsant and analgesic effects. There was a significant increase in withdrawal latency of the CPE-treated animals in the tail immersion test for analgesia ( p < 0.0001 ), while latency and duration of PTZ-induced convulsions were positively modulated. Calotropis procera extract showed significant ( p < 0.0001 ) central nervous system depressant effects in pentobarbitone-induced hypnosis at 100–1000 mg/kg and spontaneous activity test (30–1000 mg/kg). The extract also depicted impaired motor coordination at 100–1000 mg/kg dose levels. LD50 was estimated to be above 1000 mg kg−1. Conclusions. Calotropis procera extract has significant central nervous system depressant and analgesic effects in mice.
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Eiamcharoenwit, Jatuporn, Phuping Akavipat, Thidarat Ariyanuchitkul, Nichawan Wirachpisit, Aksorn Pulnitiporn, and Orawan Pongraweewan. "Perioperative anaesthetic adverse events in Thailand (PAAd THAI) study: Incident report of perioperative convulsion." Journal of Perioperative Practice 28, no. 6 (April 10, 2018): 152–58. http://dx.doi.org/10.1177/1750458918767591.
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The aim of this study was to identify the characteristics of perioperative convulsion and to suggest possible correcting strategies. The multi-centre study was conducted prospectively in 22 hospitals across Thailand in 2015. The occurrences of perioperative adverse events were collected. The data was collated by site manager and forwarded to the data management unit. All perioperative convulsion incidences were enrolled and analysed. The consensus was documented for the relevant factors and the corrective strategies. Descriptive statistics were used. From 2,000 incident reports, perioperative convulsions were found in 16 patients. Six episodes (37.5%) were related to anaesthesia, 31.3% to patients, 18.8% to surgery, and 12.5% to systemic processes. The contributing factor was an inexperienced anaesthesia performer (25%), while the corrective strategy was improvements to supervision (43.8%). Incidents of perioperative convulsion were found to be higher than during the last decade. The initiation and maintenance of safe anaesthesia should be continued.
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Parikh, Radhika, Romil Parikh, Smit Patel, Ninad Desai, Tapan Mehta, and Renee Stapleton. "Respiratory complications and 30-day unplanned hospital readmissions in patients with epilepsy." Neurology: Clinical Practice 9, no. 5 (May 24, 2019): 408–16. http://dx.doi.org/10.1212/cpj.0000000000000672.
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BackgroundTo help mitigate the burden of health care on US economy, public policymakers and health care legislation have been focusing on reducing hospital readmissions. Respiratory complications have been identified among the commonest of adverse events in neurologic patients. The goal of our study was to better understand respiratory complications and their contribution to rehospitalizations in patients with seizures.MethodsWe used the 2013 Nationwide Readmission Database to analyze unplanned 30-day readmission rate (30RR). The study population comprised of patients with index hospital discharge diagnosis of generalized convulsive epilepsy and status epilepticus. Patients under 18 years of age, who died during hospitalization or who had missing demographic data, were excluded. Patients hospitalized in December were also excluded due to lack of 30-day follow-up. The primary outcome of interest was 30-day readmission. The causes of readmission were determined by corresponding International Classification of Diseases, Ninth Revision, Clinical Modification codes.ResultsThe 30RR was highest in patients with index hospitalization discharge diagnosis of status epilepticus, followed by generalized convulsive epilepsy (intractable), followed by generalized convulsive epilepsy (nonintractable). While seizure was the most common reason for readmission, contribution of respiratory complications to readmissions was 7.85%, 12.39%, and 6.93%, respectively. Pneumonia/aspiration pneumonitis and respiratory insufficiency accounted for the majority of the readmissions in all subgroups.ConclusionsRespiratory complications are the leading nonseizure cause of 30-day unplanned readmissions in patients with generalized convulsive epilepsy and status epilepticus. Further research on identifying appropriate interventions to reduce readmissions from respiratory causes may improve outcomes for patients in these epilepsy subgroups.
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Scorza, Fulvio Alexandre, Marly de Albuquerque, Ricardo Mario Arida, Roberta Monterazzo Cysneiros, Tânia Maria Guedes Henriques, Carla Alessandra Scorza, Jener Cruz, Silvana Kesrouani, Rui Alberto Gomes, and Esper Abrão Cavalheiro. "Seizure occurrence in patients with chronic renal insufficiency in regular hemodialysis program." Arquivos de Neuro-Psiquiatria 63, no. 3b (September 2005): 757–60. http://dx.doi.org/10.1590/s0004-282x2005000500007.
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Hemodialysis-associated seizure is a complication of hemodialysis. This report describes the occurrence of seizures in patients with end stage renal disease on dialysis therapy at the Nephrology Institute of Mogi das Cruzes, São Paulo State, Brazil. A retrospective medical history of 189 patients was reviewed to investigate the occurrence of convulsive seizures during dialytic program. Seven patients with history of seizures were selected but five of them were included in our study. Three patients presented generalized tonic-clonic seizures, one had partial seizure with secondary generalization, and one presented unclassified seizure. Three patients presented seizure just during the dialysis (unique seizure) and one of them presented convulsive status epilepticus. The two other patients had already presented seizures prior the beginning of dialysis. We conclude that seizures in renal failure could be considered as occasional events that do not usually become chronic.
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Shah, Himanshu, and Rajiv Daveshwar. "Bilateral Posterior Fracture Dislocation of Shoulder." Nepal Orthopaedic Association Journal 3, no. 1 (December 14, 2013): 31–34. http://dx.doi.org/10.3126/noaj.v3i1.9324.
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Posterior dislocation of shoulder is relatively uncommon entity. Posterior fracture dislocation of shoulder is even rare and bilateral posterior fracture dislocation of shoulder is even rarest entity. We present a case of 45 years of adult male having bilateral posterior fracture dislocation of shoulder following convulsive seizure and treated with open reduction and internal fixation with satisfactory functional outcome. DOI: http://dx.doi.org/10.3126/noaj.v3i1.9324 Nepal Orthopedic Association Journal 2013 Vol.3(1): 31-34
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Nacharova, E. P., S. M. Kharit, and A. A. Ruleva. "Convulsive syndrome in the post-vaccination period: is there a connection with the vaccine?" Journal Infectology 12, no. 5 (January 21, 2021): 15–20. http://dx.doi.org/10.22625/2072-6732-2020-12-5-15-20.
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The article describes the characteristics and classification of adverse events after immunization (AEFI) according to the latest WHO recommendations. The registration systems for AEFI in the USA and in Russia are described. Particular attention is paid to the interpretation of the convulsive syndrome that developed after vaccination. Four clinical cases of the development of convulsive syndrome in children hospitalized at the Pediatric Research and Clinical Center for Infectious Diseases of Russia (St. Petersburg) in the postvaccination period are presented. The criteria for differential diagnosis of the described diseases are indicated. Only a search for the etiology of the disease allows us to assess the relationship with vaccination, timely conduct adequate therapy and generate objective information on the safety of vaccines. There is a need to register all episodes of seizures after vaccination and introduce new methods for registering PPI, as well as creating a system of statistical accounting of background health conditions (convulsions, allergies) of the population of the Russian Federation of various age groups.
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Persinger, M. A. "Geophysical Variables and Behavior: XXII. The Tectonogenic Strain Continuum of Unusual Events." Perceptual and Motor Skills 60, no. 1 (February 1985): 59–65. http://dx.doi.org/10.2466/pms.1985.60.1.59.
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Transient and very localized geophysical forces are hypothesized to be a major source of phenomena that have been traditionally labelled as haunts and poltergeists. They would be generated by increasing tectonic stresses and would display electromagnetic and gravitational characteristics. Materials would be influenced according to their physical properties. Dielectric materials would respond differently from conductors. Organic semiconductors, of which the human being is an important subcategory, would be affected as well. The conspicuous overlaps between (non-convulsive) complex partial epilepsy and many episodes of poltergeists and haunts are expected in light of the direct stimulation of the observer's brain by the transient, intense magnetic fields and the lability of temporal lobe structures. Implications and some general predictions for the distribution of these phenomena in time and space are discussed.
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Chen, Yu-Shiue, Tsang-Shan Chen, and Chin-Wei Huang. "Dementia with non-convulsive seizures: a case report." Journal of International Medical Research 49, no. 12 (December 2021): 030006052110624. http://dx.doi.org/10.1177/03000605211062453.
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Non-convulsive seizures (NCSs) are highly treatable, but appropriate management is usually delayed because of inaccurate diagnoses as a result of variable clinical presentations, including an altered mental state. It is difficult to detect NCSs in patients with dementia. We report a case of NCS superimposed on cognitive decline caused by Alzheimer’s dementia. The patient’s history was carefully recorded. An electroencephalogram was recorded with sphenoidal electrodes, which showed epileptiform discharges in the right mesial temporal lobe and focal, sharply contoured, slow wave activity in the left fronto-temporal area, suggesting an epileptic origin contributing to the patient’s cognitive decline. After treatment with antiepileptic drugs, the patient’s cognitive functioning gradually improved. An accurate diagnosis of NCS relies on performing a detailed inventory of a patient’s history, thorough physical and neurological examinations, and electroencephalogram recordings. In patients with cognitive decline, testing for NCS should always be included in the differential diagnosis of cognitive impairment, even in the case of dementia. Early administration of antiepileptic drug therapy is the mainstay treatment for reversing the condition and for preventing prolonged insults from neurological sequelae.
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Morrison, Luke. "Feasibility of phenytoin as a paramedic-led second-line anti-epileptic drug." Journal of Paramedic Practice 12, no. 9 (September 2, 2020): 349–53. http://dx.doi.org/10.12968/jpar.2020.12.9.349.
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Background: Convulsive status epilepticus (CSE) is a medical emergency that is commonly encountered in the prehospital setting. In almost all prehospital settings, treatment is limited to benzodiazepines even though the standard of care in emergency departments includes second-line agents such as phenytoin. Methods: A literature search was conducted using PubMed and Google Scholar using the search terms ‘phenytoin’, ‘seizure’ or ‘convulsive’ and ‘prehospital’, ‘EMS’ or ‘ambulance’ or ‘emergency department’. Five articles were analysed and a narrative review formed. Results: Phenytoin is an effective and commonly used second-line anti-epileptic agent but there is a distinct lack of evidence on prehospital phenytoin. Phasing the introduction of phenytoin into practice while simultaneously running a well-designed research trial could provide data for prehospital providers and the wider health community. Conclusion: Management of CSE will continue to present challenges to prehospital providers. Promoting the introduction of phenytoin to select patients, administered by advanced clinicians, could be an excellent opportunity to generate much-needed clinical data and potentially reduce morbidity and mortality in CSE.
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Ulukhanova, L. U., M. M. Yaraliev, and S. M. Attaeva. "Limbic autoimmune encephalitis with antibodies to glutamate decarboxylase (GAD)." CHILDREN INFECTIONS 19, no. 2 (June 30, 2020): 67–71. http://dx.doi.org/10.22627/2072-8107-2020-19-2-67-71.
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Limbic encephalitis (LE) is a rare neurological syndrome, in most cases has a paraneoplastic nature, but recently there has been a large number of observations of idiopathic autoimmune LE associated with antibodies to neuronal membrane proteins. A clinical case of a disease in a 13-year-old patient with the detection of antibodies to glutamate decarboxylase (GAD) is described. The debut of the disease is marked by a decrease in memory for current events after the first convulsive attack during 2 months.
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Cruickshank, Moira, Mari Imamura, Corinne Booth, Lorna Aucott, Carl Counsell, Paul Manson, Graham Scotland, and Miriam Brazzelli. "Pre-hospital and emergency department treatment of convulsive status epilepticus in adults: an evidence synthesis." Health Technology Assessment 26, no. 20 (March 2022): 1–76. http://dx.doi.org/10.3310/rsvk2062.
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Background Convulsive status epilepticus is defined as ≥ 5 minutes of either continuous seizure activity or repetitive seizures without regaining consciousness. It is regarded as an emergency condition that requires prompt treatment to avoid hospitalisation and to reduce morbidity and mortality. Rapid pre-hospital first-line treatment of convulsive status epilepticus is currently benzodiazepines, administered either by trained caregivers in the community (e.g. buccal midazolam, rectal diazepam) or by trained health professionals via intramuscular or intravenous routes (e.g. midazolam, lorazepam). There is a lack of clarity about the optimal treatment for convulsive status epilepticus in the pre-hospital setting. Objectives To assess the current evidence on the clinical effectiveness and cost-effectiveness of treatments for adults with convulsive status epilepticus in the pre-hospital setting. Data sources We searched major electronic databases, including MEDLINE, EMBASE, PsycInfo®, CINAHL, CENTRAL, NHS Economic Evaluation Database, Health Technology Assessment Database, Research Papers in Economics, and the ISPOR Scientific Presentations Database, with no restrictions on publication date or language of publication. Final searches were carried out on 21 July 2020. Review methods Systematic review of randomised controlled trials assessing adults with convulsive status epilepticus who received treatment before or on arrival at the emergency department. Eligible treatments were any antiepileptic drugs offered as first-line treatments, regardless of their route of administration. Primary outcomes were seizure cessation, seizure recurrence and adverse events. Two reviewers independently screened all citations identified by the search strategy, retrieved full-text articles, extracted data and assessed the risk of bias of the included trials. Results were described narratively. Results Four trials (1345 randomised participants, of whom 1234 were adults) assessed the intravenous or intramuscular use of benzodiazepines or other antiepileptic drugs for the pre-hospital treatment of convulsive status epilepticus in adults. Three trials at a low risk of bias showed that benzodiazepines were effective in stopping seizures. In particular, intramuscular midazolam was non-inferior to intravenous lorazepam. The addition of levetiracetam to clonazepam did not show clear advantages over clonazepam alone. One trial at a high risk of bias showed that phenobarbital plus optional phenytoin was more effective in terminating seizures than diazepam plus phenytoin. The median time to seizure cessation from drug administration varied from 1.6 minutes to 15 minutes. The proportion of people with recurrence of seizures ranged from 10.4% to 19.1% in two trials reporting this outcome. Across trials, the rates of respiratory depression among participants receiving active treatments were generally low (from 6.4% to 10.6%). The mortality rate ranged from 2% to 7.6% in active treatment groups and from 6.2% to 15.5% in control groups. Only one study based on retrospective observational data met the criteria for economic evaluation; therefore, it was not possible to draw any robust conclusions on cost-effectiveness. Limitations The limited number of identified trials and their differences in terms of treatment comparisons and outcomes hindered any meaningful pooling of data. None of the included trials was conducted in the UK and none assessed the use of buccal midazolam or rectal diazepam. The review of economic evaluations was hampered by lack of suitable data. Conclusions Both intravenous lorazepam and intravenous diazepam administered by paramedics are more effective than a placebo in the treatments of adults with convulsive status epilepticus, and intramuscular midazolam is non-inferior to intravenous lorazepam. Large well-designed clinical trials are needed to establish which benzodiazepines are more effective and preferable in the pre-hospital setting. Study registration This study is registered as PROSPERO CRD42020201953. Funding This project was funded by the National Institute for Health Research (NIHR) Evidence Synthesis programme and will be published in full in Health Technology Assessment; Vol. 26, No. 20. See the NIHR Journals Library website for further project information.
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Sørensen, Caspar Godthaab, William Kristian Karlsson, Faisal Mohammad Amin, and Mette Lindelof. "Convulsive Seizures as Presenting Symptom of Metronidazole-Induced Encephalopathy: A Case Report." Case Reports in Neurology 10, no. 1 (February 1, 2018): 34–37. http://dx.doi.org/10.1159/000485915.
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Introduction: Encephalopathy and convulsive seizures are rare manifestations of metronidazole toxicity. The incidence is unknown, but the condition has most frequently been reported in patients in their fifth to sixth decades. Usually, this condition is regarded as reversible, but permanent deficits and even death have been reported. Case Report: A 66-year-old female patient undergoing metronidazole treatment for pleural empyema was admitted to our institution after her second episode of seizure. Over the course of 1 week after admittance, the patient developed several convulsive seizures along with progressive cerebellar dysfunction and cognitive impairment. MRI revealed bilateral, symmetrical hyperintense signal changes in the pons and dentate nuclei. EEG, ECG, lumbar puncture, and blood samples were normal. The patient improved already 2–3 days after discontinuation of metronidazole and was discharged fully recovered after 17 days. Follow-up clinical assessment and MRI were unremarkable. Conclusion: Metronidazole-induced encephalopathy is a rare condition, and due to a general lack of awareness the diagnosis is often delayed. This condition should be considered in metronidazole-treated patients presenting with unprovoked seizures, myoclonus, cerebellar signs, and encephalopathy. Characteristic MRI lesions may support the clinical suspicion.
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Sparic, Radmila, Ivana Berisavac, Ljubica Arsenijevic, Milica Berisavac, Milan Dokic, Olivera Savic, Tatjana Ilic-Mostic, and Sasa Kadija. "Acute intermittent porphyria in the puerperium." Srpski arhiv za celokupno lekarstvo 138, no. 7-8 (2010): 506–9. http://dx.doi.org/10.2298/sarh1008506s.
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Introduction. Acute intermittent porphyria emerges as a result of partial defect of porphobilinogen deaminase and is manifested by repeated episodes of somatic, psychiatric and neurological disorders. The disease is conducted via the autosomaldominant gene of variable penetration, so most of the carriers never experience seizures. Timely making of diagnosis, screening of blood relatives of the patient and education of patients on avoidance of provoking factors are the key to adequate treatment. Case Outline. A 23-year-old patient having born the third child was hospitalized due to pains in the abdomen and convulsive seizures nine days after the vaginal delivery. At admittance, she suffered a generalized convulsive seizure of clonic-tonic type. The patient immediately underwent a complete clinical, laboratory, bacteriological and ultrasound examination. Bearing in mind the fact that the patient had several convulsive seizures even after the given neurological therapy, haem-arginate was introduced into therapy during four days. The administration of haem-arginate led to the normalization of blood pressure, pulse and bowel function. The administration of haem-arginate led to the normalization of blood pressure, pulse and bowel function. The patient was treated by a team of doctors, in the intensive care ward, with the use of medicaments, which are allowed in the case of acute porphyria. Sixteen days after the admittance, with clean neurological status and gynaecological and ultra-sound findings, she was released for ambulatory treatment. Conclusion. The presented case exhibits the gravity of making a diagnosis of acute intermittent porphyria in puerperium and the necessity of multi-disciplinary approach in treating this disease. Acute intermittent porphyria should be considered in cases of ambiguous abdominal pain, as well as in patients having abdominal pains followed by neuro-psychiatric disorders.
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Kalita, Jayantee, Mahesh S. Jadhav, Varun K. Singh, and Usha K. Misra. "Prolonged coma in scrub typhus: consider non-convulsive status epilepticus." Transactions of The Royal Society of Tropical Medicine and Hygiene 115, no. 9 (January 30, 2021): 1091–93. http://dx.doi.org/10.1093/trstmh/trab007.
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Abstract Background Scrub typhus is prevalent in the Tsutsugamushi belt and may manifest with meningoencephalitis and seizures. We report a patient with scrub typhus who had non-convulsive status epilepticus (NCSE). Methods A 50-y-old female with fever and altered sensorium for 5 d was diagnosed as scrub typhus based on serum IgM ELISA. She was on mechanical ventilation and received doxycycline and ceftriaxone, but did not improve until the third day of admission. Results An EEG revealed >2.5 Hz generalised epileptiform discharges, which were suppressed by intravenous lorazepam suggesting NCSE. Following valproate and levetiracetam, she became conscious and had a full recovery. Conclusion A scrub typhus patient recovers even after prolonged NCSE.
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Ivanova, A. V., and N. M. Stunzhas. "Functional state of rat brain mitochondria at hypoglycemia convulsive syndrome and different ways of its arresting." Biomeditsinskaya Khimiya 56, no. 5 (2010): 570–75. http://dx.doi.org/10.18097/pbmc20105605570.
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Respiratory and phosphorylation functions of rat brain mitochondria was studied under conditions insulin shock and after its treatment with glucose or glutamate (in combination with inhalation of hypercapnic gas mixture - air enriched with 7% СО2). Certain differences in the effects of the applied agents were found. Phosphorylation ability of mitochondria did not reach the normal level even one day after both ways of convulsive state treatment. Some respiratory parameters suggest that unfavorable changes in the respiratory chain functioning mainly occur at the respiratory chain complex I.
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Sonkusare, Kishore, and Hanmant Barkate. "Lacosamide as monotherapy in focal seizure: Literature review." International Journal of Epilepsy 04, no. 01 (June 2017): 055–58. http://dx.doi.org/10.1016/j.ijep.2016.12.006.
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AbstractLacosamide is a newer approved antiepileptic drug (AED) characterized by its novel pharmacodynamic profile. It is now approved by United States Food and Drug Administration for use as monotherapy in adults (aged>17 years) with focal seizures based on historical controlled trial by Wechsler RT et al in 2014. Randomized controlled trials on lacosamide monotherapy have demonstrated significant reduction in median seizure frequency. In addition, 50% responder rates for lacosamide was noted in half of the patients, with retention rate in two third of patients in 1 year follow up period. Adverse events reported in clinical trials were mostly mild to moderate in intensity. The most common adverse events were dizziness, headache, convulsion, nausea and fatigue while convulsion and dizziness were commonly responsible for drug discontinuation. Overall, lacosamide monotherapy can be a good treatment option in patients with focal seizure.
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Machado R, Carlos Alfonso, Leidy Samara Pinilla Q, Héctor Andrés Castañeda C., Laura Yasmín Ramírez R., Xueyi Chen, Claudia Juliana Patiño O., Silvia Camila Amaya A., and Andrea Paola Ortega G. "Hemoptisis en el espectro del edema pulmonar neurogénico." Revista Colombiana de Neumología 29, no. 1 (August 1, 2017): 50. http://dx.doi.org/10.30789/rcneumologia.v29.n1.2017.238.
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El edema pulmonar neurogénico es un diagnóstico de exclusión, cuya frecuencia de presentación no ha sido establecida, dada la falta de criterios diagnósticos bien validados que permitan realizar un abordaje inicial temprano en el paciente con un evento y/o insulto en el sistema nervioso central. Los dos principales mecanismos fisiopatológicos están dados por: aumento de la permeabilidad capilar y en la vasoconstricción pulmonar y sistémica que permiten la expresión radiológica de patrón de ocupación alveolar difusa con un sin número de diagnósticos diferenciales según el escenario clínico. Dado que el estatus convulsivo ha sido catalogado como la principal causa de edema pulmonar neurogénico; ante la presencia probable de estatus convulsivo inicial con hallazgos inespecíficos de edema pulmonar de etiología no cardiogénico y hemoptisis se expone un caso inusual de edema pulmonar neurogénico con resolución clínica y radiológica al cabo de 48 horas del cese completo de las crisis parciales, siendo esta última medida el principal objetivo de tratamiento en el paciente con dicha condición.
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Das, Dhananjoy, Kawsar Sultana, Golam Mohammed Tayeb Ali, Tanuka Barua, and Mahmood A. Chowdhury Arzu. "Rapid Neurodevelopmental Assessment (RNDA) : An Important Tool for Assessment of Psychomotor Development in Children with Perinatal Events." Chattagram Maa-O-Shishu Hospital Medical College Journal 20, no. 1 (May 25, 2021): 16–21. http://dx.doi.org/10.3329/cmoshmcj.v20i1.53581.
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Background: Infants with various perinatal events are at risks for long term neurodevelopmental impairments. Neurodevelopmental assessment at early life has been considered as a valuable tool for prediction of neurodevelopmental outcomes in this population. This present study aimed to identify the neurodevelopmental impairments in high risk children by Rapid Neurodevelopment Assessment (RNDA)
Materials and methods : This was a cross sectional study conducted in the Autism and Child Development Centre of Chattogram Maa Shishu-O-General Hospital during the period of 0ctober to December 2018. Babies aged 0 -2 years with different perinatal events like prematurity, birth asphyxia, neonatal jaundice, and without any adverse event; that attended RNDA clinic underwent Rapid Neurodevelopmental Assessment (RNDA) to find at risk children for long term neurodevelopmental impairments.
Results: Among the 50 study subjects,Perinatal asphyxia was found in 41(82%). 26(52%) had history of IUGR, 22(44%) had Preterm delivery and 25(50%) had history of Neonatal convulsion. History of neonatal jaundice was found in 14(28%) cases. 5(10%) children did not have any perinatal event. The Mean ± SD age of study subjects was 7.38±7.31month. Severe impairment in gross motor and fine motor function were found in 25(50%) and 24(48%) respondents respectively. Vision was severely impaired in 10(20%) cases. Severe cognition and behavior impairment were found in 8(16%) and 3(6%) cases accordingly. Severe hearing and speech impairment were found in 2(4%) & 10(20%) cases respectively. Severe seizure was found in 19(39%) cases. Study subjects with the history of delayed cry or Perinatal asphyxia had significantly decreased fine motor skills. Children born with IUGR had significant gross motor and fine motor skill impairment. Significant speech & cognitive impairment were observed in children with neonatal jaundice. Seizure was found significant in study subjects with a history of neonatal convulsion.
Conclusion: Rapid Neurodevelopment Assessment (RNDA) plays an important role for early identification of neurodevelopmental impairments of high-risk infants and thus screening for these can promote early therapeutic intervention and subsequent follow up, leading to better outcome.
Chatt Maa Shi Hosp Med Coll J; Vol.20 (1); January 2021; Page 16-21
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Vychopen, Martin, Tim Lampmann, Harun Asoglu, Agi Güresir, Hartmut Vatter, Johannes Wach, and Erdem Güresir. "Non-Convulsive Status Epilepticus in Aneurysmal Subarachnoid Hemorrhage: A Prognostic Parameter." Brain Sciences 13, no. 2 (January 22, 2023): 184. http://dx.doi.org/10.3390/brainsci13020184.
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A non-convulsive status epilepticus (ncSE) is a potentially fatal complication for patients in neurointensive care. In patients with aneurysmal subarachnoid hemorrhage (SAH), ncSE remains scarcely investigated. In this study, we aim to investigate the frequency and influence of non-convulsive status epilepticus on outcome in patients with SAH. We retrospectively analyzed data of consecutive patients with aneurysmal subarachnoid hemorrhage and evaluated clinical, radiological, demographical and electroencephalogram (EEG) data. Outcome was assessed according to the modified Rankin Scale (mRS) at 6 months and stratified into favorable (mRS 0-2) vs. unfavorable (mRS 3-6). We identified 171 patients with SAH, who received EEG between 01/2012 and 12/2020. ncSE was diagnosed in 19 patients (3.7%), only one of whom achieved favorable outcome. The multivariate regression analysis revealed four independent predictors of unfavorable outcome: presence of ncSE (p = 0.003; OR 24.1; 95 CI% 2.9–195.3), poor-grade SAH (p < 0.001; OR 14.0; 95 CI% 8.5–23.1), age (p < 0.001; OR 2.8; 95 CI% 1.6–4.6) and the presence of DIND (p < 0.003; OR 1.9; 95 CI% 1.2–3.1) as independent predictors for unfavorable outcome. According to our study, development of ncSE in patients suffering SAH might correlate with poor prognosis. Even when medical treatment is successful and no EEG abnormalities are detected, the long-term outcome remains poor.