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Journal articles on the topic 'Status epilepticu'

Author: Grafiati

Published: 9 March 2023

Last updated: 10 March 2023

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1

Livingston, J. H., J. K. Brown, R. A. Harkness, and G. M. McCreanor. "CEREBROSPINAL FLUID NUCLEOTIDE METABOLITES FOLLOWING NON-CONVULSIVE STATUS EPILEPTICU." Developmental Medicine & Child Neurology 31, no. 2 (November 12, 2008): 168–73. http://dx.doi.org/10.1111/j.1469-8749.1989.tb03975.x.

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2

Di Bonaventura, C., F. Mari, N. Vanacore, J. Fattouch, A. Zarabla, A. Berardelli, M. Manfredi, M. Prencipe, and A. T. Giallonardo. "Status epilepticus in epileptic patients." Seizure 17, no. 6 (September 2008): 535–48. http://dx.doi.org/10.1016/j.seizure.2008.02.002.

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3

Mandei, Jose M., and Praevilia M. Salendu. "Tatalaksana Status Epileptikus Terkini pada Anak." e-CliniC 11, no. 1 (December 20, 2022): 146–56. http://dx.doi.org/10.35790/ecl.v11i1.44460.

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Absract: Status epilepticus is one of the most common pediatric neurologic emergencies in children with progressive benzodiazepine pharmaco-resistance due to neurotransmitter receptor disturbance. This has led to revisions of definitions and guidelines to emphasize early treatment and faster escalation. The initial management of the stabilization phase is followed by the administration of benzodiazepines as the first line. Second-line medications such as valproate, fosphenytoin, or levetiracetam, or phenobarbital are recommended, and at this point there is no clear evidence that one of these options is better than the other. If seizures persist after second-line drugs, refractory status epilepticus may be established. Treatment of refractory status epilepticus consists of bolus doses and continuous infusion titration with third-line drugs. In conclusion, potential therapeutic approaches for future study may require consideration of interventions that may speed the diagnosis and treatment of status epilepticus. Major advances in the clinical field with new definitions and classifications give the clinicians a better guidance on when to treat, how aggressively to treat, and how to avoid over- or under-treating the condition of status epilepticus. Keywords: status epilepticus; management; children Abstrak: Status epileptikus merupakan salah satu kedaruratan neurologis yang paling umum pada anak dengan farmakoresistensi benzodiazepine progresif karena gangguan reseptor neurotransmiter. Hal ini menyebabkan dilakukannya revisi definisi dan pedoman untuk menekankan pengobatan dini dan eskalasi yang lebih cepat. Tatalaksana awal fase stabilisasi dilanjutkan pemberian benzodiazepine sebagai lini pertama. Pengobatan lini kedua seperti valproate, fosphenytoin, atau levetiracetam, atau fenobarbital direkomendasikan, dan pada titik ini tidak ada bukti yang jelas bahwa salah satu dari opsi ini lebih baik daripada yang lain. Jika kejang berlanjut setelah obat lini kedua, status epileptikus refrakter dapat ditegakkan. Pengobatan status epileptikus refrakter terdiri dari dosis bolus dan titrasi infus kontinu dengan obat lini ketiga. Simpulan studi ini ialah pendekatan terapeutik potensial untuk studi masa depan mungkin memerlukan pertimbangan intervensi yang dapat mempercepat diagnosis dan pengobatan status epileptikus. Kemajuan besar dalam bidang klinis dengan definisi dan klasifikasi baru memberikan panduan yang lebih baik kepada dokter tentang kapan harus mengobati, seberapa agresif untuk mengobati, dan bagaimana menghindari pengobatan yang berlebihan atau kurang dari kondisi stastus epileptikus. Kata kunci: status epileptikus; tatalaksana; anak

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4

Poursadeghfard, Maryam, Zabihollah Hashemzehi, and Nahid Ashjazadeh. "Status Epilepticus in Adults: A 6-Year Retrospective Study." Galen Medical Journal 3, no. 3 (May 21, 2014): 153–59. http://dx.doi.org/10.31661/gmj.v3i3.200.

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Background: Status epilepticus (SE) is one of the most common neurological emergencies with high mortality and morbidity. This study aims to determine the most common causes and outcomes of SE in adult patients from Fars Province in southern Iran. Materials and Methods: 134 patients with SE (either convulsive or non-convulsive), admitted to Namazi Hospital, were enrolled from January 2006 to February 2012. We designed a questionnaire to collect the patients' demographics and disease characteristics and their outcomes according to Glasgow Outcome Scale (GOS). Statistical analyses were performed using SPSS software version 15. P-value<0.05 was considered statistically significant. Results: Seventy patients were female and 64 were male with mean age of 42.97±19.66 years and 39.42±18.89 years old, respectively. Sixty-two patients (46.26%) had a history of epilepsy, and 72 patients (53.73%) had no history of epilepsy. Antiepileptic drugs (ADEs) withdrawal and cerebral infarction were the most common causes of SE in epileptics and non-epileptics, respectively. One hundred and twenty-three patients (91.8%) had generalized tonic-clonic SE. Thirty patients (22.4%) could return to work and 33 (24.6%) died during hospitalization. There was a significant relationship between mortality and age over 60 years (P<0.001), and mortality and cerebral infarction or anoxia (P= 0.022). Conclusion: ADEs withdrawal in the epileptic patients was the main cause of SE (28.40% of the total population and 62% of the epileptic patients) that can be prevented by patient and family education. This study showed that high mortality and morbidity were significantly related to the increasing age and etiology of SE.

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5

Gainetdinova, Guzel R., and Tatiana V. Danilova. "Epidemiology, clinic and diagnosis of status epilepticus in adults: A review." Consilium Medicum 24, no. 11 (January 5, 2023): 805–10. http://dx.doi.org/10.26442/20751753.2022.11.201958.

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Status epilepticus is one of the causes of impaired consciousness. Status epilepticus can develop both in patients with epilepsy and in patients without an epileptic history. The most difficult diagnostic task is to identify non-convulsive status epilepticus. The most frequently discussed in the literature issues of the clinical picture, diagnosis of different variants of status epilepticus were analyzed. Particular attention was paid to the peculiarities of status epilepticus in patients of older age groups.

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6

Momcilovic-Kostadinovic, Dragana, Perisa Simonovic, Dusan Kolar, and Nebojsa Jovic. "Chlorpromazine-induced status epilepticus: A case report." Srpski arhiv za celokupno lekarstvo 141, no. 9-10 (2013): 667–70. http://dx.doi.org/10.2298/sarh1310667m.

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Introduction. It is largely known that some antipsychotic agents could have proconvulsive and proepileptogenic effects in some patients and could induce EEG abnormalities as well. However, the association of status epilepticus with certain antipsychotic drugs has been very rarely reported. Case Report. A case of an 18-year-old adolescent girl, with chlorpromazine therapy started for anxiety-phobic disorder was reported. Her personal history disclosed delayed psychomotor development. Shortly after the introduction of the neuroleptic chlorpromazine therapy in minimal daily dose (37.5 mg), she developed myoclonic status epilepticus, confirmed by the EEG records. Frequent, symmetrical bilateral myoclonic jerks and altered behavior were associated with bilateral epileptiform discharges of polyspikes and spike-wave complexes. This epileptic event lasted 3.5 hours and it was stopped by the parenteral administration of valproate and lorazepam; she was EEG monitored until stable remission. Status epilepticus as initial epileptic event induced by neuroleptic agent was not previously reported in our national literature. Conclusion. Introduction of chlorpromazine to a patient without history of seizures is associated with the evolution of an epileptic activity, including the occurrence of status epilepticus. Clinical evaluation of the risk factors possibly related to chlorpromazine-induced seizure is recommended in individual patients before administering this drug.

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7

Karantali, Eleni, Symela Chatzikonstantinou, Ioannis Mavroudis, Constantin Trus, and Dimitrios Kazis. "Cognitive Status Epilepticus: Two Case Reports." Medicina 57, no. 8 (August 3, 2021): 799. http://dx.doi.org/10.3390/medicina57080799.

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Cognitive status epilepticus is an uncommon form of focal status epilepticus presenting with a dysfunction of language, thinking or associated higher cortical functions. The absence of ictal manifestations can be misleading and delay a prompt diagnosis. Here we present two patients; one with amnesic and one with aphasic status epilepticus. Through these cases, we aim to highlight the value of EEG performance early in the diagnostic work-up and early antiepileptic drug initiation in cases where an epileptic disorder cannot be excluded.

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8

Hasan, H., Caner F. Demir, and Hasan S. Cura. "Absence status seen in an adult patient." Journal of Neurosciences in Rural Practice 04, no. 03 (July 2013): 342–44. http://dx.doi.org/10.4103/0976-3147.118809.

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ABSTRACTAbsence status epilepticus (ASE) is a type of nonconvulsive status epilepticus in which continuous or recurrent generalized epileptiform discharges are associated with a varying grade of consciousness impairment. Absence status epilepticus may be obtained during progress of many epileptic syndromes, in several metabolic disturbances and related to use of several drugs. Absence status epilepticus is generally seen in childhood; rarely it can be seen in adulthood. In this paper, the case which has never diagnosed until now in spite of many absence seizures for years, applied for absence seizures to our clinic and diagnosed for juvenile absence epilepsy, has been discussed.

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9

Assis, Telma M. R., Aroldo Bacellar, Gersonita Costa, and Osvaldo J. M. Nascimento. "Mortality predictors of epilepsy and epileptic seizures among hospitalized elderly." Arquivos de Neuro-Psiquiatria 73, no. 6 (June 2015): 510–15. http://dx.doi.org/10.1590/0004-282x20150043.

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Epilepsy and epileptic seizures are common brain disorders in the elderly and are associated with increased mortality that may be ascribed to the underlying disease or epilepsy-related causes.Objective To describe mortality predictors of epilepsy and epileptic seizures in elderly inpatients.Method Retrospective analysis was performed on hospitalized elderly who had epilepsy or epileptic seizures, from January 2009 to December 2010. One hundred and twenty patients were enrolled.Results The most common etiology was ischemic stroke (37%), followed by neoplasias (13%), hemorrhagic stroke (12%), dementias (11.4%) and metabolic disturbances (5.5%). In a univariate analysis, disease duration (p = 0.04), status epilepticus (p < 0.001) and metabolic etiology (p = 0.005) were associated with mortality. However after adjustment by logistic regression, only status epilepticus remained an independent predictor of death (odds ratio = 13; 95%CI = 2.3 to 72; p = 0.004).Conclusion In this study status epilepticus was an independent risk factor for death during hospitalization.

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10

Zimmermann, R., V. I. Hülsmeyer, C. Sauter-Louis, and A. Fischer. "Status Epilepticus and Epileptic Seizures in Dogs." Journal of Veterinary Internal Medicine 23, no. 5 (September 2009): 970–76. http://dx.doi.org/10.1111/j.1939-1676.2009.0368.x.

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11

Karatas, Hulya, F. Irsel Tezer, Nese Dericioglu, and Serap Saygi. "Pitfalls of Psychogenic Non-epileptic Status Epilepticus." Brain Impairment 13, no. 3 (December 2012): 333–38. http://dx.doi.org/10.1017/brimp.2012.30.

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Objectives and Background: In patients with medically refractory seizures 20–30% do not have epilepsy, and the majority are diagnosed with psychogenic non-epileptic seizures (PNES). Almost one-third of this group has a prolonged episode that is termed as PNES status epilepticus (PNES-SE). The aim of this study was to describe the characteristics of patients with (1) PNES-SE only and (2) PNES-SE with concurrent epileptic seizures.Methods: We screened retrospectively all patients who underwent video-electroencephalogram (video-EEG) long-term monitoring at our institution between 1996 and 2009. Patients with PNES were identified by typical clinical features with no ictal EEG changes. Patients with continuous episodes for at least 30 min that led to intubation were identified as PNES-SE. They were divided into two groups: group 1, pure PNES-SE and group 2, PNES-SE with concurrent epilepsy. Group characteristics were defined with respect to demographic, clinical, electroencephalographic, neuroimaging and psychiatric variables.Results: PNES were recorded in 88/916 patients (10%) of whom 6 (7%) were treated intensively due to misdiagnosis of status epilepticus (SE), with two having coexistent epileptic seizures. All patients had concurrent psychiatric disorder(s), diagnosed by a psychiatrist. Duration of time until correct diagnosis was lengthy in all cases, and particularly for patients with PNES-SE with coexisting epileptic seizures (more than 10 years).Conclusion: To avoid iatrogenic complications and to treat the underlying psychiatric conditions, early diagnosis of PNES is necessary. Understanding the clinical characteristics of PNES-SE leads to early diagnoses, which may avoid iatrogenesis and economic burden.

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12

Alving, Jørgen, and Sándor Beniczky. "Epileptic prodromes: Are they nonconvulsive status epilepticus?" Seizure 22, no. 7 (September 2013): 522–27. http://dx.doi.org/10.1016/j.seizure.2013.03.013.

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13

Lipatova, L. V., I. G. Rudakova, N. A. Sivakova, and T. V. Kapustina. "Acute symptomatic epileptic seizures and status epilepticus." Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova 115, no. 4 (2015): 24. http://dx.doi.org/10.17116/jnevro20151154124-29.

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14

Helen Cross, J. "When is epileptic encephalopathy nonconvulsive status epilepticus?" Epilepsia 48, s8 (November 2007): 42–43. http://dx.doi.org/10.1111/j.1528-1167.2007.01346.x.

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15

Schiefer, Johannes, and Rainer Surges. "Notfallversorgung und Erstbehandlung epileptischer Anfälle im Erwachsenenalter." DMW - Deutsche Medizinische Wochenschrift 144, no. 02 (January 2019): 83–92. http://dx.doi.org/10.1055/a-0660-3174.

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AbstractSuspected epileptic seizures are a frequent cause of emergency hospital care. After single seizures, the emergency management includes safety measures and diagnostic efforts to distinguish epileptic seizures from its manifold mimics and to possibly detect acute causes of epileptic seizures. Convulsive status epilepticus requires rapid anticonvulsant treatment according to established protocols and diagnostics to rule out underlying acute brain diseases. After a first seizure, typical EEG- and MRI findings may indicate an elevated recurrence risk, thereby justifying the ultimate diagnosis of epilepsy and initiation of anticonvulsant therapy. This article reviews the recent definition of epilepsy, summarizes clinical characteristics of epileptic seizures and its mimics and provides an overview of established therapies of single convulsive seizures, convulsive status epilepticus and early care of adults after first unprovoked seizures.

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16

Kravljanac, Ruzica, Marija Djakovic, Biljana Vucetic-Tadic, and Djordje Kravljanac. "Super-refractory status epilepticus and pharmacoresistant epilepsy in the infant with hemorrhagic shock and encephalopathy syndrome." Srpski arhiv za celokupno lekarstvo, no. 00 (2020): 117. http://dx.doi.org/10.2298/sarh200502117k.

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Introduction. Hemorrhagic shock and encephalopathy syndrome (HSES) is a rare disorder with prevalence at the early age. The main features of HSES are: acute diarrhea, shock, disseminated intravascular coagulation, multisystem impairment, and encephalopathy. The prognosis is very poor, with high mortality, especially in the cases with status epilepticus. Case outline. The presented infant had typical features of HSES associated with superrefractory status epilepticus as de novo epileptic event, followed by parmacoresistant epilepsy. Clinical course of disease was very severe and required urgent circulatory and respiratory support, and at the same time, managing of super-refractory status epilepticus by continuous intravenous infusion of midazolam, barbiturate and levetiracetam. The outcome was very poor with serious neurological consequence and resistant epileptic seizures. Conclusion. The treatment of the presented patient with HSES was very challengeable due to life threatening condition associated with superrefractory status epilepticus, and further pharmacoresistant epilepsy. Additionally, the choice of antiepileptic drugs is limited due to multisystem impairment and adverse effects, which might worsen, anyhow, severe course of disease.

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Janszky, József, Beáta Bóné, Réka Horváth, Zsófia Sütő, László Szapáry, Vera Juhos, Sámuel Komoly, and Norbert Kovács. "Status epilepticus 2020." Orvosi Hetilap 161, no. 42 (October 18, 2020): 1779–86. http://dx.doi.org/10.1556/650.2020.31908.

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Absztrakt: A status epilepticus a második leggyakoribb, sürgősségi kezelést igénylő neurológiai állapot. Halálozása 15–25%. A „time is brain” elve a status epilepticus kezelésére is igaz: minél korábban kezdjük a megfelelő kezelést, annál nagyobb valószínűséggel tudjuk megállítani a progressziót. Magas szintű evidenciákon alapuló kezelési protokollal a status epilepticus progressziója az esetek 75–90%-ában megelőzhető, az indukált kóma és a halálos kimenetel elkerülhető. A status epilepticus kezelése akkor a legsikeresebb, ha már a korai szakban megkezdjük a parenteralis benzodiazepinterápiát: im. midazolám (0,2 mg/tskg, max. 10 mg). Szabad véna esetén lehet vénásan is adni a benzodiazepint (10 mg diazepám iv). Ha az első benzodiazepinbolusra nem reagál a status epilepticus, állandósult (benzodiazepinrefrakter) status epilepticusról beszélünk. Ilyenkor a benzodiazepin ismétlésével párhuzamosan nem benzodiazepin típusú, gyorsan ható vénás antiepileptikumot is adni kell: iv. valproát (40 mg/kg, max. 3000 mg, 10 perc alatt) vagy levetiracetám (60 mg/kg, max. 4500 mg, 10 perc alatt) javasolt. Az 1 órán túl is tartó, sem benzodiazepinre, sem antiepileptikumra nem reagáló, refrakter status epilepticust neurointenzív osztályon, teljes narcosissal (indukált kómával) kell kezelni. Az indukált kómát gyors hatású anesztetikummal lehet elérni, elsősorban propofol–midazolám kombinációval. Orv Hetil. 2020; 161(42): 1779–1786.

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18

Hamad, A. P., T. Ferrari-Marinho, L. O. Caboclo, U. Thomé, and R. M. F. Fernandes. "Nonconvulsive status epilepticus in epileptic encephalopathies in childhood." Seizure 80 (August 2020): 212–20. http://dx.doi.org/10.1016/j.seizure.2020.06.024.

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19

Feddersen, Berend, Jan Rémi, Marion Einhellig, Cordula Stoyke, Philipp Krauss, and Soheyl Noachtar. "Parkinson's disease: Less epileptic seizures more status epilepticus." Epilepsy Research 108, no. 2 (February 2014): 349–54. http://dx.doi.org/10.1016/j.eplepsyres.2013.11.013.

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20

Bhardwaj, Ankit, Atma Ram Sharma, and Sarla Sharma. "Cefixime induce non convulsive status epileptics: a neurotoxic effect." International Journal of Basic & Clinical Pharmacology 8, no. 10 (September 25, 2019): 2341. http://dx.doi.org/10.18203/2319-2003.ijbcp20194284.

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Nonconvulsive status epileptics comprises a group of syndromes that display a great diversity regarding response to anticonvulsants ranging from virtually self-limiting variants to entirely refractory forms cephalosporins are thought to provoke seizure through inhibitory effects on gamma-aminobutyric acid (GABA) transmission and GABA receptors. Interference with GABA transmission result in pre-disposition towards excitatory neurotransmission, which can leads to seizures. Antibiotics can alter the serum concentration of anti-epileptic, resulting in seizures and anti-epileptic drugs toxicity.

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José Antonio García Martínez, Maria Candelaria Benimeli López, Francisco García-Legaz Navarro, and Carlos García Palenciano. "Estatus epiléptico refractario no convulsionante en postoperatorio de pancreatectomía total: A propósito de un caso." Revista Electrónica AnestesiaR 10, no. 12 (January 2, 2019): 2. http://dx.doi.org/10.30445/rear.v10i12.653.

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Se presenta un caso clinico de Estatus Epileptico No convulsionante en el posopoeratorio de una paciente de 79 años sin antecedentes de epilepsia, y su probable relación con la antibioterapia pautada. Seguidamente se realiza una discusion acerca del estatus epileptico y su aparicion como efecto secundario del tratamiento con ciertos antibioticos. ABSTRACT We present a clinical case of non-convulsive epileptic status in the post-operative of a 79-year-old patient with no history of epilepsy, and its probable relationship with scheduled antibiotic therapy. Then a discussion about the epileptic status and its appearance as a side effect of the treatment with certain antibiotics is made.

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Knezevic-Pogancev, Marija, Ksenija Bozic, Tatjana Redzek-Mudrinic, and Ksenija Gebauer-Bukurov. "Convulsive status epilepticus in children." Medical review 63, no. 11-12 (2010): 801–4. http://dx.doi.org/10.2298/mpns1012801k.

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Introduction. Convulsive status epilepticus is the most urgent neurological medical emergency in children. Generalized convulsive status epilepticus is the most common and life-threatening type of status epilepticus. It is not a syndrome in the same sense as febrile convulsions, benign rolandic epilepsy, and infantile polymorphic epilepsy. These latter disorders have a tight age frame, seizure semiology, and a reasonably predictable outcome. Episodes of convulsive status epilepticus can occur in each: occasionally in symptomatic and febrile convulsions, and Lennox Gastaut syndrome, rarely in benign rolandic epilepsy, and West syndrome. Etiology of convulsive status epilepticus. Status epilepticus has many causes, which vary depending on the age and patient population. Convulsive status epileptucus continues to be associated with significant neurological morbidity and mortality, with different hazards and outcome. Although the outcome is dependent on etiology, it is known that appropriate early management may reduce mortality and some of the morbidity associated with convulsive status epilepticus. Discussion. Status epilepticus is a disorder in which the mechanisms attempting at terminating the seizure fail. Continued convulsive activity in convulsive status epilepticus results in decompensation of all organs and systems, thus being life threatening. Seizure activity in convulsive status epilepticus is associated with neuronal damage. The aim should be to halt this activity urgently, using, ideally, a 100% effective drug, administered quickly, without compromising the consciousness level or producing other negative effects on cardiovascular, respiratory function or other unexpected effects.

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Sсhugareva, Ludmila M., Oksana V. Poteshkina, Marina K. Kruchina, and Mikhail A. Rusak. "Fever-induced epileptic encephalopathy in children (FIRES)." HERALD of North-Western State Medical University named after I.I. Mechnikov 10, no. 4 (February 21, 2019): 65–72. http://dx.doi.org/10.17816/mechnikov201810465-72.

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Fever infection-related epilepticy syndrome, FIRES — rare severe epileptic encephalopathy infection or fever-induced refractory epileptic status developing in a previously healthy child. The etiology of FIRES remains unknown; post-inflammatory and autoimmune mechanisms are assumed. Recovery is possible, but the majority of children develop significant cognitive failure and refractory epilepsy.

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Podlepich, Vitaliy V., and Ivan A. Savin. "Clinical and Electrophysiological Differentiation between Periodical and Epileptic Discharges." Journal of Neuroanaesthesiology and Critical Care 07, no. 02 (March 27, 2020): 096–103. http://dx.doi.org/10.1055/s-0040-1701590.

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AbstractClinical differentiation between nonconvulsive status epilepticus (NCSE) and encephalopathy remains challenging. Some patients with encephalopathy exhibit periodic discharges on electroencephalography. In certain cases, however, it is rather difficult to differentiate between epileptic and periodic discharges. The lack of clear differentiation criteria makes it difficult to effectively analyze the studies in this field. In patients with refractory status epilepticus, the wrong diagnosis can lead to insufficient therapy, thereby increasing the frequency of convulsions and the likelihood of a poor outcome. Alternatively, aggressive therapy with antiepileptic drugs and anesthetic agents can aggravate neuronal damage and worsen encephalopathy. In this review, we aimed to determine whether clinical and instrumental methods can be used to differentiate between encephalopathy and epileptic states, to improve the selection of the appropriate treatment strategies. The review considers different approaches to diagnosing encephalopathy and seizures in critically ill patients. In spite of electroencephalography (EEG) still being the main method used to objectively identify brain dysfunction and diagnose epileptic discharges over the past 60 years, improvements in EEG techniques have been accompanied by increase in our understanding of the limitations of electrophysiological methods, leading to the use of additional tools for the differential diagnosis of seizures and encephalopathy. Current studies aim to develop multimodal approaches to the differential diagnosis of encephalopathy and NCSE. Modern reports describe clinical and instrumental approaches for accurately differentiating encephalopathy and epileptic conditions in patients treated in the intensive care unit based on clinical data, EEG, magnetic resonance imaging, positron emission tomography, biochemical analyses, and immune values.

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Gomes, Daniel, José Pimentel, Carla Bentes, Diana Aguiar de Sousa, Ana Patrícia Antunes, António Alvarez, and Zélia Costa e. Silva. "Consensus Protocol for the Treatment of Super-Refractory Status Epilepticus." Acta Médica Portuguesa 31, no. 10 (October 31, 2018): 598. http://dx.doi.org/10.20344/amp.9679.

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Introduction: Super-refractory status epilepticus is defined as status epilepticus that persists or recurs 24 hours after anaesthetic therapy onset or after its withdrawal. It is mostly found in intensive care units and carries high mortality but good long-term prognosis for those who survive. In contrast with the initial phases of status epilepticus, treatment lacks strong scientific evidence and is mostly derived from case reports or small case series.Objective: To propose a protocol for the treatment of super-refractory status epilepticus in level III intensive care units, focusing on the treatment strategies to control clinical and/or electroencephalographic epileptic activity.Material and Methods: Narrative review of the literature by PubMed search. Available evidence was discussed in consensus meetings by intensive care and neurology experts’ from a level III intensive care unit and one of the Portuguese reference centres for the treatment of refractory epilepsy, respectively.Results: Anaesthetics with the highest level of evidence are propofol, midazolam, thiopental and ketamine. These represent the basis of the treatment of super-refractory status epilepticus and should be used in combination with antiepileptic drugs. The level of evidence for the latter is lower, however, levetiracetam, topiramate, pregabalin, lacosamide, valproic acid, phenytoin and perampanel may be recommended. Alternative therapeutic strategies with very low level of evidence are recommended in cases of total absence of clinical response, such as magnesium sulphate, pyridoxine, ketogenic diet, therapeutic hypothermia and immunosupression.Conclusion: We propose a treatment protocol based on a sequential combination of anaesthetics, anti-epileptic drugs and alternative therapies. Strategies to evaluate treatment response and to wean drugs based on clinical results are also proposed.

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Kholin, A. A. "EPILEPTIC ENCEPHALOPTHIES WITH ELECTRICAL STATUS EPILEPTICUS SLOW SLEEP (ESES)." Epilepsia and paroxyzmal conditions 8, no. 1 (January 1, 2016): 62–65. http://dx.doi.org/10.17749/2077-8333.2016.8.1.062-065.

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27

Parsons, Angela, Akta Patel, and Amy Crepeau. "Dosing of anti-epileptic therapy in refractory status epilepticus." Epilepsy & Behavior 101 (December 2019): 106784. http://dx.doi.org/10.1016/j.yebeh.2019.08.059.

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28

YILMAZ, ARDA, KAYIHAN ULUC, KADER KARLI OGUZ, and SERAP SAYGI. "Epileptic nystagmus in a patient with nonconvulsive status epilepticus." Seizure 13, no. 3 (April 2004): 183–86. http://dx.doi.org/10.1016/s1059-1311(03)00100-6.

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Sharma, Varun, Anaita Hegde, and Fazal Nabi. "Refractory status epilepticus: Febrile Illness Related Epileptic Syndrome (FIRES)." International Journal of Epilepsy 02, no. 02 (December 2015): 090–93. http://dx.doi.org/10.1016/j.ijep.2015.07.001.

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AbstractIn recent literature, a new entity has emerged, which focuses on a possible non-encephalitic epileptic encephalopathy precipitated by fever in a previously normal child. We report a typical case of Febrile illness related epileptic syndrome (FIRES) from Indian subcontinent. The index case presented with fever and multiple seizures, which progressed to status epilepticus and encephalopathy. All infectious, metabolic and autoimmune markers were negative. Convulsions were refractory to all possible treatment except thiopentone which achieved burst suppression pattern. Breakthrough seizures were prevented by using lacosamide and ketogenic diet along with multiple anticonvulsants. At 1-year follow-up, patient had a relatively good neurological outcome, however has persistent refractory epilepsy.

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Neligan,, Aidan, Sanjeev Rajakulendran, and Matthew C. Walker. "Advances in the management of generalized convulsive status epilepticus: what have we learned?" Brain 144, no. 5 (March 29, 2021): 1336–41. http://dx.doi.org/10.1093/brain/awab049.

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Abstract Convulsive status epilepticus is the most serious manifestation of an epileptic diathesis. In the early stages (5–30 min), there exists class A evidence to support the efficacy of benzodiazepines as first-line treatment. As status epilepticus progresses into the later stages, the evidence for treatment becomes less robust until we are depending upon short case series and case reports for the treatment of refractory status epilepticus. However, the past year saw the publication of three randomized controlled trials in the setting of benzodiazepine-resistant established convulsive status epilepticus: the EcLiPSE and ConSEPT studies, compared levetiracetam to phenytoin in children; and the ESETT study compared fosphenytoin, levetiracetam and sodium valproate in adults and children. In addition, the emergence of data from the SENSE study, a multicentre multinational prospective cohort study and the publication of a systematic review and meta-analysis of the mortality of status epilepticus over the past 30 years, has brought the treatment of status epilepticus into sharp focus. In this update we provide a detailed analysis of these studies and their impact on clinical practice. We review contentious areas of management in status epilepticus where a consensus is lacking and advance the case for more research on existing and alternative treatment strategies.

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Catenoix, H., R. Marignier, C. Ritleng, M. Dufour, F. Mauguière, C. Confavreux, and S. Vukusic. "Multiple sclerosis and epileptic seizures." Multiple Sclerosis Journal 17, no. 1 (September 22, 2010): 96–102. http://dx.doi.org/10.1177/1352458510382246.

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Background: The association between epilepsy and multiple sclerosis (MS) is not a coincidence. Objective: Our objective was to compare MS patients with or without history of seizures. Methods: In a population of 5041 MS patients, we identified 102 (2%) patients with epileptic seizures. In 67 patients (1.3%), epileptic seizure could not be explained by any cause other than MS. Results: In these 67 patients, the median age at occurrence of the first epileptic seizure was 33 years. Epilepsy was the initial clinical manifestation of MS in seven patients. In total, 62 patients (92.5%) presented only one or a few seizures, and 18 patients (27%) presented at least one episode of status epilepticus, fatal in two. Compared with MS patients without epilepsy, there was no difference in gender, type of MS course and time from onset of MS to the progressive phase. Conversely, the median age at MS onset was earlier (25.0 years vs. 30, p < 0.0001) and there was a trend for a shorter time from MS onset to non-reversible disability. Conclusions: Our study confirms an increased risk of epileptic seizures in MS patients. It underlines that seizures may be the first observable symptom in MS and the frequency and seriousness of status epilepticus.

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Dobbertin, Matthew D., Greg Wigington, Ashish Sharma, and Durga Bestha. "Intubation in a Case of Psychogenic, Non-Epileptic Status Epilepticus." Journal of Neuropsychiatry and Clinical Neurosciences 24, no. 1 (January 2012): E8. http://dx.doi.org/10.1176/appi.neuropsych.11010022.

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Miller-Delaney, S. F. C., S. Das, T. Sano, E. M. Jimenez-Mateos, K. Bryan, P. G. Buckley, R. L. Stallings, and D. C. Henshall. "Differential DNA Methylation Patterns Define Status Epilepticus and Epileptic Tolerance." Journal of Neuroscience 32, no. 5 (February 1, 2012): 1577–88. http://dx.doi.org/10.1523/jneurosci.5180-11.2012.

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Roy, Mukut, Nilanjan Sengupta, Pranab Kumar Sahana, Chanchal Das, and Ranen Dasgupta. "Primary hypoparathyroidism presenting as refractory status epilepticus." Bangladesh Critical Care Journal 1, no. 2 (December 1, 2013): 99–101. http://dx.doi.org/10.3329/bccj.v1i2.17203.

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A case of adult onset primary hypoparathyroidism is reported highlighting the effect of phenytoin therapy on calcium metabolism. This patient of brain calcinosis syndrome (BCS) presented with refractory status epilepticus despite on full dose phenytoin. Seizures were controlled with correction of hypocalcemia. A change of anti-epileptic therapy to lamotrigine and supplementation with calcium and calcitriol kept the patient seizure free for last 10 months till last follow up. DOI: http://dx.doi.org/10.3329/bccj.v1i2.17203 Bangladesh Crit Care J September 2013; 1 (2): 99-101

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Sheppard, Emilie, and Sarah Lippé. "Cognitive Outcome of Status Epilepticus in Children." Epilepsy Research and Treatment 2012 (August 13, 2012): 1–8. http://dx.doi.org/10.1155/2012/984124.

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Epileptic encephalopathy encompasses conditions in which cognitive, motor, or sensory deficits result as a consequence of epileptic activity defining certain syndromes. It therefore represents a more severe subset of epilepsy, which can be generally characterized as frequent or severe seizures leading to cerebral dysfunction. This disturbance in cerebral functioning can in turn hinder, somewhat dramatically, cognitive development and further impact the future lives of patients. In this paper, we describe the cognitive consequences of status epilepticus in children and in adults in the context of plasticity theories. Recent studies maintain that consequences of SE may be severe cognitive sequelae, especially in early life. Since the residual consequences of SE in adulthood seem less detrimental and long-lasting, we argue that early life insults, such as those created by SE, during a rapid period of development and functional specialization, result in specific cognitive deficits dependent on the sensitive period at which SE occurred.

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Mahale, Rohan, Anish Mehta, Mahendra Javali, Suryanarayana Sharma, Byadaralli Madhusudhan, and Rangasetty Srinivasa. "Possible levetiracetam induced encephalopathy presenting as electrical status epilepticus: An unknown occurrence." International Journal of Epilepsy 01, no. 02 (December 2014): 084–87. http://dx.doi.org/10.1016/j.ijep.2014.10.001.

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AbstractLevetiracetam is a novel, broad spectrum anti-epileptic drug with proven efficacy in generalized as well as focal onset seizures. It has renal elimination with no hepatic metabolism. Levetiracetam induced encephalopathy is rarely reported in literature. Triphasic waves in the electroencephalogram are seen in toxic-metabolic encephalopathies of various aetiology like hepatic encephalopathy, uraemia. We report a patient who was on levetiracetam for acute symptomatic seizures and developed encephalopathy with electroencephalogram showing generalised triphasic waves. These triphasic waves disappeared with intravenous lorazepam but without clinical improvement in sensorium. The electroencephalographic abnormality appeared as electrical status epilepticus which got normalised on discontinuation of levetiracetam. This is the first report of levetiracetam induced encephalopathy presenting as electrical status epilepticus and also depicts electroencephalographic correlate of levetiracetam induced encephalopathy.

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Šarbochová, Ivana, and Lukáš Martinkovič. "Status epileticus in adults in neurointensive care." Neurologie pro praxi 18, no. 2 (May 1, 2017): 88–93. http://dx.doi.org/10.36290/neu.2019.009.

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Krijtová, Hana, David Krýsl, and Petr Marusič. "EEG in non-convulsive status epilepticus." Neurologie pro praxi 23, no. 3 (June 16, 2022): E1—E11. http://dx.doi.org/10.36290/neu.2022.017.

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Onder, Halil. "A Case of Myoclonic Epilepsy Presenting with Status Epilepticus in an Elderly Male Patient." Journal of Neurosciences in Rural Practice 11, no. 03 (June 16, 2020): 463–66. http://dx.doi.org/10.1055/s-0040-1709348.

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AbstractMyoclonic epilepsy in the form of status epilepticus is an extremely rare reported presentation. Herein, we describe an 87-year old male patient presenting with abrupt-onset rhythmic myoclonic jerks that were evaluated as synchronous positive and negative myoclonus. Further etiological investigations revealed that the myoclonus was associated with ictogenesis, and appropriate antiepileptic treatment provided total cessation of the movements. To my knowledge, this is a unique case of myoclonic status epilepticus in an elderly patient, which may have been associated with a cerebrovascular disease. In the presentation of this case, we will review the related literature and discuss some considerations to explain the pathophysiology of epileptic myoclonic movements and the possible role of pontine lesions.

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Singh Sudan, Yeeshu, K. Vinayan, and Arun Roy. "Clinical, MRI and electrographic characteristics of three children with Hemiconvulsion-Hemiplegia/Hemiconvulsion-Hemiplegia-Epilepsy (HH/HHE) syndrome–A rare childhood epileptic encephalopathy." International Journal of Epilepsy 04, no. 01 (June 2017): 079–86. http://dx.doi.org/10.1016/j.ijep.2016.12.004.

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AbstractHemi convulsion-Hemiplegia-Epilepsy (HH/HHE) syndrome is a very rare catastrophic epileptic syndrome in childhood which follows a prolonged focal motor status epilepticus in infancy and early childhood. Here we are describing the clinical, MRI and electrographic characteristics along with long term outcome of three children with HH/HHE syndrome. A review of the current literature on HH/HHE syndrome is attempted stressing on the diagnostic features and the neurobiological relationship between prolonged focal motor status epilepticus and subsequent development of HH/HHE syndrome. Early identification of this syndrome may help the treating physician in providing families with a relatively accurate prognosis regarding the functional outcome and subsequent development of epilepsy.

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Nelson, Sarah E., and Panayiotis N. Varelas. "Status Epilepticus, Refractory Status Epilepticus, and Super-refractory Status Epilepticus." CONTINUUM: Lifelong Learning in Neurology 24, no. 6 (December 2018): 1683–707. http://dx.doi.org/10.1212/con.0000000000000668.

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Inoue, Y. "Ring chromosome 20 and nonconvulsive status epilepticus. A new epileptic syndrome." Brain 120, no. 6 (June 1, 1997): 939–53. http://dx.doi.org/10.1093/brain/120.6.939.

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Tsenov, Grygoriy, Hana Kubová, and Pavel Mareš. "Changes of cortical epileptic afterdischarges after status epilepticus in immature rats." Epilepsy Research 78, no. 2-3 (February 2008): 178–85. http://dx.doi.org/10.1016/j.eplepsyres.2007.11.008.

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Herberg, L. J., and I. C. Rose. "Kindled epileptic seizures, postictal refractoriness, status epilepticus, and electrical self-stimulation." Neuroscience & Biobehavioral Reviews 18, no. 3 (September 1994): 411–20. http://dx.doi.org/10.1016/0149-7634(94)90054-x.

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Lin, Tsu-Kung, Shang-Der Chen, Kai-Jung Lin, and Yao-Chung Chuang. "Seizure-Induced Oxidative Stress in Status Epilepticus: Is Antioxidant Beneficial?" Antioxidants 9, no. 11 (October 22, 2020): 1029. http://dx.doi.org/10.3390/antiox9111029.

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Epilepsy is a common neurological disorder which affects patients physically and mentally and causes a real burden for the patient, family and society both medically and economically. Currently, more than one-third of epilepsy patients are still under unsatisfied control, even with new anticonvulsants. Other measures may be added to those with drug-resistant epilepsy. Excessive neuronal synchronization is the hallmark of epileptic activity and prolonged epileptic discharges such as in status epilepticus can lead to various cellular events and result in neuronal damage or death. Unbalanced oxidative status is one of the early cellular events and a critical factor to determine the fate of neurons in epilepsy. To counteract excessive oxidative damage through exogenous antioxidant supplements or induction of endogenous antioxidative capability may be a reasonable approach for current anticonvulsant therapy. In this article, we will introduce the critical roles of oxidative stress and further discuss the potential use of antioxidants in this devastating disease.

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Silva-Barrat, Carmen, Jean Champagnat, and Christian Menini. "The GABA-Withdrawal Syndrome: A Model of Local Status Epilepticus." Neural Plasticity 7, no. 1-2 (2000): 9–18. http://dx.doi.org/10.1155/np.2000.9.

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The GABA-withdrawal syndrome (GWS) is a model of local status epilepticus following the interruption of a chronic GABA infusion into the rat somatomotor cortex. GWS is characterized by focal epileptic electroencephalographic discharges and associated contralateral myoclonus. In neocorticai slices obtained from GWS rats, most neurons recorded in the GABA-infused area are pyramidal neurons presenting bursting properties. The bursts are induced by white-matter stimulation and/or intracellular depolarizing current injection and correlate with a decrease of cellular sensitivity to GABA, caused by its prolonged infusion. This effect is related to a calcium influx that may reduce theGABAAreceptormediated inward current and is responsible for the bursting properties. Here we present evidence for the involvement of calcium- and NMDA-induced currents in burst genesis. We also report modulatory effects of noradrenaline appearing as changes on firing patterns of bursting and nonbursting cells. Complementary histochemical data reveal the existence of a local noradrenergic hyperinnervation and an ectopic expression of tyrosine hydroxylase mRNAs in the epileptic zone.

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Dömötör, Johanna, and Béla Clemens. "Focal motor seizures and status epilepticus provoked by mirtazapine." Ideggyógyászati szemle 68, no. 7-8 (2015): 286–88. http://dx.doi.org/10.18071/isz.68.0286.

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Chopra, Kanika. "Super-Refractory Status Epilepticus in Pregnancy-An Exigent Management." International Journal of Clinical Case Reports and Reviews 11, no. 1 (April 4, 2022): 01–03. http://dx.doi.org/10.31579/2690-4861/210.

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Super-refractory status epilepticus is known as the seizure that persist beyond 24 hours even after administration of intravenous anesthesia drugs. It is a rare diagnosis especially in pregnant population and thus its management is also limited to case series and reports. Our case presented with this diagnosis and we managed it with three tier system of pharmacological agents and termination of pregnancy. Unfortunately, exact cause of the SRSE in our case was not found and patient has been discharged on dual antiepileptic drugs along with antidepressants with follow up in neurology out-patient department. It is important to keep one self-aware of the treatment protocol in cases of status epilepticus other than due to eclampsia.

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Greco, Filippo, Maria Donatella Cocuzza, Pierluigi Smilari, Giovanni Sorge, and Lorenzo Pavone. "Nonconvulsive Status Epilepticus Complicating Epstein-Barr Virus Encephalitis in a Child." Case Reports in Pediatrics 2014 (2014): 1–4. http://dx.doi.org/10.1155/2014/547396.

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Children with acute encephalopathy show prolonged electrographic seizure activity consistent with nonconvulsive status epilepticus (NCSE). Pediatric NCSE is a heterogeneous clinical entity with poor outcome and different etiologies, including central nervous system infection, stroke, toxic-metabolic syndrome, and epileptic syndrome. We report a 4-year-old girl with seizure and behavioral changes in whom the analysis of cerebrospinal fluid by polymerase chain reaction was positive for Epstein-Barr virus. We emphasize the importance of electroencephalography (EEG), and particularly, of continuous EEG monitoring for early recognition and appropriate treatment of this condition.

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Zeiler, FA, KJ Zeiler, CJ Kazina, J. Teitelbaum, LM Gillman, and M. West. "Lidocaine for status epilepticus in adults." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 42, S1 (May 2015): S17. http://dx.doi.org/10.1017/cjn.2015.98.

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Introduction: Our goal was to perform a systematic review of the literature on the use of intravenous lidocaine in adults for status epilepticus (SE) and refractory status epilepticus (RSE) to determine its impact on seizure control. Methods: All articles from MEDLINE, BIOSIS, EMBASE, Global Health, HealthStar, Scopus, Cochrane Library, the International Clinical Trials Registry Platform (inception to November 2014), and gray literature were searched. The strength of evidence was adjudicated using both the Oxford and GRADE methodology by two independent reviewers. Results: Overall, 13 studies were identified, with 11 manuscripts and 2 meeting abstracts. Seventy-six adult patients were treated for 82 episodes of SE/RSE. Patients had varying numbers of anti-epileptic drugs (AEDs), 1 to 12, on board prior to lidocaine therapy. During 69 of the 82 (84.1%) episodes of SE/RSE, phenytoin was on board. The dose regimen of lidocaine varied significantly. Overall, 70.7% of seizures responded to lidocaine, with complete cessation and greater than 50% reduction seen in 64.1% and 6.1% respectively. Patient outcomes were sparingly reported. Conclusions: There currently exists level 4, GRADE C evidence to support the consideration of lidocaine for SE and RSE in the adult population. Further prospective studies of lidocaine administration in this setting are warranted.

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