scholarly journals Epilepsy and Pregnancy

1979 ◽  
Vol 6 (3) ◽  
pp. 345-349 ◽  
Author(s):  
Joseph Bruni ◽  
L. James Willmore
Keyword(s):  
Status Epilepticus ◽  
Antiepileptic Drug ◽  
Antiepileptic Drugs ◽  
Plasma Levels ◽  
Teratogenic Effects ◽  
History Of ◽  
Close Cooperation ◽  
History Of Epilepsy ◽  
Antiepileptic Drug Therapy ◽  
In Pregnancy

SUMMARY:The management of the pregnant epileptic requires close cooperation between the neurologist and obstetrician. To prevent complications, knowledge is required about the natural history of epilepsy during pregnancy, the possible teratogenic effects of antiepileptic drugs, and changes in their absorption, biotransformation, and excretion. Close plasma antiepileptic drug monitoring is required because of the change in the handling of antiepileptic drugs during pregnancy. The treatment of status epilepticus with intravenous phenytoin is effective. Drug interactions which may lead to toxic plasma levels of some drugs and subtherapeutic plasma levels of others should be anticipated. The risk of problems resulting from antiepileptic drug therapy during pregnancy appears to be minor, provided that proper medical supervision is available. Newer antiepileptic drugs should not be administered to the pregnant epileptic until their safety in pregnancy is fully established.

Status Epilepticus in Children With Epilepsy: The Role of Antiepileptic Drug Levels in Prevention

PEDIATRICS ◽  
1996 ◽  
Vol 98 (6) ◽  
pp. 1119-1121
Author(s):  
Joseph Maytal ◽  
Gerald Novak ◽  
Catherine Ascher ◽  
Robert Bienkowski
Keyword(s):  
Status Epilepticus ◽  
Antiepileptic Drug ◽  
Medical Records ◽  
Clinic Visit ◽  
Drug Levels ◽  
Progressive Encephalopathy ◽  
History Of ◽  
The Mean ◽  
Subtherapeutic Level

Objectives. To determine the association between subtherapeutic antiepileptic drug (AED) levels or AED withdrawal and status epilepticus (SE) in children with epilepsy. Methods. We studied the AED levels at the time of SE in 51 consecutive children with epilepsy. Information about prior AED levels, possible etiology of seizures, and acute precipitants was extracted from medical records. Results. The mean age at the time of SE was 5.7 years (range, 3 months through 18 years). Forty-three patients had history of remote insult, five had history of progressive encephalopathy, and three patients were classified as idiopathic. At the time of SE all AED levels were therapeutic in 34 (66%) patients and at least one level was therapeutic in 42 (82%) patients. All levels were subtherapeutic in 9 (18%) patients. Four patients had their AED reduced or discontinued less than 1 week before SE. Twelve patients with therapeutic AED levels on their most recent clinic visit had at least one subtherapeutic level at the time of SE. Eight (16%) patients were febrile and one was hyponatremic. Of the 51 patients, 31 (61%) had no obvious explanation for the development of SE, as all known AEDs were therapeutic and there were no known acute insults. Conclusions. Neurologically abnormal children with preexisting epilepsy are at high risk for development of SE despite having therapeutic AED levels at that time. Acute precipitants of SE, such as fever or AED withdrawal, may play a role in inducing SE only in a minority of patients.

De novo convulsive status epilepticus in patients with multiple sclerosis treated with dalfampridine

2018 ◽  
Vol 25 (4) ◽  
pp. 618-621 ◽  
Author(s):  
Emilie Panicucci ◽  
Mikael Cohen ◽  
Veronique Bourg ◽  
Fanny Rocher ◽  
Pierre Thomas ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Status Epilepticus ◽  
De Novo ◽  
Case Reports ◽  
Brain Magnetic Resonance Imaging ◽  
Convulsive Status Epilepticus ◽  
Biological Tests ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
History Of Epilepsy

Background: Dalfampridine extended release (DAL) is a broad-spectrum voltage-gated potassium channel blocker that is indicated in multiple sclerosis to improve the nerve conduction of demyelinated axons. Seizures are a known side effect of DAL, which is contraindicated in patients with a history of epilepsy. Objective: Three cases of multiple sclerosis (MS) with de novo convulsive status epilepticus (CSE) probably related to dalfampridine administration are described. Methods: No patients had a history of seizures or renal impairment. Biological tests were normal. A brain magnetic resonance imaging (MRI) showed diffuse cortical and subcortical atrophy without active inflammatory lesions. Results: All three patients presented with CSE that was attributed to DAL and so was discontinued. Conclusion: These case reports illustrate that, aside from seizures, de novo CSE is a potential complication of MS patients treated with DAL.

Noncompliance Contributing to Apparent Drug Failure in Status Epilepticus

PEDIATRICS ◽  
1974 ◽  
Vol 53 (6) ◽  
pp. 938-940
Author(s):  
John T. Wilson
Keyword(s):  
Status Epilepticus ◽  
Plasma Levels ◽  
Seizure Activity ◽  
Drug Level ◽  
Continuous Control ◽  
Drug Plasma ◽  
Intravenous Diazepam ◽  
Grand Mal ◽  
History Of ◽  
Drug Plasma Levels

The case to be described illustrates apparent drug failure because of noncompliance in the drug delivery system, and the sequelae of this mishap. In connection with investigation of this case further occurrences of noncompliance were found. This incident also brings into focus the importance of plasma drug level determinations for effective application of therapy. CASE REPORT A 7-year-old, 26-kg, black girl was admitted with a 16-month history of nonprogressive neurologic disease accompanied by clinical and EEG evidence of petit mal and grand mal epilepsy which responded to diphenylhydantoin (DPH), phenobarbital or ethosuximide (Zarontin) treatment. Generalized convulsions had been infrequent for four months, but, before the present admission, a marked increase in grand mal seizures was noted. On the day of admission (day 1), recurrent generalized seizure activity progressed to status epilepticus within six hours. Intravenous diazepam (Valium [0.18/mg/kg]) controlled the seizures. Primidone (Mysoline), 250 mg tid, and ethosuximide, 500 mg tid were prescribed as maintenance anticonvulsants in an attempt to allay further progression to status epilepticus. For the next several days her seizures could be controlled only with paraldehyde (0.36 mg/kg intravenously), although administration of other drugs was continued. Assays of drug plasma levels did not become available until day 6. They disclosed that plasma levels of diazepam and demethyldiazepam were high (289 and 50 ng/ml, respectively) one hour after dosing with 0.18 mg/kg. This indicated that diazepam was not effective for continuous control of seizures, but this information was not acted upon immediately. The most striking finding was that primidone was not detected in plasma, although the prescibed dosage was 250 mg tid.

scholarly journals The peculiarities of focal epilepsy in pregnant women

2017 ◽  
Vol 98 (5) ◽  
pp. 729-732 ◽  
Author(s):  
Sh Y Melikova
Keyword(s):  
Status Epilepticus ◽  
Sleep Deprivation ◽  
Pregnant Women ◽  
Antiepileptic Drug ◽  
Antiepileptic Drugs ◽  
Seizure Frequency ◽  
Focal Epilepsy ◽  
Average Duration ◽  
Convulsive Status Epilepticus

Aim. To investigate the peculiarities of focal epilepsy in pregnant women. Methods. 70 pregnant women with symptomatic focal epilepsy during the period from 2013 to 2017 were studied. Results. The average age at the onset of epilepsy was 18.2±0.6 years. The average duration of epilepsy by the time of pregnancy was 6.6±0.7 years. 15 (21.4±4.9%) women remained seizure-free during pregnancy. Seizures during pregnancy were observed in 55 (78.6±4.9%) women: seizure frequency increased in 22 (31.4±5.5%) cases, decreased in 17 (24.3±5.1%), remained unchanged in 8 (11.4±3.8%), in 8 (11.4±3.8%) women the onset of epilepsy occurred during pregnancy. 72.7% of women who were seizure-free for 1 year prior to pregnancy remained seizure-free during pregnancy. In 21 (40.4%) of 52 women with epilepsy diagnosed prior to pregnancy and treated with antiepileptic drugs, the increase of seizure frequency was observed, which can be explained by non-compliance with the regimen and therapy and sleep deprivation in 15 (71.4%) of them. Generalized convulsive status epilepticus during pregnancy was observed in 1 (1.4±1.4%) woman after a sudden withdrawal of the antiepileptic drug. Conclusion. The risk of seizures during pregnancy is lower in women who were seziure-free for 1 year prior to pregnancy; non-compliance with the regimen and therapy and sleep deprivation may lead to worsening of epilepsy during pregnancy.

Lidocaine-induced Seizures in Patients with History of Epilepsy: Effect of Antiepileptic Drugs

2002 ◽  
Vol 97 (3) ◽  
pp. 737-739 ◽  
Author(s):  
John C. DeToledo ◽  
Alireza Minagar ◽  
Merredith R. Lowe
Keyword(s):  
Antiepileptic Drugs ◽  
History Of ◽  
History Of Epilepsy

scholarly journals CONVULSIVE STATUS EPILEPTICUS

2016 ◽  
Vol 23 (06) ◽  
pp. 660-664
Author(s):  
Dileep Kumar ◽  
Awais Bashir Larik ◽  
Amir Shahzad
Keyword(s):  
Status Epilepticus ◽  
Hospital Mortality ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Care Facility ◽  
Convulsive Status Epilepticus ◽  
Inhospital Mortality ◽  
Tertiary Care Facility ◽  
History Of ◽  
History Of Epilepsy

Objectives: To determine the in hospital mortality of convulsive status epilepticusin a tertiary care facility. Study Design: Cross sectional study. Place and Duration of Study:Neurology ward, Jinnah Postgraduate Medical Centre, Karachi, Medicine Department ofPeoples University Of Medical And Health Sciences Nawabshah from July 2015- Dec 2015.Material and Methods: All patients of either gender with age >15 years with status epilepticus,were included in the study. A detailed clinical history and relevant neurological examinationwas performed. All the patients who fulfill the inclusion criteria were enrolled in the study afterinformed written consent and explanation of the study protocol. All the information including inhospital mortality was entered on annexed proforma. All the patients were observed three to fivedays. Results: A total of 108 patients were included in this study fulfilling the inclusion criteria.The overall mean age of these patients was 31.3 ± 13.5 years. The age range of these patientswas 16 to 76 years. History of epilepsy was found in 106 (93.5%) of the patients, 88 (81.5%) ofthe patients had status epilepticus in past, 56 (51.9%) of the patients had drug withdrawal, 20(18.5%) of the patients had febrile illness and 2 (1.9%) of the patients had in hospital mortality.There was no statistical significance proportion difference was observed when comparedgender, history of epilepsy and status of epilepticus in past by in hospital mortality (p-values>0.05). Statistical significance proportion difference (p-value <0.05) was found in age and inhospital mortality. Conclusion: We recommend further studies to reach the firm conclusion.

scholarly journals Status Epilepticus in Adults: A 6-Year Retrospective Study

2014 ◽  
Vol 3 (3) ◽  
pp. 153-59
Author(s):  
Maryam Poursadeghfard ◽  
Zabihollah Hashemzehi ◽  
Nahid Ashjazadeh
Keyword(s):  
Status Epilepticus ◽  
Cerebral Infarction ◽  
High Mortality ◽  
P Value ◽  
Fars Province ◽  
Mortality And Morbidity ◽  
Common Causes ◽  
Epileptic Patients ◽  
History Of ◽  
History Of Epilepsy

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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