Seizures and Vaping—A Report of Two Cases

2021 ◽  
Author(s):  
Peter S Tatum ◽  
Joel M Oster
Keyword(s):  
Qualitative Study ◽  
Antiepileptic Drug ◽  
Clinical Course ◽  
Onset Seizure ◽  
Single Institution ◽  
New Onset

ABSTRACT The purpose of this qualitative study is to describe the clinical course of two patients who presented with new-onset seizures within hours of vaping and to survey neurologists’ screening for vaping in such patients. A 30-subject single-institution survey found that 19 out of 30 neurology providers have not been subjectively qualifying vaping as a potential seizure-provoking factor since the 2019 emergence of literature on this topic. Inquiring about vaping during a new-onset seizure assessment could lead to earlier recognition of a seizure-provoking factor. Further investigations into the epileptogenicity of vaping are needed and the utility of AntiEpileptic Drug (AED) initiation for these patients is currently unknown.

scholarly journals New-Onset Seizure With Possible Limbic Encephalitis in a Patient With COVID-19 Infection: A Case Report and Review

2021 ◽  
Vol 9 ◽  
pp. 232470962098630
Author(s):  
Riwaj Bhagat ◽  
Barbara Kwiecinska ◽  
Nolan Smith ◽  
Matthew Peters ◽  
Christopher Shafer ◽  
...  
Keyword(s):  
Brain Magnetic Resonance Imaging ◽  
Nasopharyngeal Swab ◽  
Onset Seizure ◽  
Cerebrospinal Fluid Analysis ◽  
Fluid Analysis ◽  
Global Pandemic ◽  
Elevated Protein ◽  
T2 Hyperintensity ◽  
Elevated Protein Level ◽  
New Onset

With the outbreak of COVID-19 (coronavirus disease 2019) as a global pandemic, various of its neurological manifestations have been reported. We report a case of a 54-year-old male with new-onset seizure who tested positive for severe acute respiratory syndrome coronavirus 2 from a nasopharyngeal swab sample. Investigative findings, which included contrast-enhancing right posterior temporal lobe T2-hyperintensity on brain magnetic resonance imaging, right-sided lateralized periodic discharges on the electroencephalogram, and elevated protein level on cerebrospinal fluid analysis, supported the diagnosis of possible encephalitis from COVID-19 infection. The findings in this case are placed in the context of the existing literature.

scholarly journals Disseminated Nocardia beijingensis Infection in an Immunocompetent Patient

2020 ◽  
Author(s):  
Moni Roy ◽  
Annia Martial ◽  
Sharjeel Ahmad
Keyword(s):  
Literature Review ◽  
Immunocompetent Patient ◽  
Chest Ct ◽  
Primary Site ◽  
Immunocompetent Host ◽  
Onset Seizure ◽  
Pulmonary System ◽  
Life Threatening ◽  
Immunocompromised Hosts ◽  
New Onset

Nocardia is a genus of aerobic, non-motile and non-spore-forming filamentous branching bacteria with fragmentation into bacillary or coccoid forms. Infections caused by Nocardia often occur in immunocompromised hosts and are potentially life-threatening. Nocardia beijingensis has rarely been reported to cause infection in immunocompetent hosts. We present a case of disseminated infection due to Nocardia beijingensis in a patient with no known medical comorbidities, who presented with new-onset seizure. Another interesting finding in our case is that our patient did not have any pulmonary symptoms despite chest CT showing the pulmonary system as the likely primary site of infection. As per our literature review, this is the seventh reported case of infection due to Nocardia beijingensis in an immunocompetent host.

RADT-02. FACTORS ASSOCIATED WITH NEW-ONSET SEIZURES AFTER STEREOTACTIC RADIOSURGERY FOR NEWLY DIAGNOSED BRAIN METASTASES

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi41-vi41
Author(s):  
Ethan Srinivasan ◽  
Emily Lerner ◽  
Ryan Edwards ◽  
Aden Haskell-Mendoza ◽  
David Huie ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Target Volume ◽  
Newly Diagnosed ◽  
Single Institution ◽  
Primary Tumor Site ◽  
Significant Difference ◽  
Total Treatment ◽  
Treatment Volume ◽  
New Onset

Abstract INTRODUCTION Stereotactic radiosurgery (SRS) is a highly effective therapy for newly diagnosed brain metastases. Risk factors for new-onset seizures after SRS have not been well established. In this study, we aimed to characterize the variables predictive of seizure risk. METHODS Patients treated with SRS for newly diagnosed brain metastases were retrospectively reviewed at a single institution. Data on baseline demographics, radiation parameters, and clinical courses were collected. RESULTS 120 patients without previous seizure history were identified. Median age was 65 years (56-70.8) and baseline KPS 90 (80-90). 16 (13%) patients developed new-onset seizures within 3 months of SRS. In analyses comparing patients with and without new-onset seizures, there was no association between new-onset seizures and baseline KPS(90:80, p=0.48), prior resection (31%:28%, p=0.76), prior WBRT (6%:10%, p=1), immunotherapy or chemotherapy within 1 month (31%:21%, p=0.52 and 56%:57%, p=1), primary tumor site (p=0.07), number of lesions (2.2:3, p=0.21), cerebellar (25%:37%, p=0.41) or brainstem involvement (19%:14%, p=0.71), irradiated maximum target diameter (2.8:2.0cm p=0.191), maximum target volume (7.6:2.9 cm3 p=0.133), total dose of radiation (25:20Gy, p = 0.12), or use of fractionation (56%:35%, p=0.11). However, there was a significant difference in the total irradiated target volume (11.6 vs. 3.8 cm3, p=0.019) and a trend toward increased post-treatment seizures among patients with a total irradiated volume greater than 10cm3 (20%:9%, p=0.11, OR 2.4 [0.85-6.4]). Patients with seizures were also more likely to have received steroids (69%:34%, p=0.012) and AEDs (28%:15%, p=0.021) prior to SRS. CONCLUSIONS Our data suggest that total treatment volume is associated with new-onset seizures within 3 months of SRS. The association between seizures and exposure to steroids or AEDs prior to SRS may be a surrogate for neurologic symptoms at presentation. Patients undergoing SRS to larger volumes and necessitating prophylactic steroids or AEDs may benefit from counseling or intensification of anti-seizure therapy.

scholarly journals Neurocysticercosis Diagnosed by Taenia solium PCR on Brain Biopsy

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Sean Wei Xiang Ong ◽  
Jean-Marc Chavatte ◽  
Jonathan Wei Zhong Chia ◽  
Ramez Wadie Kirollos ◽  
Yih Yian Sitoh ◽  
...  
Keyword(s):  
Taenia Solium ◽  
Granulomatous Inflammation ◽  
Brain Biopsy ◽  
Onset Seizure ◽  
Diagnostic Role ◽  
Pcr Products ◽  
Polymerase Chain ◽  
Temporal Lobe Lesion ◽  
New Onset

Neurocysticercosis is a common cause for brain lesions and adult-onset epilepsy in endemic countries. However, diagnosis is challenging in the absence of typical radiologic or histopathologic features. In this case report, we present a case of a 35-year-old male with a new-onset seizure and a rim-enhancing temporal lobe lesion. Radiologic features were nonspecific, and brain biopsy was performed. Histologic features showed only nonspecific granulomatous inflammation, and the diagnosis of neurocysticercosis was confirmed only with polymerase chain reaction (PCR) testing on brain biopsy tissue demonstrating PCR products consistent with Taenia solium. This case highlights the diagnostic role of PCR in such clinical situations whereby the diagnosis is unclear after initial routine evaluation.

scholarly journals Qualitative study of barriers to clinical trial retention in adults with recently diagnosed type 1 diabetes

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e022353 ◽  
Author(s):  
Catherine Henshall ◽  
Parth Narendran ◽  
Robert C Andrews ◽  
Amanda Daley ◽  
Keith A Stokes ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Type 1 Diabetes ◽  
Qualitative Study ◽  
Qualitative Methodology ◽  
Cell Function ◽  
Retention Rates ◽  
Newly Diagnosed ◽  
Advance Study ◽  
New Onset

ObjectivesRegular physical exercise may preserve β cell function in newly diagnosed adults with type 1 diabetes (T1D). However, clinical trials to test this theory require the recruitment and retention of adults with new-onset T1D, which can be challenging. We sought to determine the overall experiences of newly diagnosed adults with T1D in an exercise study, to understand issues that influence the retention of trial participants in such studies.DesignQualitative methodology using individual face-to-face (n=6) and telephone interviews (n=14). Interview transcripts were thematically analysed using the framework method.SettingThe study took place at five participating UK hospitals.ParticipantsTwenty participants, aged 19–55 years, in the Exercise for Type 1 Diabetes study were interviewed to explore their study experiences and identify motivators and deterrents towards the study. Participants in control and intervention arms were interviewed, as were people with T1D who had completed (n=16) and withdrawn (n=4).ResultsParticipants revealed barriers and facilitators to retention; the majority were generalisable to clinical trials of people with newly diagnosed T1D. Coming to terms with a diagnosis of T1D, lack of time, work pressures, level of health professional support, volume, clarity and consistency of information and feedback and a desire for knowledge about their condition were all cited as influencing factors to trial retention.ConclusionsTo our knowledge, this is the first qualitative study to examine the experience of being involved in an exercise trial by people with T1D. Findings suggest appointments could be shorter, available outside of working hours and planned longer in advance; study information should be clear, consistent and in electronic and paper formats; questionnaires need minimising; healthcare support and feedback needs providing regularly; thought is required around how to support non-exercising arm participants. These considerations may improve participant retention rates in new-onset T1D studies.

scholarly journals Childhood Neurocysticercosis: Clinico-Radiological Profile and Outcome

1970 ◽  
Vol 28 (1) ◽  
pp. 14-16 ◽  
Author(s):  
BM Shrestha
Keyword(s):  
Secondary Level ◽  
Preschool Age ◽  
Onset Seizure ◽  
Insufficient Information ◽  
Mri Findings ◽  
Neurological Illness ◽  
Preschool Age Children ◽  
Neuro Imaging ◽  
New Onset

Neurocysticercosis (NCC) is a major cause of neurological illness worldwide. It is the most common identifiable cause of partial seizure especially in the children of developing world. There is insufficient information about NCC in children in Nepal. This study was, therefore, conducted to evaluate the clinical, neuro-radiographic and therapeutic aspects of NCC in children. Material and Methods: 68 children with this neurocysticercosis were studied prospectively in 20 months in the Lumbini Zonal Hospital (LZH), a secondary-level-referral hospital in the Western Nepal. The diagnosis of NCC was based primarily on the neuro-imaging (CT/MRI) findings. Results: The patients were predominantly females (nearly 65%) with age ranging from 2 to 14 years. Preschool-age children constituted 10% of the patients. The three common manifestations were seizures (91%), headache and or vomiting (38%) and hemi and or monoparesis (15%). CT/MRI demonstrated a single parenchymal ring or nodular enhancing lesion (REL) in 84% of cases with perilesional oedema in nearly 90% of cases. A large majority of patients were treated only with the anticonvulsant drugs (ACDs) for 9 months. Follow-up with repeat CT after 6 months showed a complete resolution of NCC in most of the cases without the need for cysticidal treatment. Conclusion: NCC should be considered first in the differential diagnosis of new-onset seizure among the children of developing countries, where taeniasis is endemic. Most of the patients with NC do not need anticysticercal therapy. Keywords: Seizure, Children, Cysticercosis, CNS, Western Nepal.   DOI = 10.3126/jnps.v28i1.1400   J. Nepal Paediatr. Soc. Vol.28(1) p.14-16

scholarly journals Mortality & recurrent seizure risk after new-onset seizure in HIV-positive Zambian adults

BMC Neurology ◽  
2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Melissa A. Elafros ◽  
Brent A. Johnson ◽  
Omar K. Siddiqi ◽  
Jason F. Okulicz ◽  
Izukanji Sikazwe ◽  
...  
Keyword(s):  
Hiv Positive ◽  
Onset Seizure ◽  
Recurrent Seizure ◽  
New Onset
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