scholarly journals 019 Differentiating status epilepticus from prolonged psychogenic non-epileptic seizures – can peripheral cell ratios help?

2021 ◽  
Author(s):  
Tracie HL Tan ◽  
Piero Perucca ◽  
Patrick Kwan ◽  
Terence J O’Brien ◽  
Mastura Monif
Keyword(s):  
Status Epilepticus ◽  
Epileptic Seizures ◽  
Peripheral Cell

Neurologist, 26 years’ experience, Turkey

2020 ◽  
pp. 269-271
Author(s):  
Markus Reuber ◽  
Gregg H. Rawlings ◽  
Steven C. Schachter
Keyword(s):  
Status Epilepticus ◽  
Behavioral Problems ◽  
Psychiatric Treatment ◽  
Past History ◽  
Epileptic Seizures ◽  
Teenage Girl ◽  
The Third ◽  
Physical Injuries ◽  
Serious Infection ◽  
Different Types

This chapter explores the experience of a Neurologist who has seen many different types of Non-Epileptic Seizures, from very hyperactive and even aggressive movements to dissociative-like symptoms. It specifically considers the stories of three patients at different ages with different manifestations. The first patient was an older lady whose seizures seemed to be aggravated after menopause. Her past history revealed a serious infection during her first pregnancy, which had resulted in the loss of her baby. During her visit with the Neurologist, she had a seizure in which she was not able to speak, her eyes were deviated upward with eye blinking, and her face looked pale. The second patient was a teenage girl who had started to have seizures diagnosed as status epilepticus after she had been involved in an accident. Later, the Neurologist found out that she had not suffered any serious physical injuries in her head associated with the accident and that she was undergoing psychiatric treatment because of her behavioral problems. The third patient was in her twenties and had had seizures for several years, which always happened at night during sleep. The seizures were described as involving excessive movement and were happening three to four times a month.

Parkinson's disease: Less epileptic seizures more status epilepticus

2014 ◽  
Vol 108 (2) ◽  
pp. 349-354 ◽  
Author(s):  
Berend Feddersen ◽  
Jan Rémi ◽  
Marion Einhellig ◽  
Cordula Stoyke ◽  
Philipp Krauss ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Status Epilepticus ◽  
Epileptic Seizures

Roles of Very Fast Ripple (500–1000Hz) in the Hippocampal Network During Status Epilepticus

2020 ◽  
pp. 2150002
Author(s):  
Jianmin Hao ◽  
Yan Cui ◽  
Bochao Niu ◽  
Liang Yu ◽  
Yuhang Lin ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Temporal Lobe ◽  
Phase Locking ◽  
Epileptic Seizures ◽  
Network Activity ◽  
Slow Oscillations ◽  
Functional Roles ◽  
High Frequency Oscillations ◽  
Epileptiform Discharges ◽  
Hippocampal Network

Very fast ripples (VFRs, 500–1000[Formula: see text]Hz) are considered more specific than high-frequency oscillations (80–500[Formula: see text]Hz) as biomarkers of epileptogenic zones. Although VFRs are frequent abnormal phenomena in epileptic seizures, their functional roles remain unclear. Here, we detected the VFRs in the hippocampal network and tracked their roles during status epilepticus (SE) in rats with pilocarpine-induced temporal lobe epilepsy (TLE). All regions in the hippocampal network exhibited VFRs in the baseline, preictal, ictal and postictal states, with the ictal state containing the most VFRs. Moreover, strong phase-locking couplings existed between VFRs and slow oscillations (1–12[Formula: see text]Hz) in the ictal and postictal states for all regions. Further investigation indicated that during VFRs, the build-up of slow oscillations in the ictal state began from the temporal lobe and then spread through the whole hippocampal network via two different pathways, which might be associated with the underlying propagation of epileptiform discharges in the hippocampal network. Overall, we provide a functional description of the emergence of VFRs in the hippocampal network during SE, and we also establish that VFRs may be the physiological representation of the pathological alterations in hippocampal network activity during SE in TLE.

Notfallversorgung und Erstbehandlung epileptischer Anfälle im Erwachsenenalter

2019 ◽  
Vol 144 (02) ◽  
pp. 83-92
Author(s):  
Johannes Schiefer ◽  
Rainer Surges
Keyword(s):  
Status Epilepticus ◽  
Epileptic Seizures ◽  
Recurrence Risk ◽  
Brain Diseases ◽  
Convulsive Status Epilepticus ◽  
Mri Findings ◽  
Safety Measures ◽  
Anticonvulsant Treatment ◽  
Convulsive Seizures ◽  
Definition Of

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.

scholarly journals Circulating P2X7 Receptor Signaling Components as Diagnostic Biomarkers for Temporal Lobe Epilepsy

Cells ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 2444
Author(s):  
Giorgia Conte ◽  
Aida Menéndez-Méndez ◽  
Sebastian Bauer ◽  
Hany El-Naggar ◽  
Mariana Alves ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Blood Cell ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Plasma Levels ◽  
P2x7 Receptor ◽  
Inflammatory Marker ◽  
Epileptic Seizures ◽  
Egfp Reporter ◽  
Signaling Components

Circulating molecules have potential as biomarkers to support the diagnosis of epilepsy and to assist with differential diagnosis, for example, in conditions resembling epilepsy, such as in psychogenic non-epileptic seizures (PNES). The P2X7 receptor (P2X7R) is an important regulator of inflammation and mounting evidence supports its activation in the brain during epilepsy. Whether the P2X7R or P2X7R-dependent signaling molecules can be used as biomarkers of epilepsy has not been reported. P2X7R levels were analyzed by quantitative ELISA using plasma samples from controls and patients with temporal lobe epilepsy (TLE) or PNES. Moreover, blood cell P2X7R expression and P2X7R-dependent cytokine signature was measured following status epilepticus in P2X7R-EGFP reporter, wildtype, and P2X7R-knockout mice. P2X7R plasma levels were higher in TLE patients when compared with controls and patients with PNES. Plasma levels of the broad inflammatory marker protein C-Reactive protein (CRP) were similar between the three groups. Using P2X7R-EGFP reporter mice, we identified monocytes as the main blood cell type expressing P2X7R after experimentally evoked seizures. Finally, cytokine array analysis in P2X7R-deficient mice identified KC/GRO as a potential P2X7R-dependent plasma biomarker following status epilepticus and during epilepsy. Our data suggest that P2X7R signaling components may be a promising subclass of circulating biomarkers to support the diagnosis of epilepsy.

scholarly journals Misdiagnosis of prolonged psychogenic non-epileptic seizures as status epilepticus: epidemiology and associated risks

2021 ◽  
pp. jnnp-2021-326443
Author(s):  
Johannes Jungilligens ◽  
Rosa Michaelis ◽  
Stoyan Popkirov
Keyword(s):  
Status Epilepticus ◽  
Adverse Effects ◽  
Individual Patient Data ◽  
Clinical Course ◽  
Epileptic Seizures ◽  
Patient Characteristics ◽  
Final Diagnosis ◽  
Treatment Trial ◽  
Anticonvulsant Medication ◽  
Treatment Escalation

ObjectiveTo determine the epidemiology of prolonged psychogenic non-epileptic seizures (pPNES) misdiagnosed as status epilepticus, as well as the risks associated with non-indicated treatment.MethodsWe performed an individual patient data analysis from the Rapid Anticonvulsant Medication Prior to Arrival Trial (RAMPART) and the Established Status Epilepticus Treatment Trial (ESETT) to assess incidence, patient characteristics and clinical course of misdiagnosed pPNES.ResultsAmong 980 patients aged 8 years or older diagnosed and treated for status epilepticus in RAMPART and ESETT, 79 (8.1%) were discharged with a final diagnosis of pPNES. The relative incidence was highest in adolescents and young adults (20.1%). The typical female preponderance seen in that age bracket was not evident in children and older adults. Adverse effects, including respiratory depression and intubation, were documented in 26% of patients with pPNES receiving benzodiazepines in RAMPART and 33% of patients receiving additional second-line medication in ESETT. In ESETT, patients who were treated with benzodiazepines before hospital admission had higher rates of unresponsiveness and severe adverse effects than those treated after admission, suggesting cumulative effects of accelerated treatment momentum. Across trials, one in five patients with pPNES were admitted to an intensive care unit.ConclusionsMisdiagnosis and treatment of pPNES as status epilepticus are a common and widespread problem with deleterious consequences. Mitigating it will require training of emergency staff in semiological diagnosis. Status epilepticus response protocols should incorporate appropriate diagnostic re-evaluations at each step of treatment escalation, especially in clinical trials.

scholarly journals Experience in using injectable valproic acid (convulex) in patients with serial epileptic seizures and status epilepticus at the prehospital stage

2012 ◽  
Vol 0 (1S) ◽  
pp. 53
Author(s):  
Anna Valeryanovna Lebedeva ◽  
V A Karlov ◽  
A M Sidorov ◽  
V L Baratashvili ◽  
V E Khomutov
Keyword(s):  
Valproic Acid ◽  
Status Epilepticus ◽  
Epileptic Seizures
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