Status Epilepticus

1993 ◽  
Vol 6 (6) ◽  
pp. 271-277
Author(s):  
Donna J. Schroeder ◽  
Brian K. Alldredge
Keyword(s):  
Status Epilepticus ◽  
Drug Therapy ◽  
Anticonvulsant Drug ◽  
Medical Emergency ◽  
High Dose ◽  
Metabolic Disturbances ◽  
Neurological Sequelae ◽  
History Of ◽  
History Of Epilepsy ◽  
Special Circumstances

Status epilepticus is a medical emergency that requires prompt intervention with effective anticonvulsant drug therapy to minimize the risk of morbidity and mortality. Although status epilepticus can occur as the first presentation of seizures, it is more common in patients who have a history of epilepsy. Metabolic disturbances, stroke, infection, and head trauma can also precipitate repetitive or continuous seizures and, if possible, the underlying etiology should be corrected as the first step in effective management. Permanent neurological sequelae are more likely as the duration of status epilepticus exceeds 90 minutes. In this regard, it is essential that anticonvulsant drug therapy is initiated as soon as possible. Benzodiazepines (diazepam, Iorazepam) are commonly used as the agents of choice for early termination of status epilepticus. Phenytoin and phenobarbital are also useful because of their long-lasting anticonvulsant effects. Other agents that may be useful under special circumstances include midazolam, fosphenytoin (phenytoin prodrug), sodium valproate, paraldehyde, and high-dose barbiturates.

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.

scholarly journals METHANOL POISONING;

2017 ◽  
Vol 24 (03) ◽  
pp. 490-494
Author(s):  
Aurangzeb Afzal ◽  
Sana Fatima ◽  
Aizaz Mand Ahmed
Keyword(s):  
Formic Acid ◽  
Blood Gases ◽  
Metabolic Disturbances ◽  
Severe Metabolic Acidosis ◽  
Blurred Vision ◽  
Neurological Sequelae ◽  
Methanol Poisoning ◽  
Arterial Blood ◽  
Intravenous Hydration ◽  
History Of

Acute methanol poisoning produces severe metabolic acidosis, increased anionand osmolal gaps. These metabolic disturbances are due to accumulation of formic acid withhas serious neurological sequelae. If renal functions starts deteriorating that is associated withincreased mortality. Early diagnosis and treatment can reduce morbidity and mortality. Treatmentinclude infusion of sodium bicarbonate and administration of ethanol orally or parentally to inhibitthe production of formic acid from methanol. Hemodialysis is helpful in removal of methanoland its breakdown products from circulation and also in correcting acidosis. We report thecase of a boy admitted to the emergency room with a history of acute illness, characterized bynausea, vomiting, blurred vision, and shortness of breath. Arterial blood gases showed severemetabolic acidosis with high anion gap. He had ingested large quantity of alcohol containingmethanol. The patient was managed with hemodialysis and strong intravenous hydration. Heimproved well and made a full recovery.

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.

scholarly journals Epileptic Convulsions Probably Induced by Desloratadine, a Second-Generation H1-Antihistamine

2020 ◽  
Author(s):  
Xiaonian Han ◽  
Xin Zan ◽  
Fengmei Xiong ◽  
Xiaojing Nie ◽  
Lirong Peng
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Drug Therapy ◽  
Side Effects ◽  
Second Generation ◽  
Healthy Children ◽  
Probability Scale ◽  
H1 Antihistamines ◽  
History Of ◽  
History Of Epilepsy

Second-generation H1-antihistamines are generally considered to be safe. Here we describe a healthy boy who developed left-arm convulsions after repeated exposure to a dry suspension of desloratadine combined with Huatengzi granules. The boy had no family or disease history of epilepsy, convulsions, or any other drug therapy. The Naranjo Adverse Drug Reaction Probability Scale was used to determine that the convulsions were probably related to desloratadine. Our findings suggest that desloratadine (a second-generation H1-antihistamine) can cause epileptic convulsions in healthy children, and so clinicians should be vigilant of the possibility of central side effects.

scholarly journals Lamotrigine Induced DRESS Syndrome in a Child: A Case Report and Literature Review

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1063
Author(s):  
Chien-Heng Lin ◽  
Sheng-Shing Lin ◽  
Syuan-Yu Hong ◽  
Chieh-Ho Chen ◽  
I-Ching Chou
Keyword(s):  
Drug Reaction ◽  
Case Report ◽  
Skin Rash ◽  
Stable Condition ◽  
Anticonvulsant Drug ◽  
Dress Syndrome ◽  
Life Threatening ◽  
History Of ◽  
History Of Epilepsy ◽  
Systemic Symptoms

Lamotrigine is an important anticonvulsant drug. Its use, however, has been limited by the risk of potentially life-threatening dermatological reactions, such as a drug reaction with eosinophilia and systemic symptoms (DRESS). Here, we report the case of a 7-year-6-month-old girl with a history of epilepsy who developed a skin rash with dyspnoea after 2 weeks of lamotrigine treatment, with DRESS ultimately being diagnosed. After discontinuation of the offending drug and the initiation of systemic glucocorticosteroids, the DRESS symptoms were relieved and the patient was discharged in a stable condition. Anticonvulsant drugs such as lamotrigine are among the factors that induce DRESS in children. When a patient displays skin rash and systemic organ involvement following the initiation of an anticonvulsant drug, DRESS should not be overlooked as a diagnosis, and immunosuppressant drugs should be considered as an option for treating DRESS patients.

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 Lamotrigine induced DRESS syndrome in a child: a case report and literature review

2021 ◽  
Author(s):  
Chien-Heng Lin ◽  
Sheng-Shing Lin ◽  
Syuan-Yu Hong ◽  
Chieh-Ho Chen ◽  
I-Ching Chou
Keyword(s):  
Drug Reaction ◽  
Case Report ◽  
Literature Review ◽  
Skin Rash ◽  
Anticonvulsant Drug ◽  
Dress Syndrome ◽  
Life Threatening ◽  
History Of ◽  
History Of Epilepsy ◽  
Systemic Symptoms

Abstract BackgroundLamotrigine is an important anticonvulsant drug. Its use, however, has been limited by the risk of potentially life-threatening dermatological reactions, such as drug reaction with eosinophilia and systemic symptoms (DRESS).Case presentationHere, we report the case of a 7-year-6-month-old girl with a history of epilepsy who developed a skin rash with dyspnoea after 2 weeks of lamotrigine treatment, with DRESS ultimately being diagnosed. After discontinuation of the offending drug and the initiation of systemic glucocorticosteroids, the DRESS symptoms were relieved and the patient was discharged in stable condition.ConclusionAnticonvulsant drugs such as lamotrigine among the factors that induce DRESS in children. When a patient displays skin rash and systemic organ involvement following the initiation of an anticonvulsant drug, DRESS should not be overlooked as a diagnosis, and immunosuppressant drugs should be considered as an option for treating DRESS patients.

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.

Seizures and Status Epilepticus

2017 ◽  
Author(s):  
Pravin Taneja
Keyword(s):  
Status Epilepticus ◽  
Neurological Disorders ◽  
Emergency Situation ◽  
World Population ◽  
The World ◽  
Life Threatening ◽  
History Of ◽  
History Of Epilepsy ◽  
Severity Of The Disease ◽  
The U.S

Epilepsy is one of the most prevalent chronic neurological disorders both in the U.S. and worldwide, effecting ~1% of the world population. As a result, patients with a history of epilepsy frequently present for surgery. It is important to be aware of how to best characterize the severity of the disease, and treat seizures should they be encountered. In this chapter, we review the epidemiology and pathophysiology of epilepsy. We also discuss the most severe and life threatening form of the condition, status epilepticus. In this emergency situation it is critical that seizures be terminated, and supportive care given. We delineate initial treatment steps and medications, in addition to providing recommendations for refractory cases.

scholarly journals Approaches to teaching children with epilepsy and/or past status epilepticus (within the prin- ciples of inclusive education)

2021 ◽  
Vol 15 (3-4) ◽  
pp. 35-40
Author(s):  
V. M. Frolova ◽  
E. E. Kozharskaya
Keyword(s):  
Status Epilepticus ◽  
Healthcare Professional ◽  
Inclusive Education ◽  
Statistical Data ◽  
Educational Institution ◽  
Social Adaptation ◽  
Approaches To Teaching ◽  
Emergency Plan ◽  
History Of ◽  
History Of Epilepsy

This article discusses the problem of school education as one of the aspects of social adaptation of children diagnosed with epilepsy and / or children with a history of status epilepticus. The authors provide statistical data on the prevalence of epilepsy among children of different ages and information on disease control. We collected the data of patients followed-up in Mytishchi Children’s Polyclinic No. 4. Using our own experience and publications of other authors, we have developed a number of recommendations that can potentially make the presence of a child with a history of epilepsy and / or status epilepticus in an educational institution more comfortable and safe. In particular, we have suggested creating an emergency plan for each child in case of seizures. This plan should be given to a healthcare professional working in the educational institution, as well as to teachers who are responsible for the life and health of the child during classes.

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