scholarly journals Chlorpromazine-induced status epilepticus: A case report

2013 ◽  
Vol 141 (9-10) ◽  
pp. 667-670 ◽  
Author(s):  
Dragana Momcilovic-Kostadinovic ◽  
Perisa Simonovic ◽  
Dusan Kolar ◽  
Nebojsa Jovic
Keyword(s):  
Case Report ◽  
Status Epilepticus ◽  
Antipsychotic Agents ◽  
Epileptic Activity ◽  
Psychomotor Development ◽  
Epileptiform Discharges ◽  
Eeg Abnormalities ◽  
History Of ◽  
Neuroleptic Agent ◽  
Spike Wave

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.

scholarly journals Neuropsychological Outcome in Perinatal Stroke Associated With Epileptiform Discharges in Sleep

2017 ◽  
Vol 44 (4) ◽  
pp. 358-365 ◽  
Author(s):  
Aleksandra Mineyko ◽  
Wei Qi ◽  
Helen L. Carlson ◽  
Luis Bello-Espinosa ◽  
Brian L. Brooks ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Multiple Comparisons ◽  
Early Brain Injury ◽  
Population Based ◽  
Receptive Language ◽  
Cognitive Outcome ◽  
Perinatal Stroke ◽  
Epileptiform Discharges ◽  
Eeg Abnormalities

AbstractBackground: Patients with arterial perinatal stroke often suffer long-term motor sequelae, difficulties in language, social development, and behaviour as well as epilepsy. Despite homogeneous lesions, long-term behavioural and cognitive outcomes are variable and unpredictable. Sleep-related epileptic encephalopathies can occur after early brain injury and are associated with global developmental delays. We hypothesized that sleep-potentiated epileptiform abnormalities are associated with worse developmental outcomes after perinatal stroke. Methods: Participants were identified from a population-based cohort (Alberta Perinatal Stroke Project). Inclusion criteria were magnetic resonance imaging–confirmed arterial perinatal stroke, age 4 to 18 years, electroencephalogram (EEG) including sleep, and comprehensive neuropsychological evaluation. Sleep-related EEG abnormalities were categorized by an epileptologist blinded to the cognitive outcome. Associations between EEG classification and neuropsychological outcomes were explored (t tests, Bonferroni correction for multiple comparisons). Results:Of 128 potentially eligible participants, 34 (53% female) had complete EEG (mean age, 8.1 years; range, 0.2-16.4) and neuropsychology testing (mean age, 9.8 years; range 4.4-16.7). Twelve (35%) were classified as having electrical status epilepticus in sleep. Patients with abnormal EEGs were more likely to have statistically worse scores when corrected for multiple comparisons, in receptive language (median, 1st percentile; IQR 1-7th percentile; p<0.05), and externalizing behaviours (median, 82nd percentile; IQR, 79-97th percentile; p<0.05). Conclusions: Developmental outcome in language and behaviour in children with arterial perinatal stroke is associated with electrical status epilepticus in sleep. Increased screening with sleep EEG is suggested, whereas further studies are necessary to determine if treatment of EEG abnormalities can improve outcome.

Use of Unconventional Therapies in Super-refractory Status Epilepticus: A Case Report and Literature Review

2020 ◽  
pp. 155005942097561
Author(s):  
Maria Sole Vallecoccia ◽  
Alessandra Martinotti ◽  
Chiara Siddi ◽  
Cristina Dominedò ◽  
Emiliano Cingolani
Keyword(s):  
Case Report ◽  
Status Epilepticus ◽  
Functional Status ◽  
Refractory Status Epilepticus ◽  
Epileptic Activity ◽  
Cognitive Outcome ◽  
Hospital Length Of Stay ◽  
Mortality And Morbidity ◽  
Refractory Status ◽  
Unconventional Therapies

Super-refractory status epilepticus (SRSE) is a life-threatening condition characterized by the persistence or recurrence of seizures despite the use of first- and second-line antiepileptic drugs and the continuous infusion of anesthetics for more than 24 hours. This has always been a challenge for the physician, given the high mortality and morbidity related to this condition. Unfortunately, there are currently no definitive data to guide the therapy, since most of the therapeutic approaches regarding SRSE come from anecdotal evidence. Here, we present a case report of long-persisting new-onset SRSE treated with unconventional therapies recently reported to be successful such as ketamine, ketogenic diet, and tocilizumab, that could have played an important role in the management of this patient. A review of the literature regarding those is also included. SRSE has been reported to have long hospital length of stay, with a small percentage of patients returning to baseline functional status. Moreover, recent evidence showed that functional and cognitive outcome could depend on seizure duration, so prolonged duration of epileptic activity with abnormalities on the magnetic resonance imaging (MRI) could be seen as a reason to discontinue treatment. However, despite many weeks of seizures and a noncomforting MRI, our patient was discharged with a good functional status.

scholarly journals Successful Hemispherotomy in a Patient with Encephalopathy with Continuous Spikes and Waves during Sleep Related to Neonatal Thalamic Hemorrhage: A Case Report with Intracranial Electroencephalogram Findings

2021 ◽  
Vol 11 (7) ◽  
pp. 827
Author(s):  
Shimpei Baba ◽  
Tohru Okanishi ◽  
Toshiki Nozaki ◽  
Naoki Ichikawa ◽  
Kazuki Sakakura ◽  
...  
Keyword(s):  
Case Report ◽  
Epilepsy Surgery ◽  
Parietal Lobe ◽  
Sinus Thrombosis ◽  
Absence Seizures ◽  
Epileptiform Discharges ◽  
Thalamic Hemorrhage ◽  
First Case ◽  
Eeg Abnormalities ◽  
Continuous Spikes And Waves

Neonatal thalamic hemorrhage is a strong risk factor for developing encephalopathy with continuous spikes and waves during sleep (ECSWS), even when not accompanied by widespread cortical destruction. The efficacy and indication of resective epilepsy surgery in such patients has not yet been reported. A 4-year-old boy was diagnosed with ECSWS based on strong epileptiform activation during sleep and neurocognitive deterioration. He had a history of left thalamic hemorrhage related to a straight sinus thrombosis during the newborn period. He presented with daily absence seizures that were refractory to medical treatment. At age 5, he underwent intracranial electroencephalogram (EEG) recording using depth and subdural strip electrodes placed in the left thalamus and over bilateral cortex, respectively. Interictal and ictal epileptiform discharges were observed in the thalamus, always preceded by discharges in the left or right parietal lobe. Left hemispherotomy successfully normalized the EEG of his unaffected hemisphere and extinguished his seizures. This is the first case report documenting resective epilepsy surgery in a patient with ECSWS due to neonatal thalamic injury without widespread cerebral destruction. Based on intracranial EEG findings, his injured thalamus did not directly generate the EEG abnormalities or absence seizures on its own. Patients with ipsilateral neonatal thalamic injury and even mild lateralized cortical changes may be candidates for resective or disconnective surgery for ECSWS.

scholarly journals Symptomatic Cerebral Ependymal Cyst : A Case Report

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Rauf P ◽  
Aidil MN ◽  
Chan KH ◽  
Saufi A ◽  
Fadli M
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Status Epilepticus ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Neuroepithelial Cyst ◽  
Ependymal Cyst ◽  
History Of ◽  
Occipital Headache ◽  
The Brain

Cerebral ependymal cyst is a rare benign neuroepithelial cyst. We report a case of cerebral ependymal cyst in a 62-year-old lady who presented with status epilepticus. She gave history of progressive right occipital headache over a year. Magnetic Resonance Imaging of the brain showed a large occipital cyst. She underwent a right craniotomy, deroofing of the cyst and insertion of Ommaya catheter. The clinicopathological aspects of the cyst are discussed.

scholarly journals Refractory nonconvulsive status epilepticus in coma: analysis of the evolution of ictal patterns

2012 ◽  
Vol 70 (7) ◽  
pp. 501-505 ◽  
Author(s):  
Paulo Breno Noronha Liberalesso ◽  
Eliana Garzon ◽  
Elza Marcia T. Yacubian ◽  
Américo C. Sakamoto
Keyword(s):  
Status Epilepticus ◽  
Natural History ◽  
Nonconvulsive Status Epilepticus ◽  
Morbidity And Mortality ◽  
Loss Of Consciousness ◽  
Epileptiform Discharges ◽  
Neurological Morbidity ◽  
History Of ◽  
The Relationship

OBJECTIVE: Nonconvulsive status epilepticus (NCSE) is currently considered as one of the most frequent types of status epilepticus (SE). The objective of the present study was to identify the natural history of the electrographical evolution of refractory NCSE and to establish the relationship between ictal patterns and prognosis. METHODS: We analyzed, retrospectively, 14 patients with loss of consciousness and NCSE. The ictal patterns were classified as discrete seizures (DS), merging seizures (MS), continuous ictal discharges (CID), continuous ictal discharges with flat periods (CID-F), and periodic lateralized epileptiform discharges (PLEDs). RESULTS: The ictal patterns were DS (n=7; 50.0%), PLEDs (n=3; 1.4%), CID (n=2; 14.3%), MS (n=1; 7.1%), and CID-F (n=1; 7.1%). CONCLUSIONS: NCSE electrographic findings are heterogeneous and do not follow a stereotyped sequence. PLEDs were related to a higher probability of neurological morbidity and mortality.

scholarly journals Case Report: Althesin in Status Epilepticus

1979 ◽  
Vol 7 (3) ◽  
pp. 267-270 ◽  
Author(s):  
Albert Saady ◽  
D. Wong ◽  
R. G. Hicks
Keyword(s):  
Case Report ◽  
Status Epilepticus ◽  
Continuous Infusion ◽  
Epileptic Activity ◽  
And Control

A case of status epilepticus, resistant to conventional anti-epileptic treatment is described. Althesin rapidly abolished the epileptic activity, and control was achieved by a continuous infusion of Althesin.

scholarly journals Creutzfeldt-Jakob Disease Presenting as Nonconvulsive Status Epilepticus

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Aleksei Rakitin ◽  
Riina Vibo ◽  
Vaiko Veikat ◽  
Anne Õunapuu ◽  
Aive Liigant ◽  
...  
Keyword(s):  
Case Report ◽  
Status Epilepticus ◽  
Clinical Presentation ◽  
Epileptiform Activity ◽  
Epileptic Activity ◽  
Accurate Diagnosis ◽  
Morphological Features ◽  
Nonconvulsive Status Epilepticus ◽  
Spongiform Encephalopathy ◽  
Jakob Disease

Creutzfeldt-Jakob disease is a rare, rapidly progressive spongiform encephalopathy in humans. EEG plays an important role in diagnosing this disease. In some patients, epileptic activity and encephalopathy from various aetiologies may share morphological features on EEG. This similarity could create difficulties in EEG interpretation, especially if the patient presents with disturbed consciousness. In this case report, a 74-year-old female with Creutzfeldt-Jakob disease presented initially with rapidly progressive impairment of consciousness and focal epileptiform activity on EEG. An EEG performed 25 days later showed periodic sharp-wave complexes with triphasic morphology at a rate of 0.5 Hz, compatible with a diagnosis of Creutzfeldt-Jakob disease. Based on these results, we recommend that a diagnosis of Creutzfeldt-Jakob disease be considered in patients presenting with a rapid deterioration of consciousness and a clinical presentation of nonconvulsive status epilepticus. Monitoring these patients with serial EEGs could be useful to establish an accurate diagnosis.

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