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.

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 Etiology, Risk Factors, Mortality and Morbidity of Status Epilepticus in Children: A Retrospective Cross-Sectional Study in Tehran, Iran

2020 ◽  
Vol 14 (1) ◽  
pp. 95-102
Author(s):  
Mohammad Vafaee-Shahi ◽  
Elaheh Soltanieh ◽  
Hossein Saidi ◽  
Aina Riahi
Keyword(s):  
Risk Factors ◽  
Status Epilepticus ◽  
Brain Imaging ◽  
Morbidity And Mortality ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Imaging Results ◽  
History Of ◽  
Abnormal Brain ◽  
Febrile Status Epilepticus

Background: Risk factors identification associated with status epilepticus is valuable in order to prevent morbidity and mortality in children. This study aimed to consider the etiology, risk factors, morbidity and mortality in children with status epilepticus. Methods: This retrospective cross-sectional study was performed on 119 patients aged from one month old to 15 years old. Patients’ data were recorded, including basic demographic, etiology and clinical information. The different risk factors correlated to morbidity and mortality were evaluated in this study. Results: The most common etiologies were acute symptomatic and febrile status epilepticus by 32.8% and 22.7%, respectively. Abnormal brain imaging results were reported far more frequently in patients with a history of neurodevelopmental delay and previous status epilepticus (p<0.001). The overall morbidity and mortality rates were 18.9% and 10.9%, respectively; while these rates in patients with delayed development (45.16% and 18.42%, respectively) were significantly higher than patients with normal development (8% and 7.4%, respectively). The morbidity rates in patients with previous seizures and previous status epilepticus were remarkably higher than those without previous history of seizure (26.41% vs 11.32%; p=0.047) and without previous status epilepticus (36.36% versus 14.28%; p=0.018). The length of hospital stay in patients with mortality was considerably longer than patients without mortality (12.30 ± 16.1 days vs 7.29 ± 6.24 days; p=0.033). The mortality rate in patients with normal Lumbar Puncture result was notably lower than those with abnormal LP result (2.9% vs 50%). The morbidity rate in patients with abnormal brain imaging results (p<0.001) was significantly greater than those in patients with normal results. The mortality rate was relatively higher in patients with abnormal imaging results compared to those normal results. Etiology was an important predictor of mortality and morbidity rates; acute symptomatic (32.8%), febrile status epilepticus (22.7%) and remote symptomatic (16.8%) etiologies were the most common underlying causes of S.E. While in children less than 3 years old, the acute symptomatic etiology and febrile status epilepticus etiologies were estimated as the most common, in most patients older than 3 years old the most common etiology of status epilepticus was unknown. Congenital brain defects etiology had the highest mortality (36.36%) and morbidity (42.85%) rate. The lowest morbidity (3.84%) and mortality (0%) rates were for patients with febrile status epilepticus etiology. Conclusion: Age, developmental delay, history of previous status epilepticus, the length of hospital stay, abnormal brain imaging results and the underlying etiology of status epilepticus were associated with increased morbidity and mortality among children with status epilepticus.

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.

Pneumopericardium in the Neonate

2017 ◽  
Vol 36 (6) ◽  
pp. 368-373
Author(s):  
Tiffany L. Walker ◽  
Dorothy A. Shannon
Keyword(s):  
Mechanical Ventilation ◽  
Birth Weight ◽  
Respiratory Distress ◽  
Premature Infants ◽  
High Mortality ◽  
Neonatal Care ◽  
Mortality And Morbidity ◽  
Surfactant Replacement ◽  
Antenatal Steroids ◽  
History Of

AbstractPneumopericardium occurs when air accumulates in the pericardial sac surrounding the heart and is one of the rarest forms of air leaks in neonates. Because of various advances in neonatal care, including gentler modes of ventilation, surfactant replacement, and antenatal steroids, the incidence of pneumopericardium has decreased. Despite the decrease in incidence of pneumopericardium, most cases arise in premature infants with a history of respiratory distress and mechanical ventilation. Evidence has shown that the incidence is inversely related to birth weight and that pneumopericardium has high mortality and morbidity rates.

scholarly journals Misdiagnoses of Epilepsy as Ekbom Syndrome, Mood Instability, and Nocturnal Visual Hallucinations

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
M. Duarte Mangas ◽  
Y. Martins ◽  
L. Bravo ◽  
A. Matos Pires
Keyword(s):  
Psychiatric Disorder ◽  
Psychiatric Symptoms ◽  
Epileptic Seizures ◽  
Visual Hallucinations ◽  
Mood Instability ◽  
Nonconvulsive Seizures ◽  
Epileptic Patients ◽  
Ekbom Syndrome ◽  
History Of ◽  
History Of Epilepsy

Epileptic seizures may be misdiagnosed if they manifest as psychiatric symptoms. We report three female patients with no preexisting history of epilepsy that were unsuccessfully treated as primary psychiatric disorder: one patient was initially diagnosed with somatization and Ekbom syndrome; the second was referred to psychiatrist due to mood instability and visual hallucinations; and the third one was referred for anxiety and hallucinations related to sleep. A carefully taken medical history clarified diagnoses of epilepsy. None of the patients responded to medications aimed at treating psychiatric symptoms, and all the patients had favorable response to antiepileptic treatment. These cases illustrate that epileptic patients may experience nonconvulsive seizures that might be misdiagnosed as primary psychiatric disorder.

scholarly journals Super-refractory status epilepticus in a 29-year-old pregnant female

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110004
Author(s):  
Cinthya Carrasco ◽  
Audra Schwalk ◽  
Byungkwan Hwang ◽  
Kenneth Iwuji ◽  
Ebtesam Islam
Keyword(s):  
Status Epilepticus ◽  
Antiepileptic Drugs ◽  
High Mortality ◽  
Safety Profile ◽  
Seizure Control ◽  
Prolonged Exposure ◽  
Refractory Status Epilepticus ◽  
Pregnant Female ◽  
Mortality And Morbidity ◽  
Refractory Status

Super-refractory status epilepticus is a rare medical and neurological emergency due to the high mortality and morbidity associated with this condition. Furthermore, there is very little data regarding its incidence, etiology, and management in the pregnant population with super-refractory status epilepticus. The treatment of super-refractory status epilepticus during pregnancy is specifically a major challenge as there are limited available therapeutic options due to the well-established teratogenicity of most antiepileptic drugs and the unknown safety profile of some of the anesthetics commonly used for seizure control. We report a case of successfully treated super-refractory status epilepticus in a 29-year-old, 26 weeks pregnant female who after an emergent delivery and prolonged exposure to multiple antiepileptic drugs recovered full neurological function.

Headache and Epilepsy: Two Autonomous Entities?

Cephalalgia ◽  
1984 ◽  
Vol 4 (1) ◽  
pp. 39-44 ◽  
Author(s):  
Faustino Savoldi ◽  
Amelia Tartara ◽  
Raffaele Manni ◽  
Maurizia Maurelli
Keyword(s):  
Family History ◽  
Epileptic Seizure ◽  
Past History ◽  
Primary Headache ◽  
Headache Attack ◽  
Epileptic Patients ◽  
History Of ◽  
History Of Epilepsy ◽  
The Relationship

The relationship between headache and epilepsy remains unresolved. We studied 3,600 patients affected by primary headache and 36 epileptic patients with a present or past history of headache. In the first group, no family history of epilepsy nor epileptiform EEG patterns were found. In the second group, there was no chronological relationship between epileptic seizure and headache attack in more than half of the patients; when found (46.1%) the relationship was neither precise nor specific. Taken as a whole, these data suggest the autonomous nature of epilepsy and headache.

scholarly journals Pilot Study on Role of Family History of Epilepsy and Consanguinity in Yemeni Epileptic Patients

2018 ◽  
Vol 04 (03) ◽  
Author(s):  
Abdul-Rahman Sallam ◽  
Hadi Mujilli ◽  
Amin Abdulrab ◽  
Zumurudah Haroon
Keyword(s):  
Pilot Study ◽  
Family History ◽  
Epileptic Patients ◽  
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 Refractory status epilepticus – a major problem for the practitioners

2021 ◽  
Vol 64 (2) ◽  
pp. 12-15
Author(s):  
Cornelia Calcii ◽  
◽  
Svetlana Hadjiu ◽  
Mariana Sprincean ◽  
Ludmila Feghiu ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Refractory Status Epilepticus ◽  
Medical Intervention ◽  
Mortality And Morbidity ◽  
Cns Infections ◽  
Refractory Status ◽  
Risk Of Mortality ◽  
Antiepileptic Medication ◽  
Common Causes ◽  
Life Threatening

Introduction: Status epilepticus (SE) is a life-threatening neurological emergency requiring immediate medical intervention and is associated with high mortality and morbidity. The aim of this research was evaluation of clinical and etiological profile of refractory status epilepticus (RSE) among children aged between 1 month and 18 years. Material and methods: The study was done between January 1, 2017 and December 24, 2019. All children with the age limits mentioned above, who presented convulsive SE, subsequently with development in refractory status epileptic (RSE), were included in the study. Patients were investigated and evaluated according to a standard protocol. Subsequently, the characteristics of children with RSE and those without an evolution in RSE were compared. Results: 55 children, out of whom 32 boys with SE were enrolled in the study, of which 20 children (36%) developed RSE. Central nervous system (CNS) infections were the most common causes of SE and development of RSE (51% in SE and 53% in RSE, p > 0.05). Noncompliance of antiepileptic medication served as the second cause for evolution of RSE. The overall mortality rate was 10.9%, the chances of death in RSE (20%) being higher than in SE (5.7%). The unfavorable prognosis was seven times higher in children with RSE, compared to children who developed SE. Conclusions: In the management of CNS infections, pediatricians should be aware of the high risk of developing RSE. In addition, the possibility of developing RSE should be considered and promptly managed in an intensive care unit in order to reduce the risk of mortality and morbidity of this severe neurological condition

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