scholarly journals Non-convulsive Status Epilepticus in Children, Electro-Clinical Profile and Response to a Specific Treatment Protocol

1970 ◽  
Vol 33 (3) ◽  
pp. 90-99
Author(s):  
Selina Husna Banu ◽  
Mostafa Mahbub ◽  
AZM Moshiul Azam ◽  
Shipra Rani ◽  
Naila Z Khan
Keyword(s):  
Status Epilepticus ◽  
De Novo ◽  
Involuntary Movement ◽  
Treatment Protocol ◽  
Specific Treatment ◽  
Convulsive Status Epilepticus ◽  
Daily Routine ◽  
Related Information ◽  
Specific Protocol ◽  
Long Time

Objective: Non-convulsive status epilepticus (NCSE) is an under-diagnosedneurological condition. We report the electroclinical profile and treatment outcome ofchildren diagnosed with NCSE.Methods: Total 45 children were identified with NCSE at the EEG laboratory fromSeptember 2004 to January 2009. Their presenting complaints, past clinical andbirth related information were meticulously recorded. On diagnosis the referringphysicians were requested to repeat the test after starting treatment. Later they weretreated with a specific protocol on admission at the Neurology Unit of Dhaka ShishuHospital. Two lines of treatment with daily routine EEGs were introduced. Electroclinicaloutcome were recorded on discharge. The children are still on regular followup to record the long-time result of the protracted treatment.Results: Motor regression and postural problem were the primary complaints in themajority (37/45, 82%) followed by involuntary movement, muscle twitching, jerks orfrequent fall (31/45, 69%), speech regression (29, 64%) and change of usual behavior(25/45, 56%). Prior major seizures (generalized tonic clonic, tonic or clonic) wasreported in 32/45, 71%, within 1 week to 1 year. Initial diagnosis was multiple includinghysteric conversion reaction, post-ictal regression or neuro-degenerative disorder.None was suspected with NCSE. Diagnosis was confirmed by the EEG finding ofcontinuous generalized (82%) or localized (18%) slow spike-wave complexes. Onprotracted treatment, 82% achieved the target.Conclusion: NCSE is common in children, may occur de-novo. The variable phenotypemay lead to erroneous diagnosis. A protracted treatment protocol is suggested. Furtherreporting on this issue will help to assist the clinicians for early-diagnosis and treatment.Key words: non-convulsive status epilepticus; electro-clinical diagnosis; motorfunctional regression; speech regression; behavioural changes.DOI: 10.3329/bjch.v33i3.5689Bangladesh Journal of Child Health 2009; Vol.33(3): 90-99

scholarly journals Immediate Treatment Outcome of Convulsive Status Epilepticus Following a Specific Management Protocol

2019 ◽  
Vol 5 (1) ◽  
pp. 33-37
Author(s):  
Jobaida Parvin ◽  
Narayan Chandra Saha ◽  
Dipa Saha ◽  
Sk Azimul Huque ◽  
Ariful Islam ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Behavioral Problems ◽  
Treatment Guidelines ◽  
Neuronal Damage ◽  
Treatment Protocol ◽  
Specific Treatment ◽  
Convulsive Status Epilepticus ◽  
College Hospital ◽  
Systemic Complications ◽  
Management Protocol

Background: Status epilepticus (SE) is a medical and neurologic emergency. Rapid and aggressive treatmentis required to prevent neuronal damage, systemic complications and death. Standardized treatment guidelines may improve the quality of emergency managementof SE. Objectives: The objective of the present study was to assess under lying causes of seizure and the immediate outcome of treatment following the specific proposed management protocol care. Methodology: This cross-sectional study was undertaken on 94 consecutive cases admitted inPediatrics department of Dhaka Medical College Hospital, Dhaka diagnosed as convulsive status epilepticus, age<15 years from September, 2012 – February, 2013. Cases were treated with specific institutional protocol. Under lying causes, outcome of the treatment and side effects of the drugs used were analyzed. Results: Among 94 cases, most of the patients belonged to 6 months - 5 years (73.34%), M: F was1.17:1. The leading presenting features were fever (75.53%), headache (36.17%), meningeal irritation (22.34%).Major causes of convulsive status epilepticus were febrile convulsion (42.6%), meningitis (22.3%), and epilepsy (21.3%), more than two-third (71%) had GTCS, 29% had focal seizure. Most of them presented within 6 hours of convulsion and nearly half of the patient responded to per-rectal diazepam with complete recovery and without any residual problems. A very few cases developed immediate or late behavioral problems or residual neurological deficit like hemiplegiaand epilepsy. Conclusion: Establishing causative factors and early intervention with specific treatment protocol can make rapid seizure control with better outcome. Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 33-37

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.

Determining Peritoneal Dialysis Prescriptions by Employing a Patient -Specific Protocol

1993 ◽  
Vol 13 (3) ◽  
pp. 189-193 ◽  
Author(s):  
Paul M. Zabetakis ◽  
Randi Krapf ◽  
Maria v. DeVita ◽  
Gilbert W. Gleim ◽  
Michael F. Michelis
Keyword(s):  
New York ◽  
Peritoneal Dialysis ◽  
Creatinine Clearance ◽  
Treatment Protocol ◽  
Specific Treatment ◽  
Simple Calculation ◽  
Patient Specific ◽  
Specific Protocol ◽  
Continuous Cycling ◽  
Dialysate Volume

Objective To develop a formula that would permit a rapid and simple calculation of required dialysate volume needed to provide a predetermined daily creatinine clearance. Design Prospective study of peritoneal dialysis patients followed for 6 months. Setting A primary care teaching hospital in New York. Patients Twenty-six patients beginning peritoneal dialysis entered and completed the study. Intervention By employing each patient's measured peritoneal equilibration test (PET) and a standard clearance formula, a patient-specific treatment protocol (PSP) was calculated. The PET 2-hour DIP croat was used for continuous cycling peritoneal dialysis (CCPD) and the 4hour DIP patients on continuous ambulatory peritcornoeal dialysis (CAPD) to determine a PSP that would provide a minimum of 6 L of creatinine clearance daily. Main Outcome Measures Patients were followed for 6 months to assess the ability of this approach of maintaining acceptable levels of blood urea nitrogen, creatinine, albumin, and hematocrit over the 6–month period of observation. Results Our study of 26 patients revealed that only 6 patients (23%) could be treated with the standard prescription of 8 L/day on CAPD. The remaining 77% of our patients required 9–13 L/day for CAPD and 12–21 L/day for CCPD. All patients were free of uremic symptoms and demonstrated acceptable biochemical parameters over a 3–6 month period of observation. Conclusions A patient-specific protocol utilizing individually derived PET data provides an acceptable and easy to calculate initial treatment prescription for each patient that avoids the necessity for trial and error that has heretofore been employed.

scholarly journals De novo generalised non-convulsive status epilepticus triggered by piperacillin/tazobactam

Seizure ◽  
2010 ◽  
Vol 19 (8) ◽  
pp. 529-530 ◽  
Author(s):  
José L. Fernández-Torre ◽  
Carlos Santos-Sánchez ◽  
Ana Lara Pelayo
Keyword(s):  
Status Epilepticus ◽  
De Novo ◽  
Convulsive Status Epilepticus

scholarly journals Prognostic Effects of Treatment Protocols for Febrile Convulsive Status Epilepticus in Children

2021 ◽  
Author(s):  
Shoichi Tokumoto ◽  
Masahiro Nishiyama ◽  
Hiroshi Yamaguchi ◽  
Kazumi Tomioka ◽  
Yusuke Ishida ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Cerebral Performance Category ◽  
Treatment Protocol ◽  
Treatment Strategies ◽  
Convulsive Status Epilepticus ◽  
Barbiturate Coma ◽  
Historical Cohort ◽  
Treatment Protocols ◽  
Poor Outcome ◽  
Attending Physician

Abstract Background: Febrile status epilepticus is the most common form of status epilepticus in children. No previous reports compare the effectiveness of treatment strategies using fosphenytoin (fPHT) or phenobarbital (PB) and those using anesthetics as second-line anti-seizure medication for benzodiazepine-resistant convulsive status epilepticus (CSE). We aimed to examine the outcomes of various treatment strategies for febrile convulsive status epilepticus (FCSE) in a real-world setting while comparing the effects of different treatment protocols and their presence or absence.Methods: This was a single-center historical cohort study that was divided into three periods. Patients who presented with febrile convulsive status epilepticus for ≥60 min even after the administration of at least one anticonvulsant were included. During period I (October 2002–December 2006), treatment was performed at the discretion of the attending physician, without a protocol. During period II (January 2007–February 2013), barbiturate coma therapy (BCT) was indicated for FCSE resistant to benzodiazepines. During period III (March 2013–April 2016), BCT was indicated for FCSE resistant to fPHT or PB. Results: The rate of EEG monitoring was lower in period I than period II+III (7.7% vs. 83.3%, p<0.01). Midazolam was administered by continuous infusion more often in period I than period II+III (84.6% vs. 25.0%, p<0.01), whereas fPHT was administered less often in period I than period II+III (0% vs. 27.4%, p<0.01). The rate of poor outcome, which was determined using the Pediatric Cerebral Performance Category scale, was higher in period I than period II+III (23.1% vs. 7.1%, p=0.03). The rate of poor outcome did not differ between periods II and III (4.2% vs. 11.1%, p=0.40).Conclusions: While the presence of a treatment protocol for FCSE in children may improve outcomes, a treatment protocol using fPHT or PB may not be associated with better outcomes.

scholarly journals Convulsive status epilepticus in children: Etiology, treatment protocol and outcome

Seizure ◽  
2011 ◽  
Vol 20 (2) ◽  
pp. 115-118 ◽  
Author(s):  
Eylem Ulas Saz ◽  
Bulent Karapinar ◽  
Mustafa Ozcetin ◽  
Muzaffer Polat ◽  
Ayse Tosun ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Treatment Protocol ◽  
Convulsive Status Epilepticus
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