scholarly journals Ping-pong gaze in a refractory focal status epilepticus

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Laura Sánchez-Cirera ◽  
◽  
Gary Álvarez Bravo ◽  
Keyword(s):  
Status Epilepticus ◽  
Eye Movement ◽  
Polymorphonuclear Leukocytes ◽  
Brain Lesions ◽  
Pathological Findings ◽  
Fixed Frequency ◽  
Paroxysmal Activity ◽  
Ping Pong ◽  
Level Of Consciousness ◽  
Focal Status Epilepticus

An 83-year-old woman presented to emergency department with fever, low level of consciousness and right deviation in the conjugate gaze. Neurological examination revealed a spontaneous, slow, horizontal and continuous conjugate eye deviation alternating every 2 to 3 seconds. An electroencephalogram revealed periodic paroxysmal activity with a frequency of 2-3 Hz in left frontal hemispheric. Neuroimaging didn’t show pathological findings. Polymorphonuclear leukocytes were observed in CSF without evidence of microorganisms. Antiepileptic therapy was started without improvement. Finally, the patient died because of refractory focal status. Ping Pong Gaze (PPG) is a slow and rhythmical horizontal abnormal eye movement with a fixed frequency that is observed in comatose states and indicates diffuse structural brain lesions with preserved brainstem functions. PPG presence is an indicator of bad prognosis. We describe a PPG case with a synchronous eye movement with the electroencephalogram activity. Keywords: Ping-pong gaze; status epilepticus; electroencephalography; epilepsy; seizure.

Headache and Focal Status Epilepticus as Initial Symptom of POLG Mutation

2015 ◽  
Vol 46 (S 01) ◽  
Author(s):  
M. Bachmann ◽  
U. Albrecht ◽  
M. Baumann ◽  
S. Baumgartner Sigl ◽  
S. Scholl-Bürgi ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Initial Symptom ◽  
Polg Mutation ◽  
Focal Status Epilepticus

Brain pathology in focal status epilepticus: evidence from experimental models

2021 ◽  
Author(s):  
Marco de Curtis ◽  
Andrea O. Rossetti ◽  
Diogo Vila Verde ◽  
Erwin A. van Vliet ◽  
Christine T. Ekdahl
Keyword(s):  
Status Epilepticus ◽  
Experimental Models ◽  
Brain Pathology ◽  
Focal Status Epilepticus

scholarly journals Characterizing Cefepime Neurotoxicity: A Systematic Review

2017 ◽  
Vol 4 (4) ◽  
Author(s):  
Ayesha A Appa ◽  
Rupali Jain ◽  
Robert M Rakita ◽  
Shahin Hakimian ◽  
Paul S Pottinger
Keyword(s):  
Systematic Review ◽  
Status Epilepticus ◽  
Renal Dysfunction ◽  
Older Patients ◽  
Review Of The Literature ◽  
Single Center ◽  
Level Of Consciousness ◽  
The Mean ◽  
Convulsive Seizures ◽  
New Onset

Abstract Neurotoxicity due to cefepime has not been well characterized. We performed a systematic review of the literature and included 5 additional cases from our center. Of the 198 cases found, the mean age was 67 years and 87% of patients had renal dysfunction. The most common clinical features were diminished level of consciousness (80%), disorientation/agitation (47%), and myoclonus (40%). It is worth noting that nonconvulsive status epilepticus was relatively common with 31% of cases, whereas only 11% had convulsive seizures. Single-center estimate of incidence was 1 in 480 courses of cefepime. Cefepime neurotoxicity should be considered in older patients with renal dysfunction and new onset encephalopathy, especially if concurrent myoclonus is present. More work is needed to prospectively assess incidence and outcomes related to cefepime neurotoxicity.

Focal status epilepticus in anti-Hu encephalitis

2019 ◽  
Vol 18 (11) ◽  
pp. 102388
Author(s):  
Valerio Frazzini ◽  
Vi-Huong Nguyen-Michel ◽  
Marie-Odile Habert ◽  
Phintip Pichit ◽  
Emmanuelle Apartis ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Focal Status Epilepticus

scholarly journals Epileptic Encephalopathies with Status Epilepticus during Sleep: New Techniques for Understanding Pathophysiology and Therapeutic Options

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Daniela Brazzo ◽  
Maria Carmela Pera ◽  
Marco Fasce ◽  
Grazia Papalia ◽  
Umberto Balottin ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Treatment Guidelines ◽  
Task Force ◽  
Epileptiform Activity ◽  
Clinical Manifestations ◽  
Epileptic Encephalopathy ◽  
Computer Assisted ◽  
Paroxysmal Activity ◽  
New Techniques ◽  
Eeg Abnormalities

Encephalopathy with status epilepticus during sleep (ESES) is an epileptic encephalopathy, as defined by the International League Against Epilepsy (ILAE) Task Force on Classification and Terminology, that is, a condition in which the epileptic processes themselves are believed to contribute to the disturbance in cerebral function. Clinical manifestations of ESES are heterogeneous: apart from different seizure types, they consist in combinations of cognitive, motor, and behavioural disturbances associated with a peculiar electroencephalographic pattern of paroxysmal activity significantly activated during slow sleep, which culminates in a picture of continuous spikes and waves during sleep (CSWS). The pathophysiological mechanisms underlying this condition are still incompletely understood. Establishing a clear-cut correlation between EEG abnormalities and clinical data, though interesting, is very complex. Computer-assisted EEG analyses especially if combined with functional magnetic resonance imaging (EEG-fMRI) and metabolic neuroimaging have recently emerged as useful approaches to better understand the pathophysiological processes underlying ESES. Treatment of ESES is not just limited to seizures control but it should be focused on controlling neuropsychological outcome through an improvement of the continuous epileptiform activity. General agreement on treatment guidelines is still lacking. Implementation of new techniques might allow a better understanding of the pathophysiology of ESES and could enhance therapeutics options.

Neuropsychological Performance 1 Year After Status Epilepticus in Adults

2020 ◽  
Author(s):  
Arne Gramstad ◽  
Kjersti N Power ◽  
Bernt A Engelsen
Keyword(s):  
Status Epilepticus ◽  
Cognitive Dysfunction ◽  
Cognitive Rehabilitation ◽  
Neuropsychological Test ◽  
Verbal Learning ◽  
Word List ◽  
Negative Influence ◽  
Brain Lesions ◽  
Adult Intelligence Scale

Abstract Objectives Status epilepticus (SE) may lead to or worsen cognitive dysfunction. Few studies have evaluated magnitude and profile of cognitive dysfunction in patients after SE. Characterization of cognitive deficits may be important for rehabilitation and follow-up. We assessed cognitive function in a consecutive, non-selected group of relatively healthy survivors with a comprehensive neuropsychological test battery. Methods A total of 33 patients (24 men, 9 women; mean age 54,9 years, mean education 11,8 years) were tested 1 year after SE with Wechsler Adult Intelligence Scale Fourth edition (WAIS-IV), Rey Auditory Verbal Learning Test, subtests from the Wechsler Memory Scale–Revised, Phonemic and Semantic word list generation, and the Halstead-Reitan Battery. Premorbid IQ was estimated with a Norwegian version of the National Adult Reading Test (NART). Results were compared to published norms. Regression analyses and independent groups t-tests were performed to assess the influence of background variables. Results Mean performance generally was about one standard deviation below average. Full scale IQ (WAIS-IV) was significantly reduced compared to estimated premorbid IQ (NART). Negative influence on cognition of brain lesions visible on computed tomography or magnetic resonance imaging and duration of SE >30 min was shown by group comparisons. Conclusions SE represents a marker for possible cognitive dysfunction, and follow-up with neuropsychological assessment and cognitive rehabilitation seems warranted in most patients. Complex problem-solving abilities with high general sensitivity to brain impairment showed the most prominent reduction. Otherwise, no specific profile of domain affection was found. Structural brain lesions and duration of SE over 30 min represent risk factors for cognitive deficit.

scholarly journals THC intoxication in a 16-month-old child

2019 ◽  
Vol 24 (5) ◽  
pp. 299-300
Author(s):  
Kim Burrows ◽  
Jennifer Ann Williams
Keyword(s):  
Status Epilepticus ◽  
Young Children ◽  
Healthy Child ◽  
Normal Development ◽  
Clinical Presentation ◽  
Mandatory Reporting ◽  
Head Ct ◽  
Level Of Consciousness ◽  
Other Substances ◽  
Normal Head

Abstract A 16-month-old previously healthy child with normal development presented with decreased level of consciousness, apneas, and seizure requiring intubation and treatment for status epilepticus. Investigations revealed no evidence of infection or trauma, normal head CT scan, and urine positive for tetrahydrocannabinol (THC) and negative for other substances. This report outlines the clinical presentation, approach to treatment, and potential seriousness of THC intoxication in young children. Mandatory reporting and monitoring of THC intoxication in children is recommended. The need for effective education of parents about the risks of unintentional THC poisoning and measures to safeguard young children is discussed.

scholarly journals Continuous Visual Focal Status Epilepticus as the Primary Presentation of NMDA-R and GAD65-R Autoimmune Epilepsy

2020 ◽  
Vol 11 ◽  
Author(s):  
Elma M. Paredes-Aragón ◽  
Héctor E. Valdéz-Ruvalcaba ◽  
Andrea Santos-Peyret ◽  
Marcela Cisneros-Otero ◽  
Raúl Medina-Rioja ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Early Identification ◽  
Acid Decarboxylase ◽  
Visual Aura ◽  
Epilepsia Partialis Continua ◽  
Autoimmune Epilepsy ◽  
Immune Mediated ◽  
Focal Status Epilepticus ◽  
Patients With Epilepsy ◽  
Primary Presentation

Epilepsia partialis continua (EPC) has changed in its clinical and pathophysiological definition throughout time. Several etiologies have been described in addition to classic causes of EPC. The following case depicts a young woman who had a peculiar onset of epilepsy with a continuous visual aura becoming a form of chronic recurrent and non-progressive EPC. The patient was initially misdiagnosed as a non-neurological entity (assumed psychiatric in origin), but finally, an immune-mediated epilepsy was diagnosed, and EEG showed focal status epilepticus during evolution. Once the diagnosis was achieved and immune treatment was established, the patient is seizure free. Early identification of an immune basis in patients with epilepsy is important because immunotherapy can reverse the epileptogenic process and reduce the risk of chronic epilepsy. To date, this is the only case reported with EPC manifesting as a continuous visual aura associated with antiglutamic acid decarboxylase 65 (anti-GAD65) and anti-N-methyl-d-aspartate (anti-NMDA) antibodies.

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