Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0038220 (status epilepticus)
 7,272 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Among 60 cases of status epilepticus, there were 45 cases of convulsive status and 15 cases of nonconvulsive or confusional status. In 37 cases, status was due to an identifiable cause. The most frequent etiologic factors were vascular (nine cases), traumatic (seven cases), and metabolic (five cases). Four patients with metabolic encephalopathy had focal status. While the possibility of expanding lesions should be investigated in every case of convulsive status, a complete metabolic screening is also necessary. Non-convulsive status was represented by two cases of psychomotor status and 13 cases of absence status. Clinically, these cases were characterized by various impairments of intellectual functioning and confusion. Diagnosis was determined by characteristic changes in the electroencephalogram. Aggressive treatment is indicated by one or more of the major anticonvulsants, supplemented by adequate oxygenation and maintenance of biochemical homeostasis.
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PMID:Modern concepts of status epilepticus. 81 59

A five-year-old male was admitted to the hospital with generalized seizures. Enlarged lymph nodes raised the suspicion of cat-scratch disease. The diagnosis was confirmed by a positive history of a cat bite, typical histopathologic findings in the biopsy of the lymph nodes, and a positive skin test. Brain CT scan and LP were repeatedly normal. The clinical course was remarkable for recurrent episodes of status epilepticus refractory to usual anticonvulsant therapy and prolonged encephalopathy consisting of mental confusion, hemiparesis, tremor, chorea, and vomiting. All neurologic symptoms gradually resolved within nine months, without sequelae. Cat-scratch encephalopathy should be suspected in a child presenting with status epilepticus and enlarged lymph nodes. Aggressive and prolonged anticonvulsant therapy is strongly recommended.
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PMID:Cat-scratch encephalopathy presenting as status epilepticus and lymphadenitis. 232 Apr 87

This report details the management of status epilepticus with high-dose lorazepam in a 14-year-old patient who was receiving oral clonazepam, ethosuximide, and phenobarbital for an intractable seizure disorder. Although respiratory depression is a frequently cited potential complication of therapy, it did not occur in this patient despite an extraordinarily high total dose of lorazepam, possibly because of tolerance associated with benzodiazepine-receptor down-regulation in this patient's chronic clonazepam therapy. Aggressive dosing of a benzodiazepine may be required for patients receiving chronic benzodiazepine therapy.
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PMID:High-dose lorazepam therapy for status epilepticus in a pediatric patient. 323 56

A young man developed pathological thirst and hyperdipsia, hyperphagia, disordered temperature regulation, a lowered threshold for aggressive behavior, apathy, impaired memory, and seizures following encephalitis. He had marked hyponatremia. Bouts of water drinking produced water intoxication and precipitated status epilepticus. Studies of water handling with measurements of plasma osmolality and arginine vasopressin (AVP) revealed a very low thirst threshold (below 242 mOsm/kg) with resetting of the osmostat to a new level (255 mOsm/kg) but normal control of plasma osmolality at that level with adequate AVP release.
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PMID:Thirst, resetting of the osmostat, and water intoxication following encephalitis. 683 Jan 80

Suzie, a ten year old child well known on our pediatric neuroscience ward at a children's hospital in British Columbia, was admitted in August 1991 for continuing seizures and unmanageable behaviour after her fourth epilepsy surgery. She was to remain with us for a total of nine months. Very soon, it became apparent that we had an untenable situation on the ward. On the one hand, seizure control was poor and Suzie required hospitalization to adjust her medications and to treat frequent episodes of status epilepticus. On the other hand, her behaviour was seriously disruptive to other patients and staff, as well as presenting a safety concern. Negative behaviours fell into three categories--disinhibition, aggression and hyperactivity. Through slides and video tape, we will introduce Suzie and describe the progression of her disease. We will discuss, using a Nursing Case Management Model, how we took over her care, accessed community resources and eventually even accompanied her to Montreal for a right hemispherectomy. The "Suzie Experience" forced administration and staff to devise creative solutions and empowered nurses on the ward to implement new and unique strategies.
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PMID:Oh, Suzanna! A nursing challenge. 827 94

A 19-year-old woman presented with status epilepticus and ventricular dysrhythmias less than one hour after ingesting 5,000 mg dimenhydrinate (Dramamine). Aggressive resuscitation including the use of physostigmine stabilized the cardiac rhythm; however, she suffered a severe neurologic deficit. Development of ischemic and infarcted bowel necessitated colonic resection. After surgery, her condition worsened, and after demonstration of minimal cerebral activity, supportive measures were withdrawn, and she died. Overdose with dimenhydrinate and diphenhydramine, both of which are over-the-counter drugs, can result in rapid central nervous system stimulation, including status epilepticus. Death can occur within two hours. To our knowledge, this is the first reported fatality resulting from ingestion of dimenhydrinate.
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PMID:Fatality secondary to massive overdose of dimenhydrinate. 836 25

The goal of epilepsy monitoring is to capture several seizures, utilizing continuous electroencephalography (EEG)/video for later analysis. Various provocative techniques, such as withdrawing antiepileptic drugs or sleep deprivation are used to precipitate seizures. Patients run a higher risk of injuries due to having an increase in seizure frequency and/or intensity or a change in seizure type. Evaluating the potential for, and preventing injuries is an important part of risk management. However, very little information has been published regarding safety issues in an epilepsy monitoring unit (EMU). Several types of safety issues have been identified during monitoring: uncontrolled behavior (ictal and post-ictal aggression, self injurious behavior, psychosis); seizure related injuries (falls, status epilepticus); problems related to electrodes (pulling out scalp and surgically implanted electrodes); and specific concerns regarding children in the EMU. Use of restraints and sitters in selected patients, appropriate medication for psychosis, shock absorbing carpet and "child-proofing" rooms for the young are among the preventative actions discussed. Central to risk management is the education of the staff in the assessment of each patient's potential for injury and use the appropriate interventions. Consideration should be given to balancing the need to avert harm, with an unrestricted environment.
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PMID:Safety in long-term EEG/video monitoring. 895 Jun 95

Status epilepticus is more common among children than young adults. Children might be less likely to die and might be resistant to permanent neurologic damage due to status epilepticus, but significant sequelae also have been demonstrated. Aggressive intervention and rapid termination of seizures contribute significantly to better prognosis and reduced mortality from status epilepticus. Initial treatment of status epilepticus typically consists of either diazepam or lorazepam, immediately followed by phenytoin or phenobarbital. However, approximately 100% to 15% of status epilepticus episodes are refractory to these conventional therapies. Traditionally, refractory status epilepticus is treated with barbiturate coma or general anesthetics, both of which require invasive cardiorespiratory and hemodynamic monitoring and are associated with significant complications. Midazolam is a water-soluble benzodiazepine with a fast onset of action, a short half-life, and inactive metabolites that has been very effective in terminating seizures refractory to diazepam, lorazepam, phenytoin, and phenobarbital in pediatric patients. Midazolam is a valuable treatment option for refractory status epilepticus, especially in pediatric patients.
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PMID:Use of midazolam for refractory status epilepticus in pediatric patients. 988 28

The relationship of epilepsy with psychosis is intriguing to neurologists and psychiatrists alike. This review highlights these relationships, including (a) interictal psychosis, in which the presence of psychotic episodes is not temporally related to the occurrence of seizures, (b) postictal psychosis, characterized by an increased number of seizures followed by a period of lucidity and subsequent psychotic symptoms, and (c) ictal psychosis, in which psychotic symptoms occur in association with ictal discharges on EEG. Also discussed are other kinds of episodic symptoms that may mimic psychosis, including nonconvulsive status epilepticus, postictal delirium, and peri-ictal aggressive behavior. The controversial concept of "forced normalization," which proposes an antagonistic relationship between seizures and psychosis, is also explored. Finally, the potential contribution of antiepileptic drugs to psychotic symptomatology and the effects of antipsychotic agents on seizure threshold are examined.
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PMID:Psychosis and peri-ictal confusional states. 1049 32

We evaluated the use of midazolam versus thiopental in 50 children with refractory status epilepticus (RSE), admitted in a pediatric intensive care unit. The study consisted of two groups of patients: Group A - Midazolam, a prospective study, and Group B - Thiopental, a historical group. These patients already had previous medication with benzodiazepin and diphenylhydantoin and other drugs. When there was no effective control of the seizures, the patients of Group A received midazolam of 200 microg/kg intravenous in bolus, being followed by continuous intravenous infusion at the rate 0. 25-15 microg/kg/min. Group B received thiopental 1 mg/kg intravenous in bolus followed by continuous intravenous infusion at the rate of 10-120 microg/kg/min. In relation to the time of seizure control and effectiveness, there was no statistical significance for the two groups. The Midazolam Group had significantly less complications during the treatment: less cyanosis (p=0.00006), and they did not need respiratory support (p<0.00001). When the therapy with midazolam was ceased, 12.5% of the patients from this group showed psychological disorders such as mental confusion, aggressive behavior, restlessness, hallucinations and agitation.
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PMID:[Comparative non-randomized study with midazolam versus thiopental in children with refractory status epilepticus]. 1084 28


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