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Query: UMLS:C0038220 (status epilepticus)
 7,272 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Electrical status epilepticus during slow sleep (ESES) is characterized by an EEG picture that justifies its name. It can be accompanied by epileptic seizures, speech and behavior disturbances and in rare cases by an acquired sensory aphasia. We describe the case of a six-year-old girl, whose EEG presented the typical ESES picture, and who in the span of one year developed a complete sensory aphasia, followed by motor aphasia. After 6 months of treatment with clobazam recovery of speech was nearly complete, but after 8 months clobazam lost its effectiveness and the girl presented a speech regression. Treatment with nitrazepam led to a complete recovery of speech for a second time, while at the same time ESES in the EEG again disappeared. This case, in addition to others described in the literature, suggests the possibility of a direct correlation between electrical abnormalities of the brain and cognitive and speech disturbances.
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PMID:Electrical status epilepticus during slow sleep: one case with sensory aphasia. 339 7

Bedside assessment of consciousness and awareness after a severe brain injury might be hampered by confounding clinical factors (i.e., pitfalls) interfering with the production of behavioral or motor responses to external stimuli. Despite the use of validated clinical scales, a high misdiagnosis rate is indeed observed. We retrospectively analyzed a cohort of 49 patients with severe brain injury admitted to an acute neuro-rehabilitation program. Patients' behavior was assessed using the Motor Behavior Tool and Coma Recovery Scale Revised. All patients underwent systematic assessment for pitfalls including polyneuropathy and/or myopathy and/or myelopathy, major cranial nerve palsies, non-convulsive status epilepticus, aphasia (expressive or comprehensive), cortical blindness, thalamic involvement and frontal akinetic syndrome. A high prevalence (75%) of pitfalls potentially interfering with sensory afference (polyneuropathy, myopathy, myelopathy, and sensory aphasia), motor efference (polyneuropathy, myopathy, motor aphasia, and frontal akinetic syndrome), and intrinsic brain activity (thalamic involvement and epilepsy) was found. Nonetheless, the motor behavior tool identified residual cognition (i.e. a cognitive motor dissociation condition) regardless of the presence of these pitfalls in 70% of the patients diagnosed as unresponsive using the Coma Recovery Scale Revised. On one hand, pitfalls might contribute to misdiagnosis. On the other, it could be argued that they are clues for diagnosing cognitive motor dissociation rather than true disorders of consciousness given their prominent effect on the sensory-motor input-output balance.
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PMID:Early discrimination of cognitive motor dissociation from disorders of consciousness: pitfalls and clues. 3275 29