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)

Fifty adult patients with partial motor status epilepticus were treated with a single intravenous (i.v.) injection of diphenylhydantoin (DPH), 20 mg/kg body weight at a rate of 1 mg/kg/min. Seizures were controlled in 32 patients (64%) during the injection or within the following hour; in 13 of them previous (i.v.) injections out of benzodiazepines had been ineffective. DPH was effective in 10 patients of 11 with a previous history of epileptic seizures and without problems of consciousness during their epileptic status. In contrast, 13 failures out of 18 concern occasional status in patients deeply comatose because of head trauma, neurosurgical operation or intracerebral hemorrhage. Total plasmatic levels of DPH, when measured 24 h after the injection, were found between 38 mumol/l in all patients, and were in the range of 40 mumol/l-100 mumol/l in 77% of cases. Adverse effects were: pain at the injection site (6 cases), horizontal nystagmus during injection (5 cases), transient cerebellar symptoms (3 cases). This study confirms that single loading doses of DPH can maintain DPH plasmatic levels within the therapeutic range during 24 h, with minor or transient side effects, provided that cardiovascular contra-indications are respected.
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PMID:[Treatment of partial motor status epilepticus in adults with intravenous diphenylhydantoin (DPH). Prospective study of 50 cases]. 644 81

Three pediatric patients with generalized status epilepticus unresponsive to therapy with conventional anticonvulsants were successfully treated with moderate hypothermia (30 degrees to 31 degrees C) and barbiturate coma with thiopental. All 3 patients were treated with thiopental at doses producing burst suppression or an isoelectric tracing on the EEG and thiopental and barbiturate levels were followed sequentially in the plasma. Continuous thiopental infusion rates of 5 to 55 mg/kg X h maintained burst suppression and correlated with plasma thiopental levels of 25 to 40 mg/dl. Total doses of thiopental used to obtain and maintain burst suppression ranged from 15 to 50 g over 48 to 120 h. In all 3 patients, control of the status epilepticus was obtained. Moderate hypothermia and thiopental barbiturate coma are indicated in patients with generalized tonic-clonic status epilepticus which cannot be controlled with standard anticonvulsant drug therapy. This regimen has the advantage that the patient can be managed in an ICU without the need for general anesthesia with volatile anesthetic agents.
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PMID:Hypothermia and barbiturate coma for refractory status epilepticus. 670 45

A patient who ingested 1.5 g pentazocine developed status epilepticus, coma, respiratory depression, acidosis, profound hypotension, and ventricular arrhythmias. Although this patient survived after institution of general supportive measures, she did not respond to usual doses of naloxone. We describe the clinical symptoms and course of recovery of a patient with pentazocine overdose. Our case suggests that pentazocine overdose may require higher doses of naloxone (5 to 20 mg) than are customarily used for narcotic overdoses.
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PMID:Pentazocine overdose. 684 22

Five cases of encephalopathy due to intravenous penicillin treatment (penicillin G sodium in 4 cases, oxacillin in 1) are reported in 5 uraemic patients. The first abnormalities noted were decreased consciousness and myoclonic jerks (3 cases), followed by seizures and coma (2 cases). Lumbar puncture and cerebral computed tomography gave normal results. Electroencephalograms showed diffuse sharp and slow activities over the brain areas. The diagnosis was confirmed by the high blood levels of the penicillins. Three patients recovered after discontinuation of the drugs; two patients died in status epilepticus and coma resistant to all treatments.
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PMID:[Penicillin-induced encephalopathy]. 709 52

We studied the safety and efficacy of intravenous propofol in the out-of-hospital treatment of convulsive status epilepticus (SE) in 8 patients (age 29-70 years), 4 of them with posttraumatic epilepsy. Four patients had no history of seizures. Convulsions ceased promptly after patients received a bolus of 100-200 mg propofol administered before hospital admission by staff of a mobile intensive care unit (ICU). The median duration of coma was 3 h 15 min (range 2-41 h), and the median duration of hospital treatment was 3 1/2 days (range 12 h to 23 days). Only 1 patient was admitted to the hospital's ICU. No adverse effects was observed except for a transient decrease in systolic blood pressure (SBP). Propofol may be a useful drug for the prehospital treatment of recurrent seizures not responding to intravenous diazepam (DZP).
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PMID:Propofol in prehospital treatment of convulsive status epilepticus. 748 3

Forty-five patients under the age of 20 years with rhinogenic subdural empyema were treated at Groote Schuur Hospital and Red Cross War Memorial Children's Hospital between 1979 and 1991. Thirty-two were male and 13 female. The majority were between 13 and 19 years of age. Headache was the predominant symptom in 41 patients. Vomiting occurred in 15 and 21 presented with seizures, 2 in status epilepticus. Thirty had swinging pyrexias and 26 neck stiffness while only 14 had focal neurological signs. Swelling of the face or orbit was seen in 24. Twenty-two had depressed levels of consciousness and 7 had Glasgow Coma Scale (GCS) values below 11/15. White cell counts and erythrocyte sedimentation rates were raised in all cases. Twenty-three patients underwent lumbar punctures despite the inherent danger in this procedure. Cerebrospinal fluid analysis showed a pleocytosis in all cases; no organisms were cultured in any of the specimens. The diagnosis in all cases was made by contrast-enhanced computed tomography. Twenty-five patients underwent multiple burrholes, 9 small craniectomies and 11 craniotomies. Thirty-four patients made an excellent recovery. All of the 6 patients who died had GCS values below 11 at the time of their surgery.
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PMID:Rhinogenic subdural empyema in older children and teenagers. 757 Feb 36

When a child is admitted to the hospital with presumed encephalitis, the physician must use clinical criteria to gauge the appropriate level of hospital care and to give a preliminary assessment of outcome to the family because the etiology is unknown. This study attempted to determine which clinical factors gathered on hospital admission would be most helpful to the physician. The records of 106 children (ages 1 month to 20 years), admitted to Rainbow Babies and Childrens Hospital between 1978-1989 who had discharge diagnoses of encephalitis, were reviewed. Seventy-five met the case definition of presumed viral encephalitis, with viral etiology established in 23% of patients. Poor short-term outcome was defined as the presence of an abnormal neurologic examination at hospital discharge, and was present in 32% of patients. Focal signs on neurologic examination (odds risk: 16.30, P < .05) and abnormal neuroimaging studies (odds risk: 5.66, P < .05) were the only 2 factors present at admission that predicted a poor short-term outcome. Glasgow coma scale at admission was predictive of an abnormal neurologic examination at discharge only when profoundly depressed (6 or less); otherwise, this scale was not useful as a prognostic tool. Factors that were not correlated with adverse outcomes included age younger than 1 year, any type of seizure occurrence, status epilepticus, diffuse or focal electroencephalographic abnormalities, or abnormal cerebrospinal fluid findings.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Predictive factors of short-term neurologic outcome in children with encephalitis. 770 91

Status epilepticus is one of the most frequent neurological emergencies in the intensive care unit. Standard treatment includes intravenous barbiturates, benzodiazepines and phenytoin. However, drug coma is sometimes necessary to control refractory status epilepticus. We report such a case, successfully treated by intravenous propofol coma to EEG burst suppression.
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PMID:Propofol in the management of refractory status epilepticus: a case report. 775 88

Neuron-specific enolase (NSE) is a sensitive marker of brain injury after stroke, global ischemia, and coma. We report changes in serum NSE (s-NSE) in 19 patients who sustained status epilepticus. s-NSE peaked within 24 to 48 hours after status epilepticus. The mean peak s-NSE level for the entire group was elevated compared with the levels for normal controls (24.87 ng/ml versus 5.36 ng/ml, p = 0.0001) and for epileptic controls (24.87 ng/ml versus 4.61 ng/ml, p = 0.0001). The mean peak s-NSE level for the 11 subjects without an acute neurologic insult (15.44 ng/ml) was also significantly increased compared with levels for normal and epileptic controls. Further, s-NSE was significantly correlated with outcome and duration. We conclude that s-NSE is a promising in vivo marker of brain injury in status epilepticus and warrants further study in larger populations.
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PMID:Serum neuron-specific enolase in human status epilepticus. 864 98

A 44-year-old man suffered a severe anoxic encephalopathy with rapid fatal outcome. His EEG prior to expiration showed a burst-suppression pattern (BSP) with occurrence of two previously unreported clinical features: spontaneous chewing movements during the burst and tonic posturing during the suppression phase. In coma the appearance of BSP in the EEG commonly implies a severe anoxic/metabolic insult to the brain with a grave prognosis. The pattern is considered to be interictal, except in cases presenting with myoclonic status epilepticus. Subtle intermittent movements of the eye, mouth and cardiovascular rhythm are uncommon and it is unclear whether these are epileptic events or not. This case indicates that the suppression phase can also have associated clinical signs.
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PMID:Burst-suppression pattern with unusual clinical correlates. 781 97


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