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

Two patients, aged 23 and 74 years, manifested prolonged episodes of mildly impaired consciousness in conjunction with rhythmical spike waves or spikes (mostly 3/s). This paroxysmal EEG activity was consistently accentuated unilaterally over the superior frontal regions. The first patient showed ictal aphasia and occasional right hemiparesis during these episodes, and partial left frontal lobectomy resulted in temporary freedom from seizures. The classification of these ictal episodes is difficult. They apparently fall into the category of absence status (petit mal status), but the focal neurological signs do not fit the presently valid definitions of absence status, nor does the lack of symmetrical bilateral-synchronous paroxysmal discharges. Perhaps a special category of status epilepticus should be established.
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PMID:Absence status (petit mal status) with focal characteristics. 11 Feb 95

Between 3700 and 3900 children are admitted annually to this children's hospital. During the past four years a total of 455 children with convulsions were admitted for investigation. 255 of these cases were calcified as epilepsy, 202 as febrile convulsions and 28 as neonatal convulsions. A quarter of the epileptic children showed fits of the petit mal type. There were only 5 cases of infantile propulsive petit mal. High frequency of fits and, in particular, status epilepticus, were very rarely seen in the present study. A case of self-induced photosensitive epilepsy, later combined with psychomotor epilepsy, is referred to in detail. Of 149 children with grand mal epilepsy, 36 were classed as idiopathic, and 88 as symptomatic cases. 37 of the symptomatic cases showed focal epilepsy with generalisation. It was concluded from the clinical course and the EEG that the combined effects of familial predisposition towards fits and exogenous cerebral lesions were operative factors in 14 patients. Children with febrile, convulsions possessed an EEG suggestive of a familial predisposition towards fits in slightly more than 50% of the cases. No cause could be found for the seizures in 5 infants with neonatal convulsions, but the mother of one of these infants was an epileptic herself, undergoing treatment with anticonvulsive drugs in high dosage and a withdrawal syndrome was suspected in this particular case. 17 infants with neonatal convulsions were symptomless on leaving hospital and remained so during the first year of life. Of the remaining cases, 10 showed neurological disturbances and one died. There was only one case in which neonatal convulsions progressed directly to epilepsy. The peak incidence of the first appearance of fits occurred during the first year of life (136 children), with 18% of the entire case material presenting within the first 6 months. 108 children presented with fits for the first time during the second year of life. Thereafter, the tendency towards the development of fits for the first time in life declined with increasing age.
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PMID:[Aspects of epilepsy in childhood (author's transl)]. 81 19

The risk of precipitating a convulsion in epileptic patients with methohexitone has been judged to vary widely. This article reports such complications arising during methohexitone-activated E.E.G. recording in a series of 48 epileptic patients from whom anticonvulsant medication was withheld. Two patients developed grand mal convulsions during induction with methohexitone 1-0%. Two others exhibited status epilepticus of the petit mal type and one of the myoclonic type, after stopping an infusion of 0-09% methohexitone. The specificity for methohexitone-induced convulsions in epileptics or crypto-epileptics is supported by a review of the literature.
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PMID:Methohexitone-induced convulsions in epileptics. 90 Apr 62

Clonazepam or 5-(2-chlorphenyl)-1, 3-dihydro-7-nitro-2H-1,4benzodiazepin-2-one, is a close structural and pharmacological relative of nitrazepam. It has a broad spectrum of activity against the various types of epilepsy, and is effective in many patients whose condition has proved resistant to other antiepileptic drugs. Its chief uses are in status epilepticus, in which intravenous clonazepam may replace diazepam as the drug of first choice, and in the minor motor seizures of childhood, particularly petit mal absences, the Lennox-Gastaut syndrome and infantile spasms. Clonazepam is also at least as effective as current treatment in psychomotor and myoclonic epilepsies, but seems unlikely to replace phenytoin and the barbiturates in the treatment of grand mal or focal motor seizures except in patients resistant to standard therapy. Initial success with clonazepam can be followed by loss of effect, but benefit can often be restored, at least initially, by temporary interruption and re-institution of treatment. Side-effects are common with clonazepam. Most patients experience drowsiness and fatigue, which are frequent causes of withdrawal, together with lesser incidences of ataxia, dystonia, hypotonia, and hyperactivity. These effects usually disappear with continued therapy, and are minimised by gradual introduction of the drug over 2-4 weeks. Hypersalivation and excessive bronchial secretion may be a problem in children and infants.
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PMID:Clonazepam: a review of its pharmacological properties and therapeutic efficacy in epilepsy. 97 34

The GABA withdrawal syndrome (GWS) is a new model of focal epilepsy in which paroxysmal activity is induced through the interruption of a chronic, intracortical infusion of GABA. Preliminary studies have shown extraordinary resistance of this epileptogenic activity to classic anticonvulsants including diazepam, the most effective agent for treating status epilepticus. However, GWS can be inhibited by GABA itself. The rat with petit mal-like seizures is a genetic model of generalized non-convulsive epilepsy (GNCE), with behavioral characteristics and electrical (spike-and-wave discharges) signs resembling absences. Moreover, GABAmimetics aggravate this type of seizure. Rats with GWS induced by cessation of a localized GABA infusion (50 micrograms/microliters/h for 24 h), and the rat model of GNCE, were treated with HEPP, a new anticonvulsant agent. In the case of GWS, the drug produced a significant decrease of focal spike activity in animals which started discharging at low frequencies while in rats with higher frequency discharge, HEPP was without effect. HEPP administered on the second day of the GWS in naive rats had no effect. In rats with GNCE, doses of 50 and 100 mg/kg i.p. blocked the spike-and-wave discharges. The higher dose produced sedation in this absence seizures model. Although the mechanism of action of HEPP is still unknown, its unique antiepileptic profile deserves further studies.
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PMID:Effects of 3-hydroxy,3-ethyl,3-phenylpropionamide (HEPP) on rat models of generalized and focal epilepsy. 139 31

The correlations between sleep and prolonged epileptic activity are discussed on the basis of the status classification of Gastaut (1983). Little information is available on the interrelation of sleep and the status of tonic-clonic seizures (grand mal status). Most important is the therapeutical management of these cases. Tonic seizures have been reported to occur in large numbers during NREM sleep in patients with Lennox-Gastaut syndrome. A status-like increase is possible. Tonic seizures occur almost exclusively during sleep. Myoclonic status epilepticus arising (a) in the course of primary generalized epilepsy and (b) in the course of encephalopathies, are usually markedly attenuated during sleep. In absence status (petit mal status) synchronized sleep generally fragments the continuous discharge which is replaced by isolated bursts of polyspikes, or polyspike and wave complexes. The absence status can recur upon awaking during the night or in the morning. The abnormal EEG activity of a petit mal status can, however, occasionally persist during the whole night. Improvement as well as activation during sleep have been observed in elementary (= simple) partial status epilepticus; improvement seems to be more frequent. Epilepsia partialis continua may persist or decrease during sleep. An increase as well as decrease of motor phenomena has been observed during the REM stages. 'Epileptic aphasia' of childhood is associated with subclinical bioelectric status epilepticus during sleep. The electrical status epilepticus must be delineated as a separate group. The term encephalopathy related to electrical status epilepticus during slow sleep (ESES) has been proposed on the basis of associated psychic syndromes. This form of status epilepticus disappears during the waking state and during REM sleep. Cases with hypsarrhythmia without clinical signs may also be classified under the group of electrical or bioelectrical status. In some cases, a continuous hypsarrhythmia is observed only during sleep. In this context, one must also mention those patients who demonstrate continuous activation of spikes, or spike and wave potentials (without clinical seizures) during eye closure.
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PMID:Sleep and prolonged epileptic activity (status epilepticus). 176 86

Clinical features of status epilepticus (SE) were analysed retrospectively in a five-year period. Among 55 patients there were 65 episodes of SE, most frequently of generalised tonic-clonic type. There were also 7 episodes of simple motor, 5 of complex partial, 1 of petit mal and 4 of nonconvulsive "electric" SE. Seventy-five percent of patients with initial SE had organic brain disease as an underlying cause versus 14% of patients with intercurrent SE (p = 0.002). The most frequent precipitating factor in the group of intercurrent status epilepticus was erroneous antiepileptic drug treatment. Median duration of SE in the group with idiopathic causes was 5.5, in the group with acute symptomatic causes 6.5, in the group with chronic symptomatic causes 14, in the group of fatal cases 5, and in the whole group 10.5 hours (p0.05). Most of this time (30% to 98% of the whole time, median value 79%) elapsed before admission to the Department, showing poor prehospital management. Termination of SE was accomplished with standard treatment (intravenous diazepam and intramuscular phenobarbital) in 47 cases within 30 minutes, while the others required additional treatment. Due to the underlying diseases there were 6 fatal cases (9.2%), 2 during uninterrupted SE and 4 after the seizure abolishion. There was no neurological or intellectual deterioration after the termination of SE, that could be attributed to detrimental effects of SE per se. Finally, the description of 5 cases of complex partial SE is included. These results were also compared to other research results as presented in several recent references.
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PMID:[Status epilepticus: retrospective analysis of clinical characteristics over a 5-year period]. 210 52

Next to tonic-clonic seizures psychomotor (complex focal) seizures are the most common form of all epileptic seizures, except in infancy where they are seen rarely. Differently from generalised non convulsive seizures (like petit mal absences), their first appearance has no typical age limit, however, their proportion to other forms of seizures increases in adolescence and adults especially between the third and fifth decade of life. The main symptom is the disorder of consciousness which lasts at least more than half a minute, normally several minutes in completely distinct seizures, which doesn't begin abruptly and which often ends ill defined. This twilight attack is proceeded by an aura of sensory, psychic or vegetative character. The aura is followed either by a transitory state of immobility and later by motor phenomena or at once by motor phenomena in the form of diverse automatisms of variable intensity, reaching from mild movements in the oral region over verbal expressions to highly dramatic scenes, often accompanied by vegetative symptoms. Tonic versive and tonic symmetrical or tonic asymmetrical seizure symptoms are quite often motor variants which also can lead to sudden drops. Psychomotor attacks can be reduced to "pseudo-absences", however, they also can develop into tonic-clonic seizures (Grand mal). Generally, the succession of seizure symptoms is constant in the same patient, the expression can differ from seizure to seizure. Psychomotor attacks can be spread over the whole day or can show a strict connection to sleep, in the course they can likely occur in clusters and can accumulate to a continuous or discontinuous form of psychomotor status epilepticus. Predominantly, but not exclusively psychomotor attacks start from the temporal lobe, whereas neocortical temporal attacks (especially of lateral posterior origin) can be distinguished from those coming from the limbic system, especially from hippocampal or mesio-basal temporal structures and from the nucleus amygdalae. About 20% of the psychomotor attacks are of frontal origin coming from the mesial frontal region or from the gyrus cinguli anterior. Also seizures of occipital or parietal origin can spread so quickly that the seizure itself is impressing as a "temporal lobe attack". On account of that, epilepsies with psychomotor attacks cannot be compared to temporal lobe epilepsies. The etiology of psychomotor epilepsies is closely connected to the topographic site of the temporal lobe, who is especially vulnerable for traumatic lesions, cerebral edema and hypoxemia. Also small dysgeneses, heterotopies or small abnormalities of vessels are relatively often found in surgical specimens.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Psychomotor epilepsy: phenomenology, localization, pathogenesis and therapy]. 219 20

Alterations of consciousness with impaired perception and drive persisting over hours to days can be due to a nonconvulsive status epilepticus. This possibility has to be considered not only in patients with already known epilepsy, but also in those with a negative history for seizure disorders. The immediately recorded electroencephalogram (EEG) provides decisive clues. In the case of petit mal status most frequently appear tiredness, reduced vigilance and lack of drive. The EEG shows a generalized spike-wave activity. In status psychomotoricus, the clinical symptomatology varies from case to case. It can be characterized by anxiety, dreamy states or productive-psychotic states with agitation, automatisms and hallucinations. In the EEG a temporal or temporally-accentuated epileptic activity will be recorded. Transitional and mixed forms of petit mal status and status psychomotoricus can also be found. I.v. injections of benzodiazepines (clonazepam, diazepam) are an appropriate therapy for any type of nonconvulsive status epilepticus. Phenytoin is indicated in status psychomotoricus, but contra-indicated in the case of petit mal status.
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PMID:[Epileptic impaired consciousness in adults]. 250 9

One or several status were observed in 90 chronic adult epileptics. Partial status, especially motor and of similar type, is rare in the clinical course of usual partial epilepsy. Generalized status, chiefly petit mal (PM) status, appears in more severe generalized epilepsies. Partial status epilepticus is observed in motor attacks and rarely in partial complex epilepsies, although the latter are more frequent. In 40% of cases the aetiology is unknown. Delay of the first status is variable, from 2 to 30 years. Status does not make previous epilepsy worse. Generalized status, mainly PM status, appears in patients with absences and generalized attacks, sometimes some decades after the beginning of the disease. In half of the cases PM status are frequent but are sometimes the only expression of the epilepsy.
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PMID:[Status epilepticus in adult epileptics followed in a neurologic hospital]. 644 78


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