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)

Absence status is a form of generalized status epilepticus usually presenting as an acute confusional state. It is often initially mistaken for a psychiatric disorder, as was true in two of the six adult cases reviewed in this series. The differential diagnosis includes drug intoxication, post-ictal state, complex partial status epilepticus, transient global amnesia, organic brain syndrome, and interictal psychosis. Associated convulsive movements, such as eyelid flutter or rhythmic facial movements, if seen, should alert the clinician to consider absence status, and an electroencephalogram is needed to verify the diagnosis. Although usually occurring in known epileptics, in this small series 50% of patients did not have a history of a seizure disorder. Small fractional doses of intravenous diazepam is the treatment of choice for acute termination of the episode.
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PMID:Absence status. Case reports and a review of the literature. 743 15

Epileptiform activity in the brain, whether localized or generalized, constitutes an important category of abnormal electroencephalogram (EEG). Seizures are episodes of relatively brief disturbances of mental, motor or sensory activity caused by paroxysmal cerebral activity. They are not always accompanied by the characteristic convulsions that we commonly associate with the word epilepsy. In this case, they may be referred to as non-convulsive status epilepticus (NCSE) or as absence seizures (formerly called "petit mal" seizures). They often manifest themselves in scalp-recorded EEG as large-amplitude spike-wave "patterns" (or "events"), usually occurring in bursts. If left undetected and untreated, they can potentially cause significant brain and behavioral dysfunctions, interfere with information processing, or otherwise contribute to altered mental status. In this paper, we describe an algorithm to be implemented in a prototype BrainScope_ED instrument meant to alert to a detected seizure in an emergency department (ED) or other clinical setting. BrainScope_ED uses a reduced electrode set (8 instead of 19). The proposed signal processing algorithm is based on the detection of spike-wave events obtained from a wavelet analysis of the EEG signal, combined with an analysis of the complexity of the EEG using fractal dimension estimates. We show that this algorithm has excellent sensitivity and specificity. In particular, the fractal analysis is a key factor in the removal of falsely detected spike-wave events (false positives) that can be caused by voluntary or involuntary artifacts such as fast eyelid flutter.
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PMID:Automatic identification of spike-wave events and non-convulsive seizures with a reduced set of electrodes. 1800 60

Lacosamide (LCM) is a well-tolerated and increasingly used second-generation AED, and side effects such as atrial fibrillation are rare and poorly characterized. Supported by a literature review, we share our experience of the management of the first reported case of cardioembolic cerebral infarcts in the context of de novo atrial fibrillation, which appeared following a 200-mg intravenous infusion of LCM for the treatment of non-convulsive status epilepticus. Case report and literature review using search items including "atrial fibrillation OR atrial flutter AND LCM" in the thesaurus of Medline. We found three cases of atrial fibrillation/atrial flutter secondary to LCM, one following a 200-mg intravenous infusion. In one patient, previous risk factors for atrial fibrillation were reported and another was started on warfarin; all required suspension of LCM for cessation of atrial fibrillation. Previous risk factors for atrial fibrillation in our patient were older age, male gender, obesity, hypertension, valvular disease, first-degree atrioventricular block and left anterior fascicle block. Atrial fibrillation appeared at the end of the infusion and ceased after a loading dose of amiodarone and suspension of LCM. Apixaban was initiated indefinitely five days later, and MRI showed four acute silent infarctions. The appearance of atrial fibrillation has severe therapeutic and clinical implications and the use of LCM might be reconsidered within a context of increased predisposition to developing atrial fibrillation. If atrial fibrillation appears, the drug should be discontinued and anticoagulation should be considered according to embolic risk. Further investigation is needed in order to better categorize the risk profile of lacosamide regarding atrial fibrillation.
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PMID:Cardioembolic acute cerebral micro-infarcts in the context of atrial fibrillation after low-dose intravenous infusion of lacosamide. 3204 69