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

A retrospective study was performed to determine the clinical and pathologic features, etiology, and outcome of children with the reversal sign. The reversal sign, a striking CT finding, probably represents a diffuse, anoxic/ischemic cerebral injury. CT features of the reversal sign are diffusely decreased density of cerebral cortical gray and white matter with a decreased or lost gray/white matter interface, or reversal of the gray/white matter densities and relatively increased density of the thalami, brainstem, and cerebellum. Twenty children with the reversal sign were retrospectively analyzed. We divided the patients into three groups: (1) acute reversal, (2) intermediate group, and (3) chronic reversal. There were nine cases of trauma (seven of child abuse); nine hypoxia/anoxia incidents (birth asphyxia, drowning, status epilepticus); one bacterial meningitis; and one degenerative encephalitis. All acute- and intermediate-group patients had respiratory problems requiring ventilator support and intensive care. In five of seven patients who died, autopsy findings were consistent with anoxic/ischemic encephalopathy. Surviving patients have profound neurologic deficits with severe developmental delay. The CT reversal sign carries a poor prognosis and indicates irreversible brain damage.
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PMID:Reversal sign on CT: effect of anoxic/ischemic cerebral injury in children. 251 81

We retrospectively reviewed the clinical features and results of investigation of 62 patients with acute encephalitis or encephalopathy in the acute phase to identify the prognostic factors in the development of postencephalitic epilepsy. Patients who later developed epilepsy showed more marked disturbance of consciousness, convulsions, and seizure activities on EEG during the acute phase than those who did not. There was no relation between CSF abnormalities and postencephalitic epilepsy. Control of convulsions during the acute phase, especially of status epilepticus, seems to be important to improve the prognosis.
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PMID:Clinical and electroencephalographic studies of postencephalitic epilepsy. 251 72

A case history of a 19-year old epileptic woman with diffuse encephalopathy of unknown aetiology and frequent attacks of status, epilepticus, whose last episode of the status epilepticus was successfully treated with intravenous lidocaine, after several first-line antiepileptic drugs failed to control, it, is presented. Although highly effective in treating refractory status epilepticus this treatment received little attention in clinical practice. We observed no un desired side effects of such treatment. The authors shortly reviewed current knowledge about several widely used treatment protocols. Some specific pharmacokinetic and pharmacodynamic properties of lidocaine during convulsions were also mentioned. A warning was drawn to toxic fide effects of lidocaine which were precipitated by increasing brain-blood pH gradient during convulsions, which in high doses included seizures caused by lidocaine per se. The effects of high dose lidocaine on the latencies and the amplitudes of the BAER and possible ways for mechanism of drug action were also reviewed.
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PMID:[Treatment of status epilepticus with intravenous lidocaine (Xylocaine)]. 259 78

Between 1982 and 1985, 14 infants aged 3-26 weeks presented with severe hypoxic episodes as a result of the 'near miss' sudden infant death syndrome (SIDS). They all had metabolic acidosis, cardiovascular instability, acute renal failure, ischaemic colitis, or acute neurological dysfunction. Investigation of the cause excluded infection and trauma, or a primary metabolic, pulmonary, cardiac, or seizure disorder. Seven infants were deeply comatose on admission, never regained consciousness, and died within 60 hours. A characteristic evolution of hypoxic-ischaemic encephalopathy not previously clearly described after near miss SIDS was seen in the seven who lived. Five of the seven were conscious within one hour of resuscitation and showed a striking interval of near normality before neurological deterioration that was characterised by status epilepticus, deep coma, and brain stem dysfunction from 36-96 hours after the event. A biphasic course was not apparent in the remaining two, each of whom was comatose on admission, though refractory seizures did develop. Computed tomograms of the brain more than a week after the event showed cortical infarction or cerebral atrophy. Six of the survivors, followed up from 16-55 months, have serious residual deficits including spastic quadriplegia, delayed development, cortical blindness, or infantile spasms.
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PMID:Hypoxic-ischaemic encephalopathy after near miss sudden infant death syndrome. 273 Jan 24

Three patients had status epilepticus appearing de novo as the presenting manifestation of Epstein-Barr virus (EBV) encephalopathy. Clinical findings of infectious mononucleosis were absent and EBV-specific serologic tests made or confirmed the diagnosis in each case. Epstein-Barr virus should be considered as a potential cause when status epilepticus occurs in the absence of previous seizures or an identified cause of seizures. The diagnosis may be made in some cases only with the use of EBV-specific serologic testing.
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PMID:Status epilepticus and Epstein-Barr virus encephalopathy. Diagnosis by modern serologic techniques. 299 28

Body movements (BMs) during sleep in patients with age dependent epileptic encephalopathy (ADEE) were studied polysomnographically in order to clarify the underlying mechanism of intractability and the age dependent trend. Twenty patients were divided into two groups according to the prognosis of convulsions. In the good prognosis group, BMs were nearly normal except for a low frequency in some cases. In the intractable group with seizures which were uncontrollable by medication and recurred within a year, BMs showed abnormalities as follows: abnormal distribution according to sleep stages, and/or a low frequency; increased BMs on therapy with prednisolone or ACTH. Moreover, a paradoxical increase of BMs with age and recurrence of seizures concomitantly occurred in the course of the disease. Status epilepticus appeared in cases under 1-DOPA administration or with a strikingly high frequency of BMs. Since electrophysiological evidence indicates that BMs during sleep are modulated by the dopaminergic (DA) system, the present data might suggest that prognosis of convulsions in ADEE depend upon, at least in part, the DA system. And denervated supersensitivity of that system might give rise to recurrence of seizures and status epilepticus.
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PMID:Polygraphical study on age dependent epileptic encephalopathy--relationship between body movements during sleep and prognosis. 302 90

Neuropediatric emergencies are reviewed. In particular in this topic the Authors point out the diseases in which an immediate treatment is required. Hypoxic ischemic encephalopathy, acute neonatal metabolic disease, seizures disorders and status epilepticus, meningitis, encephalitis, post viral neurological syndromes, acute hemiplegia, coma, acute endocranial hypertension are discussed with special emphasis on the possible causes and treatment.
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PMID:[Neurologic emergencies in children]. 307 30

Between August 1984 and September 1986, data were gathered prospectively on 114 episodes of convulsive status epilepticus, defined as seizure duration longer than 30 minutes, affecting 97 children. Status epilepticus was symptomatic in 72% (chronic 59%, acute 13%) and idiopathic or febrile in 28%. We identified precipitating factors in 63% of episodes. The most common factors were inadequate blood levels of anticonvulsants (32 of 60 episodes in children with prior seizures) and febrile illnesses, excluding meningitis or encephalitis (38 of 114 episodes). There was an elevated peripheral white blood cell count in 60%, acidosis with a pH of less than 7.0 in 12.5%, and cerebrospinal fluid pleocytosis not due to meningitis or encephalitis in 8 of 64 episodes. Eight children died, three with severe pre-existing brain damage, two with meningitis, and two with a poorly defined encephalopathy. Eighteen children developed a new neurologic deficit. Outcome was associated with the etiology and duration of status epilepticus, with age at the time of status a minor factor. A permanent deficit occurred in only five children with idiopathic or febrile status epilepticus.
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PMID:Status epilepticus in children: etiology, clinical features, and outcome. 320 42

Among 13 infants with apparently cryptogenic status epilepticus occurring between two and four months of age, two shared several features of 'poliodystrophy' encephalopathy. For the other 11, an anoxic-ischaemic event was suggested by the history, the seizure and EEG characteristics, and clinical and CT-scan evolution. The possible relationship with 'near-miss' sudden infant death is discussed.
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PMID:Infantile status epilepticus as a complication of 'near-miss' sudden infant death. 397 71

The present study, conducted between January 1975 and June 1983, includes 282 adult patients admitted for status epilepticus (SE) in 2 intensive care units (3.5% of all admissions). In their great majority, i.e., 201, patients had no previous history of epilepsy, and initiated the SE during the course of recent affections such as brain or systemic diseases. In 81 patients with previous seizure, epilepsy was idiopathic in 20, and symptomatic in 61, the 3 main causes being cranial traumatism, cerebrovascular accident and chronic alcoholism. SE was of various causes. The most frequent were cerebro-vascular disease, post-anoxic encephalopathy, intoxication, bacterial or viral meningo-encephalitis. In some patients, SE was preceded by manifestations such as convulsions, behavorial disturbances or conscience impairment. One should be aware of these facts and undertake or increase an anticonvulsivant medication at their onset. Duration of SE, when clearly established, was highly variable but had no apparent correlation to sequelae or death occurrences. SE itself was directly related to death in only 2 cases; in all other instances death was the consequence of the primary disease. These results are consistent with previous reports: presently SE occurs more frequently in the course of other affections than in prior epileptic patients. The better vital prognosis of SE is due to the simultaneous conjunction of new anticonvulsivant medication and supportive care associated with the cure of the causative disease.
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PMID:[Status epilepticus in the adult. Epidemiologic and clinical study in an intensive care unit]. 402 53


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