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)

The purpose of this study was to investigate the safety and efficacy of intravenous levetiracetam (LEV-iv) in refractory status epilepticus (SE). A retrospective chart review was performed on patients who received LEV-iv for treatment of SE (n = 36) and had failed at least one other antiepileptic drug. LEV-iv (median 3000 mg/day; range 1000-9000) was administered as a bolus loading (500-2000 mg per 30-60 min, n = 30) or as a continuous pump infusion (n = 6). SE was terminated in 69% ("responders"); 31% ("non-responders") remained in SE. Factors associated with failure were: dose escalation over 3000 mg/day, lack of bolus loading, treatment latency over 48 h, age over 80 years, non-convulsive SE with coma ("subtle SE"), periodic lateralised epileptiform discharges (PLEDs) on EEG, acute cerebral lesion and intubation narcosis. SE was terminated in all eight patients without brain lesion (p = 0.033), and in all seven patients with complex partial SE (p = 0.051). Outcome was favourable (ambulatory patients) in 48% (responders) compared with 0% (non-responders), and "adverse" (death or continuing coma/stupor) in 24% (responders) compared with 100% (non-responders). Mortality was 17% (responders 4%, non-responders 45%). No patient had cardiocirculatory side effects or worsening of SE. Two patients experienced nausea and vomiting during LEV-iv loading, leading to aspiration pneumonia in one. This study suggests that LEV-iv may be a safe and efficacious treatment of SE. Prospective and controlled trials are imperative to confirm these preliminary findings.
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PMID:Intravenous levetiracetam: a new treatment alternative for refractory status epilepticus. 1944 97

Vomiting is a common sign of illness in the pediatric population. Its etiology is diversified, ranging from mild functional disorders to severe life-threatening systemic diseases. Vomiting most often occurs in the course of gastrointestinal tract diseases, however, it may also coexist with numerous other ailments located outside the GI tract. Due to its diverse etiology encompassing various systems and organs, it can sometimes cause diagnostic difficulties. The present paper illustrates a case of Panayiotopoulos syndrome, which is an early-onset childhood occipital epilepsy (EOCOE). Characteristic of this syndrome are seizures with symptoms originating from the autonomic nervous system or the occurrence of vegetative status epilepticus. The dominant signs and symptoms are vomiting and nausea, which in the first place most frequently suggest inflammation of the stomach or intestines, migraine, or a proliferative process in the central nervous system. Rarely is the possibility of vomiting taken into account as an element of epileptic seizure in the differential diagnosis. The aim of this paper is to draw attention to the difficulty in defining the precise cause of recurrent vomiting. Many times, despite collecting a detailed medical history and extensive physical examination, it is only observation-based diagnosis that allows the doctor to make a final evaluation.
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PMID:[Vomiting as a symptom of epilepsy. Panayitopoulos Syndrome - review of the literature and own experience]. 3095 78