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)

In 1979-80, 82 cases of grand mal status epilepticus (71 patients, 39 male and 32 female) were admitted to the Casualty Department of Meilahti University Hospital in Helsinki, Finland. The cause of the underlying epilepsy was symptomatic in 43 cases (52.4%) and idiopathic in 19 cases (23.2%). In 6 cases (7.3%), there was a history of alcohol withdrawal seizures, and in 14 cases (17.1%) there was no earlier history of convulsions. Status epilepticus was associated with an acute or progressive cerebral disorder in 14 episodes. These comprised 6 bouts of status with brain tumour, 4 with acute stroke and 4 with brain injury. Alcohol abuse preceded the status in 29 episodes (35.4%), 23 of which occurred in men (53.5% of the male cases). Excessive use of alcohol was the only obvious precipitating factor for status in 16 cases, and in 6 cases the status presented as a prolonged alcohol withdrawal seizure. A change or irregularity of anticonvulsive drug therapy could be documented in 14 cases and an acute infection outside the central nervous system in 7 cases. Intravenous diazepam, used as the only therapy for status epilepticus, was effective in 58 of 78 episodes. In 7 cases of prolonged status, a thiopental sodium anaesthesia proved effective. The total mortality was 4.2%, including 2 deaths from concomitant extracerebral disorders and one late death from brain metastasis.
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PMID:Status epilepticus and alcohol abuse: an analysis of 82 status epilepticus admissions. 651 94

A transition from sufficient to insufficient cerebral oxygenation has been reported during recurrent seizures, but it was unknown whether this phenomenon was limited to particular species, anesthetics, or convulsant agents. Focal measurements were made of cortical PO2 and redox changes of cytochrome a, a3 in rats and cats anesthetized with sodium pentobarbital, nitrous oxide, or ketamine, or decerebrated. Seizures were induced with pentylenetetrazol, bicuculline, or electroconvulsive shock. Transition from oxygen sufficiency to insufficiency always occurred in association with inadequate vascular responses, regardless of experimental conditions. These results indicate that transition is a general characteristic of experimental status epilepticus.
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PMID:Oxidative metabolic responses during recurrent seizures are independent of convulsant, anesthetic, or species. 668 71

In one patient, status epilepticus did not respond to commonly used anticonvulsants but was completely controlled by sodium valproate syrup given rectally. Rectal use of valproate syrup may obviate the need for assisted respiration.
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PMID:Rectal valproate syrup and status epilepticus. 677 43

Intravenous (IV) diazepam or phenobarbital is generally accepted as the initial treatment of choice for status epilepticus in children. The risk of severe respiratory depression with either drug is a major problem, particularly in emergency centers that do not have appropriate equipment or personnel for rapid endotracheal intubation of infants. While some pediatric centers are not reluctant to recommend paraldehyde for secondary therapy in status epilepticus, most texts and publications recommend it only as a last resort because of reported complications. We investigated the benefits and complications from varied dosing regimens in 16 trials. The results indicated no significant complications in patients who did not receive an initial IV bolus. Even though treatment with phenobarbital or diazepam and phenytoin sodium had failed, 37% had a good therapeutic response.
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PMID:Paraldehyde therapy in childhood status epilepticus. 687 Jun 7

A 4-month-old infant was admitted to the Pediatric Intensive Care Unit with Pneumococcal meningitis. A few hours after admission he developed intractable convulsions that could not be stopped with phenytoin, phenobarbitone and a continuous drip of diazepam. Thiopentone sodium anaesthesia was induced for 24 h terminating the status epilepticus. The clinical course, correlary EEG findings, treatment protocol and blood levels of the drugs given are described in detail.
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PMID:Treatment of status epilepticus with thiopentone sodium anaesthesia in a child. 688 90

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

The treatment of status epilepticus can be improved by using recent developments in the pharmacokinetics and method of intravenous (IV) administration of phenytoin sodium. While diazepam, administered IV, remains the drug of choice for the short-term control of seizures associated with compromised respiratory exchange, phenytoin is effective in preventing recurrence of such seizures and in treating most other forms of status epilepticus. A loading dose of 18 mg/kg given by IV infusion in either 0.45% or 0.9% sodium chloride at a rate no greater than 50 mg/min results in therapeutic serum levels for up to 24 hours in most patients. Maintenance therapy with phenytoin should start at 4 to 7 mg/kg/day and be adjusted to both clinical response and serum levels.
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PMID:Status epilepticus. The role of intravenous phenytoin. 742 Jun 42

Status epilepticus can lead to impaired renal function, which has been attributed to complications of myoglobinuria. We confirmed changes in renal function in the absence of myoglobinuria by measuring renal hemodynamics, fluid and electrolyte excretions, and plasma levels of renin and atrial natriuretic peptide (ANP) before and after a 30-min period of recurrent generalized seizures in anesthetized, paralyzed rats. Renal plasma flow (RPF), renal blood flow (RBF) and glomerular filtration rate (GFR) decreased by approximately 60% after seizures. In contrast, urinary sodium excretion, urine flow, and plasma ANP levels increased approximately threefold. Urinary potassium excretion and plasma renin levels were unchanged. Renal function is profoundly altered after 30 min of seizures, primarily due to intense renal vasoconstriction precipitating a dramatic reduction in GFR. The concomitant increases in sodium and urine excretion may be mediated by the marked increase in plasma ANP levels. The decreases in GFR and RBF might contribute to the renal failure observed in some patients after status epilepticus.
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PMID:Recurrent seizures alter renal function and plasma atrial natriuretic peptide levels in rats. 755 80

We present a case of a six-week-old infant who developed life-threatening complications after unintentional sodium bicarbonate intoxication. Baking soda was being used by the mother as a home remedy to "help the baby burp." A review of the literature regarding the use (or misuse) of baking soda follows. Our patient, along with the other noted case reports, emphasizes the need for warnings on baking soda products whose labels recommend its use as an antacid. Poisonings must be high in the differential diagnosis of any patient, regardless of age, who presents with altered mental status or status epilepticus.
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PMID:Baking soda: a potentially fatal home remedy. 759 70

The present study investigates some neuropharmacological effects of an ethanolic extract of the leaves of Trema guineensis (Ulmaceae), a medicinal plant of central Africa. Intraperitoneal administration of the extract induced hypothermia. In addition, the extract significantly shortened the latency to sleep and prolonged the duration of sleeping time induced by sodium pentobarbital in mice. Moreover, T. guineensis significantly delayed the onset of clonic seizures induced by pentylenetetrazole in mice. In contrast, T. guineensis did not affect convulsions induced by maximal electroshock and picrotoxin in mice nor status epilepticus produced by pilocarpine and kainic acid in rats.
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PMID:Some pharmacological effects of an ethanolic extract of Trema guineensis on the central nervous system in rodents. 793 62


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