Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0038220 (status epilepticus)
 7,272 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 2-month-old girl survived a lethal serum level of paraldehyde after being given the drug intravenously (IV) for status epilepticus. On the basis of known pharmacokinetic data in man, a slow IV infusion, over a period of five minutes, of 200 mg/kg of paraldehyde followed by a drip of 20 mg/kg/hr should result in safe, rapid control of status epilepticus when first-line anticonvulsant drugs have failed. The paraldehyde should be diluted to a 10% solution with 5% dextrose water.
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PMID:Paraldehyde toxicity during treatment of status epilepticus. 708 Nov 59

Rat brains (n = 17) with flurothyl-induced status epilepticus (SE) have been imaged with a gradient-echo diffusion-weighted imaging sequence at 2.0 T. The apparent water diffusion coefficient (ADC) decreased during seizure discharges. The magnitude of the ADC reduction correlated well with the duration of flurothyl exposure. A 17% reduction in the water ADC compared with preseizure condition was observed in rats with the longest flurothyl exposure time. In 13 rats, pentobarbital was used to arrest the electrographic seizure activity. ADC values began to return to normal a few minutes after the injection. In four rats with no pentobarbital administration, ADC values remained depressed up to 1 h after seizure onset. The results suggest that diffusion-weighted MR imaging may be useful for mapping recent intense seizure activity in human patients with medically intractable epilepsy.
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PMID:Barbiturate-reversible reduction of water diffusion coefficient in flurothyl-induced status epilepticus in rats. 770 17

Unexpected sudden death is a common event in otherwise healthy epileptics, though its etiology has remained unclear. Many authors have suggested cardiac arrhythmias as the cause, and limited data in humans and animal studies have supported this. However, autopsy series in humans have shown pulmonary edema, a phenomenon not compatible with a sudden arrhythmic death, as a possible cause. We developed a model of status epilepticus in unanesthetized, chronically instrumented sheep in which sudden death and pulmonary edema occur. Catecholamine levels and seizure type and duration did not differ between animals dying suddenly and those surviving. Benign arrhythmias were generated in all animals; in no case did an arrhythmia account for the death of an animal. Striking hypoventilation was demonstrated in the sudden death group but not in the surviving animals. Differences in peak left atrial and pulmonary artery pressures, and in extravascular lung water were also demonstrated; pulmonary edema did not account for the demise of the sudden death animals. Thus, our model of epileptic sudden death supports a role of central hypoventilation in the etiology of sudden unexpected death and confirms the association with pulmonary edema. The importance of arrhythmia in its pathogenesis is not confirmed.
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PMID:The role of hypoventilation in a sheep model of epileptic sudden death. 771 90

Midazolam is a short-acting water soluble benzodiazepine that has been used with an increasing frequency in the last years. Although there are reports on its use in status epilepticus, there is none in the neonatal period. A pre-term (35 w) AGA newborn infant with a severe hypoxic-ischemic encephalopathy secondary to grade III hyaline membrane disease developed status epilepticus in the first 6 hours of life and was successfully treated with midazolam after phenobarbital and phenytoin failed to achieve seizure control. Dosage schedule was 0.2 mg/kg IV, followed by continuous infusion of 0.025 mg/kg/h. Midazolam is an effective drug for neonatal status epilepticus and more experience should accumulate before it can be routinely employed in the neonatal period. This case shows that it is a possible option before using more dangerous drugs, such as thionembutal.
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PMID:Midazolam for treatment of refractory neonatal seizures. A case report. 782 58

To investigate the potential role of drug therapy in preventing or exacerbating seizure-related brain injury in the prepubescent brain, we administered kainic acid to rats at postnatal day 35. Therapy with daily phenobarbital was started directly before or 1 day after kainic acid was administered, and was continued through postnatal day 153. Rats receiving phenobarbital had therapeutic concentrations during most of the 24-hour dosing period, but also experienced supratherapeutic peak concentrations. The animals were subsequently tested using the water maze (a measure of visuospatial memory), open field (a measure of activity level), and handling tests (a measure of emotionality). The frequency of spontaneous recurrent seizures was monitored during and after phenobarbital therapy. Kainic acid resulted in status epilepticus on postnatal day 35 in all the rats that received it but those receiving phenobarbital first manifested a shorter and less severe status epilepticus as compared to the rats given kainic acid alone. Rats starting phenobarbital immediately before kainic acid was administered did not differ from control rats on behavioral testing and had no subsequent spontaneous recurrent seizures and no histological lesions. Rats receiving kainic acid alone performed significantly poorer than did control rats in the water maze, were more aggressive, had histological lesions, and manifested spontaneous recurrent seizures. As compared to the group treated only with kainic acid, rats receiving kainic acid followed by phenobarbital at postnatal days 36 to 153 manifested similar aggressiveness and histological lesions, similar frequency of spontaneous recurrent seizures after phenobarbital taper, and even greater disturbances in memory, learning, and activity level.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Phenobarbital modifies seizure-related brain injury in the developing brain. 808 Feb 50

Midazolam is a water-soluble benzodiazepine proven to be efficacious in sedation, hypnosis, and induction and maintenance of anesthesia. Because of its water solubility, it is a desirable drug for the control of status epilepticus when intravenous (IV) access is not obtainable. This study compares intramuscular (IM) versus IV routes of administration of midazolam in the control of tonic-clonic activity produced by chemically induced generalized seizures in a swine model. When midazolam was administered by IV route, tonic-clonic activity lasted a mean of 34 +/- 5.4 seconds, and when administered by IM route, the tonic-clonic activity lasted a mean of 116 +/- 41 seconds. Both were considerably abbreviated when compared with the expected duration of pentylenetetrazol-induced seizures in the swine model. Serum levels of midazolam achieved by the IV route were considerably higher than those achieved by the IM route. It is concluded that midazolam is effective in the control of tonic-clonic manifestations of generalized seizures when administered by the IV or the IM route and that no correlation exists between serum levels achieved and the time to control the seizure.
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PMID:Intravenous versus intramuscular midazolam in treatment of chemically induced generalized seizures in swine. 817 31

Midazolam is a water-soluble benzodiazepine imide that has been used in recent years to manage status epilepticus (SE). We describe four patients with SE refractory to conventional treatment, whose seizures were controlled with midazolam administered intramuscularly in two cases and intravenously in the remaining two. Given the pharmacokinetic traits of this drug, the intramuscular route offers great advantages. Midazolam also produces fewer side effects than do other benzodiazepines, suggesting the possibility of its use as a first line treatment for SE and frequent epileptic seizures.
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PMID:[Treatment of status epilepticus with midazolam: report of four cases]. 820 58

Magnetic resonance spectroscopy (MRS) can be used for noninvasive measurement of more than two dozen small metabolites in the brains of living animals and humans. In the first decade of its use for study of seizure phenomena in animals, MRS successfully detected in vivo seizure-induced cerebral acidosis and reduction of phosphocreatine concentration, changes that had been described previously by techniques requiring destruction of tissue. Thus validated, MRS was used to reveal new aspects of epileptic pathophysiology in animals: (a) dissociation of brain lactate and pH during experimental status epilepticus of low and intermediate intensity, reflecting metabolic compartmentation; and (b) long persistence of metabolically active elevated brain lactate after brief cortical electroshock. The latter phenomenon may be an extreme form of a mechanism by which lactate production primes synaptic terminals for maximal sustained firing rates during normal brain activation. Diffusion-weighted imaging of rat brain has shown that status epilepticus apparently shortens the mean path length of water diffusion, a novel finding that provides new insight concerning the physical conditions under which the seizure-related chemical changes detected by MRS occur. MRS study of epileptic patients has been undertaken more recently as instruments large enough for observations on humans have become available. Acidosis, reduction of phosphocreatine, and elevation of lactate have all been demonstrated in the human brain during seizure discharge. Chronic reduction of N-acetylaspartate in limbic regions probably reflects neuronal loss and may correlate with mesial temporal sclerosis.
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PMID:Nuclear magnetic resonance spectroscopy of seizure states. 820 10

Diffusion-weighted (DW) imaging has been used to record changes associated with status epilepticus (SE) in rat brain. It was found that the apparent diffusion coefficient (ADC) of water in brain decreased 14-18% during SE, and it fell a further 20-22% when the animals were sacrificed. The transverse decay time constant T2* showed corresponding reductions, but no significant changes were seen in relaxation times T1 or T2 values. Changes in ADC in status epilepticus are similar to those seen in stroke and ischemia but occur under very different conditions of blood flow and metabolism.
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PMID:Changes in water diffusion and relaxation properties of rat cerebrum during status epilepticus. 836 5

Felbamate (FBM), a newly developed antiepileptic drug (AED), was previously shown to offer some neuroprotective effects against hypoxic injury in both in vivo and in vitro studies. We administered FBM (100 or 300 mg/kg) to 30-day-old rats 1 h after they received a convulsant dosage of kainic acid (KA). Animals were then tested at age 80 days in the water maze, open field, and handling tests. Seizure latency was then tested by flurothyl inhalation. Animals that received 300 mg/kg FBM performed better in all three tests and had longer latencies to flurothyl-induced seizures than did animals that received vehicle. This study suggests that FBM may have some neuroprotective effects after KA-induced status epilepticus (SE).
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PMID:Neuroprotective effect of felbamate after kainic acid-induced status epilepticus. 845 45


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