Seizure, New Onset
Total Page:16
File Type:pdf, Size:1020Kb
Load more
Recommended publications
-
Status Epilepticus Clinical Pathway
JOHNS HOPKINS ALL CHILDREN’S HOSPITAL Status Epilepticus Clinical Pathway 1 Johns Hopkins All Children's Hospital Status Epilepticus Clinical Pathway Table of Contents 1. Rationale 2. Background 3. Diagnosis 4. Labs 5. Radiologic Studies 6. General Management 7. Status Epilepticus Pathway 8. Pharmacologic Management 9. Therapeutic Drug Monitoring 10. Inpatient Status Admission Criteria a. Admission Pathway 11. Outcome Measures 12. References Last updated: July 7, 2019 Owners: Danielle Hirsch, MD, Emergency Medicine; Jennifer Avallone, DO, Neurology This pathway is intended as a guide for physicians, physician assistants, nurse practitioners and other healthcare providers. It should be adapted to the care of specific patient based on the patient’s individualized circumstances and the practitioner’s professional judgment. 2 Johns Hopkins All Children's Hospital Status Epilepticus Clinical Pathway Rationale This clinical pathway was developed by a consensus group of JHACH neurologists/epileptologists, emergency physicians, advanced practice providers, hospitalists, intensivists, nurses, and pharmacists to standardize the management of children treated for status epilepticus. The following clinical issues are addressed: ● When to evaluate for status epilepticus ● When to consider admission for further evaluation and treatment of status epilepticus ● When to consult Neurology, Hospitalists, or Critical Care Team for further management of status epilepticus ● When to obtain further neuroimaging for status epilepticus ● What ongoing therapy patients should receive for status epilepticus Background: Status epilepticus (SE) is the most common neurological emergency in children1 and has the potential to cause substantial morbidity and mortality. Incidence among children ranges from 17 to 23 per 100,000 annually.2 Prevalence is highest in pediatric patients from zero to four years of age.3 Ng3 acknowledges the most current definition of SE as a continuous seizure lasting more than five minutes or two or more distinct seizures without regaining awareness in between. -
Cognitive Impairment: Causes, Diagnosis and Treatment
NEUROLOGY - LABORATORY AND CLINICAL RESEARCH DEVELOPMENTS COGNITIVE IMPAIRMENT: CAUSES, DIAGNOSIS AND TREATMENT No part of this digital document may be reproduced, stored in a retrieval system or transmitted in any form or by any means. The publisher has taken reasonable care in the preparation of this digital document, but makes no expressed or implied warranty of any kind and assumes no responsibility for any errors or omissions. No liability is assumed for incidental or consequential damages in connection with or arising out of information contained herein. This digital document is sold with the clear understanding that the publisher is not engaged in rendering legal, medical or any other professional services. NEUROLOGY – LABORATORY AND CLINICAL RESEARCH DEVELOPMENTS SERIES Intracranial Hypertension Stefan Mircea Iencean and Alexandru Vladimir Ciurea 2009 ISBN: 978-1-60741-862-7 (Hardcover Book) Intracranial Hypertension Stefan Mircea Iencean and Alexandru Vladimir Ciurea 2009 ISBN: 978-1-60876-549-2 (Online Book) Cerebral Blood Flow Regulation Nodar P. Mitagvaria and Haim (James) I. Bicher 2009 ISBN: 978-1-60692-163-0 Cerebral Ischemia in Young Adults: Pathogenic and Clinical Perspectives Alessandro Pezzini and Alessandro Padovani (Editors) 2009 ISBN: 978-1-60741-627-2 Dizziness: Vertigo, Disequilibrium and Lightheadedness Agnes Lindqvist and Gjord Nyman (Editors) 2009: ISBN 978-1-60741-847-4 Somatosensory Cortex: Roles, Interventions and Traumas Niels Johnsen and Rolf Agerskov (Editors) 2009. ISBN: 978-1-60741-876-4 Cognitive Impairment: Causes, Diagnosis and Treatment Melanie L. Landow (Editor) 2009. ISBN: 978-1-60876-205-7 NEUROLOGY - LABORATORY AND CLINICAL RESEARCH DEVELOPMENTS COGNITIVE IMPAIRMENT: CAUSES, DIAGNOSIS AND TREATMENT MELANIE L. -
Non-Epileptic Seizures a Short Guide for Patients and Families
Non-epileptic seizures a short guide for patients and families Department of Neurology Information for patients Royal Hallamshire Hospital What are non-epileptic seizures? In a seizure people lose control of their body, often causing shaking or other movements of arms and legs, blacking out, or both. Seizures can happen for different reasons. During epileptic seizures, the brain produces electrical impulses, which stop it from working normally. Non-epileptic seizures look a little like epileptic seizures, but are not caused by abnormal electrical activity in the brain. Non-epileptic seizures happen because of problems with handling thoughts, memories, emotions or sensations in the brain. Such problems are sometimes related to stress. However, they can also occur in people who seem calm and relaxed. Often people do not understand why they have developed non-epileptic seizures. Are non-epileptic seizures rare? For every 100,000 people, between 15 and 30 have non- epileptic seizures. Nearly half of all people brought in to hospital with suspected serious epilepsy turn out to have non- epileptic seizures instead. One of the reasons why you may not have heard of non- epileptic seizures is that there are several other names for the same problem. Non-epileptic seizures are also known as pseudoseizures, psychogenic, dissociative or functional seizures. Sometimes people who have non-epileptic seizures are told that they suffer from non-epileptic attack disorder (NEAD). How can I be sure that this is the right diagnosis? Non-epileptic seizures often look like epileptic seizures to friends, family members and even doctors. Like epilepsy, non- epileptic seizures can cause injuries and loss of control over bladder function. -
An Atypical Presentation of Epilepsy; What a Headache! J Neurol Transl Neurosci 5(1): 1078
Central Journal of Neurology & Translational Neuroscience Bringing Excellence in Open Access Case Report Corresponding author Sarah Seyffert, Trinity School of Medicine, 505 Tadmore court Schaumburg, Illinois 60194, USA, Tel: 847-217-4262; An Atypical Presentation of Email: Submitted: 13 April 2017 Epilepsy; What a Headache! Accepted: 07 June 2017 Published: 09 June 2017 Sarah Seyffert* and Wade Kvatum ISSN: 2333-7087 Trinity School of Medicine, USA Copyright © 2017 Seyffert et al. Abstract OPEN ACCESS The relationship between headache and seizure is a poorly understood and controversial topic; however, the literature has recently suggested that the two conditions may be related. Keywords The interplay between these conditions seems to be even more complex in a group of • Epilepsy patients with epilepsy related headaches. It has been proposed that the association could • Headache be classified into preictal, ictal, postictal, or interictal headaches. Here we present a case • Ictal epileptic headache report of a 62 year old male who presented with a chief complaint of new onset severe headache and subsequently underwent multiple diagnostic testing modalities before he was finally diagnosed and treated for epilepsy, which lead to the resolution of his headache. We conclude with a short discussion of how to subcategorize seizure related headaches based on their temporal relationship and why they can pose such a difficult diagnostic challenge. ABBREVIATIONS afebrile with a normal CBC and CMP. On arrival to the hospital he underwent a non-contrast head CT scan; however, no evidence of EEG: Electroencephalogram; CBC: Complete Blood Count; acute intracranial abnormality was seen. Additionally, a lumbar CMP: Complete Metabolic Panel; CT scan: Computerized puncture was performed which was negative for xanthochromia Tomography Scan; CTA: Computed Tomographic Angiography; and showed a protein count of 27, glucose 230, and 2 white MRI: Magnetic Resonance Imaging blood cells. -
Seizure Triggers
SEIZURE TRIGGERS M A R I A R AQUEL LOPEZ. M.D M I A M I V H A DEFINITION OF SEIZURE VS. EPILEPSY • Epileptic seizure: Is a transient symptom of abnormal excessive electric activity of the brain. EPILEPSY • More than one epileptic seizure. TYPE OF SEIZURES ETIOLOGY • Epilepsy is a heterogeneous condition with varying etiologies including: 1. Genetic 2. Infectious 3. Trauma 4. Vascular 5. Neoplasm 6. Toxic exposures TRIGGERS FOR EPILEPTIC SEIZURES • What is a seizure trigger? It is a factor that can cause a seizure in a person who either has epilepsy or does not. • Factors that lead into a seizure are complex and it is not possible to determine the trigger in each patient. TRIGGERS A. Most common ones Stress Missing taking the medication THE MOST OFTEN REPORTED BY PATIENTS • Sleep deprivation and tiredness • Fever OTHER COMMON CAUSES . Infection . Fasting leading into hypoglycemia. Caffeine: particularly if it interrupts normal sleep patterns. Other medications like hormonal replacement, pain killers or antibiotics. OTHER TRIGGERS External precipitants • Alcohol consumption or withdrawal. *Specific triggers that are related to Reflex epilepsy Bathing Eating Reading OTHER TRIGGERS • Flashing light: especially with patients with idiopathic generalized seizure disorder STRESS . Stress is the most common patient –perceived seizure precipitant, studies of life events suggest that stressful experiences trigger seizures in certain individuals. Animals epilepsy models provide more convincing evidence that exposure to exogenous and endogenous stress mediators has been found to increase epileptic activity in the brain, especially after repeating exposure. SOLUTION ABOUT STRESS • Intervention of copying with stress STRESS MANAGEMENT • Include trying to get in a place of peace utilizing multiple techniques: • Regular exercise • Yoga and medication • Therapy or psychological support with a provider. -
A Rare Case of Immune Reconstitution Inflammatory Syndrome Development in an Immunocompromised Patient with Progressive Multifocal Leukoencephalopathy And
Hindawi Publishing Corporation Case Reports in Neurological Medicine Volume 2013, Article ID 460701, 5 pages http://dx.doi.org/10.1155/2013/460701 Case Report A Rare Case of Immune Reconstitution Inflammatory Syndrome Development in an Immunocompromised Patient with Progressive Multifocal Leukoencephalopathy and Multicentric Castleman’s Disease Mohankumar Kurukumbi,1 Sheldon Steiner,1,2 Shariff Dunlap,1 Sherita Chapman,3 Noha Solieman,1 and Annapurni Jayam-Trouth1 1 Department of Neurology, Howard University Hospital, 2041 Georgia Avenue, Washington, DC 20060, USA 2 Department of Neurology, Howard University College of Medicine, Washington, DC 20060, USA 3 Department of Neurology, University of Virginia, Charlottesville, VA 22908, USA Correspondence should be addressed to Mohankumar Kurukumbi; [email protected] Received 27 June 2013; Accepted 17 July 2013 AcademicEditors:T.K.Banerjee,J.L.Gonzalez-Guti´ errez,´ R. Hashimoto, J. C. Kattah, and Y. Wakabayashi Copyright © 2013 Mohankumar Kurukumbi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Immune reconstitution inflammatory syndrome (IRIS) development in HIV with preexistent progressive multifocal leukoen- cephalopathy (PML) has been extensively studied. PML-IRIS typically manifests clinically as new or worsening neurologic symptoms in conjunction with enlarging CNS lesions and occurs in approximately 10–20 percent of HIV-infected patients with PML who begin HAART. Likewise, Multicentric Castleman’s Disease (MCD), a rare malignant lymphoproliferative disorder, has a strong and well-known association with HIV. Our case provides a rare instance of PML-IRIS in combination with MCD in an HIV-positive individual. -
Epilepsy Syndromes E9 (1)
EPILEPSY SYNDROMES E9 (1) Epilepsy Syndromes Last updated: September 9, 2021 CLASSIFICATION .......................................................................................................................................... 2 LOCALIZATION-RELATED (FOCAL) EPILEPSY SYNDROMES ........................................................................ 3 TEMPORAL LOBE EPILEPSY (TLE) ............................................................................................................... 3 Epidemiology ......................................................................................................................................... 3 Etiology, Pathology ................................................................................................................................ 3 Clinical Features ..................................................................................................................................... 7 Diagnosis ................................................................................................................................................ 8 Treatment ............................................................................................................................................. 15 EXTRATEMPORAL NEOCORTICAL EPILEPSY ............................................................................................... 16 Etiology ................................................................................................................................................ 16 -
The Relationship Between the Components of Idiopathic Focal Epilepsy
Journal of Pediatrics and Neonatal Care Review Article Open Access The relationship between the components of idiopathic focal epilepsy Abstract Volume 8 Issue 3 - 2018 The classification of epileptic syndromes in children is not a simple duty, it requires Cesar Ramon Romero Leguizamon a great clinical ability as well as some degree of experience. Until today there is no Department of Drug Design and Pharmacology, University of international consensus regarding the different diseases that are part of the Idiopathic Copenhagen, Denmark Focal Epilepsies However, these diseases are the most prevalent in children suffering from some type of epilepsy, for this reason it is important to know more about these, Correspondence: Cesar Ramon Romero Leguizamon their clinical characteristics, pathological findings in studies such as encephalogram, M.D., Department of Drug Design and Pharmacology Faculty resonance, polysomnography and others. In the same way, to explore the possible of Health and Medical Science, University of Copenhagen, genetic origins of many of these pathologies, that have been little explored and Denmark, Jagtev 160, 2100 Copenhagen, Denmark, become an important therapeutic goal. A description of the most relevant aspects of Email [email protected] atypical benign partial epilepsy, Landau-Kleffner syndrome, benign epilepsy with centrotemporal spikes, electrical status epilepticus during sleep and Panayiotopoulos Received: February 17, 2018 | Published: May 14, 2018 syndrome is presented in this review, Allowing physicians and family members of children suffering from these diseases to have a better understanding and establish in this way a better diagnosis and treatment in patients, as well as promote in the scientific community the interest to investigate more about these relevant pathologies in childhood. -
ILAE Classification and Definition of Epilepsy Syndromes with Onset in Childhood: Position Paper by the ILAE Task Force on Nosology and Definitions
ILAE Classification and Definition of Epilepsy Syndromes with Onset in Childhood: Position Paper by the ILAE Task Force on Nosology and Definitions N Specchio1, EC Wirrell2*, IE Scheffer3, R Nabbout4, K Riney5, P Samia6, SM Zuberi7, JM Wilmshurst8, E Yozawitz9, R Pressler10, E Hirsch11, S Wiebe12, JH Cross13, P Tinuper14, S Auvin15 1. Rare and Complex Epilepsy Unit, Department of Neuroscience, Bambino Gesu’ Children’s Hospital, IRCCS, Member of European Reference Network EpiCARE, Rome, Italy 2. Divisions of Child and Adolescent Neurology and Epilepsy, Department of Neurology, Mayo Clinic, Rochester MN, USA. 3. University of Melbourne, Austin Health and Royal Children’s Hospital, Florey Institute, Murdoch Children’s Research Institute, Melbourne, Australia. 4. Reference Centre for Rare Epilepsies, Department of Pediatric Neurology, Necker–Enfants Malades Hospital, APHP, Member of European Reference Network EpiCARE, Institut Imagine, INSERM, UMR 1163, Université de Paris, Paris, France. 5. Neurosciences Unit, Queensland Children's Hospital, South Brisbane, Queensland, Australia. Faculty of Medicine, University of Queensland, Queensland, Australia. 6. Department of Paediatrics and Child Health, Aga Khan University, East Africa. 7. Paediatric Neurosciences Research Group, Royal Hospital for Children & Institute of Health & Wellbeing, University of Glasgow, Member of European Refence Network EpiCARE, Glasgow, UK. 8. Department of Paediatric Neurology, Red Cross War Memorial Children’s Hospital, Neuroscience Institute, University of Cape Town, South Africa. 9. Isabelle Rapin Division of Child Neurology of the Saul R Korey Department of Neurology, Montefiore Medical Center, Bronx, NY USA. 10. Programme of Developmental Neurosciences, UCL NIHR BRC Great Ormond Street Institute of Child Health, Department of Clinical Neurophysiology, Great Ormond Street Hospital for Children, London, UK 11. -
Epilepsy After Stroke
Stroke Helpline: 0303 3033 100 Website: stroke.org.uk Epilepsy after stroke In the first few weeks after a stroke some people have a seizure, and a small number go on to develop epilepsy – a tendency to have repeated seizures. These can usually be completely controlled with treatment. This factsheet explains what epilepsy is, the different types of seizures, and how epilepsy is diagnosed and treated. It also includes advice about coping with a seizure, and a glossary. Epilepsy is a tendency to have repeated What causes seizures? seizures – sometimes called ‘fits’ or ‘attacks’. It affects just under one per cent Cells in the brain communicate with one of people in the UK. Stroke is one of many another and with our muscles by passing conditions that can lead to epilepsy. electrical signals along nerve fibres. If you have epilepsy this electrical activity can Around five per cent of people who have a become disordered. A sudden abnormal stroke will have a seizure within the following burst of electrical activity in the brain can few weeks. These are known as acute or lead to a seizure. onset seizures and normally happen within 24 hours of the stroke. You are more likely There are over 40 different types of seizures to have one if you have had a severe stroke, ranging from tingling sensations or ‘going a stroke caused by bleeding in the brain (a blank’ for a few seconds, to shaking and haemorrhagic stroke), or a stroke involving losing consciousness. the part of the brain called the cerebral cortex. If you have an onset seizure, it This can mean that epilepsy is sometimes does not necessarily mean you have or will confused with other conditions, including develop epilepsy. -
A Prospective Open-Labeled Trial with Levetiracetam in Pediatric Epilepsy Syndromes: Continuous Spikes and Waves During Sleep Is Definitely a Target
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Elsevier - Publisher Connector Seizure 20 (2011) 320–325 Contents lists available at ScienceDirect Seizure journal homepage: www.elsevier.com/locate/yseiz A prospective open-labeled trial with levetiracetam in pediatric epilepsy syndromes: Continuous spikes and waves during sleep is definitely a target S. Chhun a,b,c, P. Troude d, N. Villeneuve e, C. Soufflet a,b,f, S. Napuri g, J. Motte h, F. Pouplard i, C. Alberti d, S. Helfen j, G. Pons a,b,c, O. Dulac a,b,k, C. Chiron a,b,k,* a Inserm, U663, Paris, France b University Paris Descartes, Faculty of Medicine, Paris, France c APHP, Pediatric Clinical Pharmacology, Cochin-Saint Vincent de Paul Hospital, Paris, France d APHP, Unit of Clinical Research, Robert Debre Hospital, Paris, France e APHM, Neuropediatric Department, Marseille, France f APHP, Necker Hospital, Department of Functional Explorations, Paris, France g Neuropediatric Department, Rennes Hospital, France h Neuropediatric Department, American Memorial Hospital, Reims, France i Neuropediatric Department, Angers Hospital, France j APHP, Necker Hospital, Unit of Clinical Research, Paris, France k APHP, Necker Hospital, Neuropediatric Department, Paris, France ARTICLE INFO ABSTRACT Article history: Although LVT is currently extensively prescribed in childhood epilepsy, its effect on the panel of Received 12 October 2010 refractory epilepsy syndromes has not been entirely evaluated prospectively. In order to study the Received in revised form 17 December 2010 efficacy and safety of LVT as adjunctive therapy according to syndromes, we included 102 patients with Accepted 27 December 2010 refractory seizures (6 months to 15 years) in a prospective open-labeled trial. -
Supplementary Table Term* Revised Term** Focal Seizure Without Impairment of a Subjective Sensory Or Psychic Experience As Part of Migraine Or Epilepsy
Supplementary table Term* Revised term** Focal seizure without impairment of A subjective sensory or psychic experience as part of migraine or epilepsy. In epilepsy it is a focal consciousness or awareness Aura seizure without loss of consciousness (a simple partial seizure). It may or may not be followed by involving subjective sensory or other seizure manifestations. psychic phenomena only Automatic behaviour associated with loss of awareness, such as lip smacking or hand wringing, Automatism Focal dyscognitive seizure occurring as part of a complex partial seizure. Convulsion (previously "grand Tonic-clonic seziure, convulsive Seizure with involuntary, irregular myoclonic, clonic or tonic–clonic movements of one or more mal") seizure limbs. Onset may be focal or primary generalised. Literally ‘already seen’, this refers to a false impression that a present experience is familiar. It is used to refer to something heard, experienced or seen. It can be the aura of a temporal lobe Déjà vu seizure, but also happens in other settings (normal experience, intoxication, migraine, psychiatric). Focal seizure (previously "partial, Focal seizure A seizure originating in a specific cortical location. May be due to a structural lesion. localization related") Literally a ‘blow’. Usually used for an epileptic seizure (but can refer to other paroxysmal events, Ictus such as migraine, transient neurological events and stroke). Similarly pre- and post-ictal are used may for the period before and after a seizure. Idiopathic Genetic In relation to epilepsy, this implies that there is an underlying genetic cause. Literally ‘never seen’, this refers to a false impression that a present experience is unfamiliar. It is Jamais vu used for something seen, heard or experienced.