27 results on '"Status epilepticu"'
Search Results
2. Admission neutrophil-to-lymphocyte ratio predicts length of hospitalization and need for ICU admission in adults with Status Epilepticus
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Sasha Olivo, Alex Buoite Stella, Stefania Pavan, Matteo Cegalin, Giovanni Furlanis, Marta Cheli, Marinella Tomaselli, David Stokelj, Paolo Manganotti, Olivo, Sasha, Buoite Stella, Alex, Pavan, Stefania, Cegalin, Matteo, Furlanis, Giovanni, Cheli, Marta, Tomaselli, Marinella, Stokelj, David, and Manganotti, Paolo
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Inflammation ,Systemic inflammatory response syndrome ,Neurology ,Biomarkers ,Status epilepticus ,Status epilepticu ,Neurology (clinical) ,General Medicine ,Biomarker - Abstract
Background and objectives: Status epilepticus (SE) is a time-dependent neurological emergency. The current study evaluated the prognostic value of admission neutrophil-to-lymphocyte ratio (NLR) in patients with status epilepticus. Methods: In this retrospective observational cohort study we included all consecutive patients discharged from our neurology unit with the clinical or EEG diagnosis of SE from 2012 to 2022. Stepwise multivariate analysis was conducted to test the association of NLR with length of hospitalization, need for Intensive Care Unit (ICU) admission and 30 days mortality. Receiver operating characteristic (ROC) analysis was performed to identify the best cutoff for NLR to identify patients who will need ICU admission. Results: A total of 116 patients were enrolled in our study. NLR was correlated with length of hospitalization (p = 0.020) and need for ICU admission ( p = 0.046). In addition, the risk of ICU admission increased in patients with intracranial hemorrhage and length of hospitalization was correlated with C-reactive protein-to-albumin ratio (CRP/ALB). ROC analysis identified a NLR of 3.6 as best cutoff value to discriminate need of ICU admission (area under the curve [AUC]=0.678; p = 0.011; Youden's index=0.358; sensitivity, 90.5%, specificity, 45.3%). Discussion: In patients with SE admission NLR could be a predictor of length of hospitalization and need for ICU admission.
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- 2023
3. Case of Severe Epstein-Barr Virus Encephalitis in a Child
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Mikuc, Barbara, Matek, Tena, and Stemberger Marić, Lorna
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barbiturate coma ,encephalitis ,EpsteinBarr virus ,status epilepticu - Abstract
Epstein-Barr virus usually causes mild and self-limiting infections in children and adolescents. Infectious mononucleosis is the most common clinical manifestation but neurologic complications, such as encephalitis, occur in up to 8% of patients.
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- 2023
4. EPIDEMIOLOGICAL CHARACTERISTICS AND THERAPY OF STATUS EPILEPTICUS IN PAULS STRADINS CLINICAL UNIVERSITY HOSPITAL FROM 2012 TO 2016.
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Vanaga, Eva
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STATUS epilepticus treatment , *UNIVERSITY hospitals , *MEDICAL emergencies , *EPIDEMIOLOGY , *DISEASE incidence - Abstract
Introduction. Status epilepticus (SE) is a medical emergency and requires rapid treatment. Incidence of SE is 10-41 per 100 000 population. [1] There are no data about incidence, principles of treatment and outcome of status epilepticus in Latvia, so this study was made to collect information at Pauls Stradiņš Clinical University Hospital. Aim. To analyse clinical profile, diagnostics, therapy and outcome of status epilepticus patients stationed at Pauls Stradiņš Clinical University Hospital from 2012 to 2016. Methods. In this retrospective study all status epilepticus patients stationed in Pauls Stradiņš Clinical University Hospital from 2012 to 2016 were selected. Patient medical records were analysed and information about previous history of seizures, type of seizure, duration of hospitalization, electroencephalogram (EEG) results, therapy, complications and outcome of therapy was collected. Collected data were compared to evidence-based guidelines. Results. In the study 44 patients with status epilepticus were found. The most of the seizures were focal and only some were generalized, but in some cases medical records had no information about the seizure. The electroencephalogram was made for more than a half of the patients and served as the basis for the diagnosis of non-concurrent status epilepticus. Almost all patients received first line and second line treatment. Third line treatment was given in 73% of cases. Half of the patients developed treatment-related complications during hospitalization, the most common complication was intrahospital infection. Intrahospital mortality was 11%, all the other patients were discharged or transferred to another hospital. [ABSTRACT FROM AUTHOR]
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- 2018
5. Cholesterol 24-hydroxylase is a novel pharmacological target for anti-ictogenic and disease modification effects in epilepsy
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Alessia Salamone, Gaetano Terrone, Rossella Di Sapia, Silvia Balosso, Teresa Ravizza, Luca Beltrame, Ilaria Craparotta, Laura Mannarino, Sara Raimondi Cominesi, Massimo Rizzi, Alberto Pauletti, Sergio Marchini, Luca Porcu, Till S. Zimmer, Eleonora Aronica, Matthew During, Brett Abrahams, Shinichi Kondo, Toshiya Nishi, Annamaria Vezzani, Salamone, Alessia, Terrone, Gaetano, Di Sapia, Rossella, Balosso, Silvia, Ravizza, Teresa, Beltrame, Luca, Craparotta, Ilaria, Mannarino, Laura, Cominesi, Sara Raimondi, Rizzi, Massimo, Pauletti, Alberto, Marchini, Sergio, Porcu, Luca, Zimmer, Till S., Aronica, Eleonora, During, Matthew, Abrahams, Brett, Kondo, Shinichi, Nishi, Toshiya, Vezzani, Annamaria, Pathology, APH - Aging & Later Life, APH - Mental Health, and ANS - Cellular & Molecular Mechanisms
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Epilepsy ,Pyridines ,Status epilepticu ,Hippocampus ,Epileptogenesis ,Neuroprotection ,Disease Models, Animal ,Mice ,Cholesterol ,Neurology ,Epilepsy, Temporal Lobe ,Piperidines ,Seizures ,Glia ,Cholesterol 24-Hydroxylase ,Animals ,Humans ,RNA ,Temporal lobe epilepsy ,Status epilepticus - Abstract
Therapies for epilepsy mainly provide symptomatic control of seizures since most of the available drugs do not target disease mechanisms. Moreover, about one-third of patients fail to achieve seizure control. To address the clinical need for disease-modifying therapies, research should focus on targets which permit interventions finely balanced between optimal efficacy and safety. One potential candidate is the brain-specific enzyme cholesterol 24-hydroxylase. This enzyme converts cholesterol to 24S-hydroxycholesterol, a metabolite which among its biological roles modulates neuronal functions relevant for hyperexcitability underlying seizures. To study the role of cholesterol 24-hydroxylase in epileptogenesis, we administered soticlestat (TAK-935/OV935), a potent and selective brain-penetrant inhibitor of the enzyme, during the early disease phase in a mouse model of acquired epilepsy using a clinically relevant dose. During soticlestat treatment, the onset of epilepsy was delayed and the number of ensuing seizures was decreased by about 3-fold compared to vehicle-treated mice, as assessed by EEG monitoring. Notably, the therapeutic effect was maintained 6.5 weeks after drug wash-out when seizure number was reduced by about 4-fold and their duration by 2-fold. Soticlestat-treated mice showed neuroprotection of hippocampal CA1 neurons and hilar mossy cells as assessed by post-mortem brain histology. High throughput RNA-sequencing of hippocampal neurons and glia in mice treated with soticlestat during epileptogenesis showed that inhibition of cholesterol 24-hydroxylase did not directly affect the epileptogenic transcriptional network, but rather modulated a non-overlapping set of genes that might oppose the pathogenic mechanisms of the disease. In human temporal lobe epileptic foci, we determined that cholesterol 24-hydroxylase expression trends higher in neurons, similarly to epileptic mice, while the enzyme is ectopically induced in astrocytes compared to control specimens. Soticlestat reduced significantly the number of spontaneous seizures in chronic epileptic mice when was administered during established epilepsy. Data show that cholesterol 24-hydroxylase contributes to spontaneous seizures and is involved in disease progression, thus it represents a novel target for chronic seizures inhibition and disease-modification therapy in epilepsy.
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- 2022
6. Disabling Resting Tremors Induced by the Short-term Infusion of Valproate: A Reversible Phenomenon.
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Gupta, Ashutosh and Kushwaha, Suman
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TARDIVE dyskinesia ,ANTICONVULSANTS ,VALPROIC acid ,TREMOR ,DRUG side effects - Abstract
Background: Drug-induced tremors after long-term administration of anti-epileptics have been described in the literature. Such tremors are usually postural or action in nature with infrequent resting nature. Case Report: A 23-year-old female presented in status epilepticus. Past and family histories were negative for seizures. She was managed per protocol with valproate. Within hours, she developed resting tremors. The tremors subsided on changing the anti-epileptic. Discussion: Resting tremors have mostly been described in the literature as long-term side-effects of valproate. This case illustrates that even short-term infusion of valproate can cause resting tremors. [ABSTRACT FROM AUTHOR]
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- 2018
- Full Text
- View/download PDF
7. Combining perampanel and ketamine in super refractory post-traumatic status epilepticus: a case report
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Francesco Biaduzzini, Alessandro Dinoto, Stefano Meletti, Marta Cheli, Paolo Manganotti, Erik Roman-Pognuz, Giulia Mazzon, Marinella Tomaselli, Manganotti, P., Cheli, M., Dinoto, A., Biaduzzini, F., Tomaselli, M., Mazzon, G., Roman-Pognuz, E., and Meletti, S.
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ketamine ,super refractory ,Pyridones ,Status epilepticus ,Pyridone ,perampanel ,Perampanel ,chemistry.chemical_compound ,Epilepsy ,Status Epilepticus ,Nitriles ,Anticonvulsant ,medicine ,Humans ,Ketamine ,Anticonvulsants ,business.industry ,Status epilepticu ,General Medicine ,medicine.disease ,Neurology ,chemistry ,Anesthesia ,Neurology (clinical) ,medicine.symptom ,business ,Nitrile ,Super refractory ,Human ,medicine.drug - Abstract
Status Epilepticus (SE) is a condition resulting either from the failure of seizure termination mechanisms or from the abnormal activation of prolonged seizure mechanisms. It represents a life-threatening medical emergency associated with high morbidity and mortality that requires prompt diagnosis and treatment. SE treatment begins with a quick-acting benzodiazepine, followed by intravenous (IV) loading and a continuous infusion of antiseizure medications (ASMs). The failure of first- and second-line treatments is defined as “refractory SE” (RSE) and requires infusion of IV anaesthetics. If anaesthetics fail or SE recurs after 24 hours, SE is defined as “super refractory status epilepticus” (SRSE).
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- 2021
8. Clinical pathways of epileptic seizures and status epilepticus: results from a survey in Italy
- Abstract
Objective: Patients with seizures or status epilepticus (SE) access the hospital through emergency departments and may be admitted into different wards according to the level of care required. Clinicians with different expertise are in charge of taking critical therapeutic decisions. To date, very few studies have investigated the stage at which these patients are referred to neurologists or epileptologists and how guideline recommendations are applied in clinical practice. Methods: A survey was used to investigate how patients with epileptic seizures or SE are managed in emergency and in subsequent hospital pathways in Italy. Results: One hundred and seventy-seven physicians (mainly neurologists) from all parts of Italy filled in a questionnaire. Less than half of the participants (35%) answered that, in their hospital, patients with epilepsy were managed by epileptologists. The percentages were lower for patients presenting with acute seizures (21%) or SE (16%). Diagnostic, therapeutic, and assistance pathways (PDTA) for patients presenting with seizure(s) or SE were available for both conditions in about 50% of cases, while, in the rest of the hospitals, participants indicated informal agreements (about 25% of cases) or lack of any agreement (about 25% of cases) between clinicians. Professionals more often involved in PDTA were epileptologists/neurologists, emergency physicians, and intensivists. More than half ot the participants (55%) thought that organizational issues are the most important criticalities for such patients and need to be improved (61%). Significance: There is a high variability in hospital clinical pathways for epilepsy in Italy.
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- 2020
9. Clinical pathways of epileptic seizures and status epilepticus: results from a survey in Italy
- Abstract
Objective: Patients with seizures or status epilepticus (SE) access the hospital through emergency departments and may be admitted into different wards according to the level of care required. Clinicians with different expertise are in charge of taking critical therapeutic decisions. To date, very few studies have investigated the stage at which these patients are referred to neurologists or epileptologists and how guideline recommendations are applied in clinical practice. Methods: A survey was used to investigate how patients with epileptic seizures or SE are managed in emergency and in subsequent hospital pathways in Italy. Results: One hundred and seventy-seven physicians (mainly neurologists) from all parts of Italy filled in a questionnaire. Less than half of the participants (35%) answered that, in their hospital, patients with epilepsy were managed by epileptologists. The percentages were lower for patients presenting with acute seizures (21%) or SE (16%). Diagnostic, therapeutic, and assistance pathways (PDTA) for patients presenting with seizure(s) or SE were available for both conditions in about 50% of cases, while, in the rest of the hospitals, participants indicated informal agreements (about 25% of cases) or lack of any agreement (about 25% of cases) between clinicians. Professionals more often involved in PDTA were epileptologists/neurologists, emergency physicians, and intensivists. More than half ot the participants (55%) thought that organizational issues are the most important criticalities for such patients and need to be improved (61%). Significance: There is a high variability in hospital clinical pathways for epilepsy in Italy.
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- 2020
10. Management of status epilepticus in adults. Position paper of the Italian League against Epilepsy
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Francesco Brigo, Stefano Meletti, Oriano Mecarelli, Roberto Michelucci, Monica Ferlisi, Nicola Specchio, Fabio Minicucci, Stefano Sartori, Paolo Tinuper, Massimo Mastrangelo, Umberto Aguglia, Minicucci F., Ferlisi M., Brigo F., Mecarelli O., Meletti S., Aguglia U., Michelucci R., Mastrangelo M., Specchio N., Sartori S., and Tinuper P.
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Adult ,medicine.medical_specialty ,Epileptologist ,Antiepileptic drugs ,Status epilepticus ,Neurosurgical Procedures ,03 medical and health sciences ,Behavioral Neuroscience ,Epilepsy ,0302 clinical medicine ,Status Epilepticus ,Medicine ,Humans ,Position paper ,030212 general & internal medicine ,Italian League against Epilepsy ,Treatment ,Disease management (health) ,Anticonvulsants ,Italy ,Randomized Controlled Trials as Topic ,Disease Management ,business.industry ,Status epilepticu ,Neurointensive care ,medicine.disease ,nervous system diseases ,Neurology ,Family medicine ,Neurology (clinical) ,Levetiracetam ,Neurosurgery ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Antiepileptic drug ,medicine.drug - Abstract
Since the publication of the Italian League Against Epilepsy guidelines for the treatment of status epilepticus in 2006, advances in the field have ushered in improvements in the therapeutic arsenal. The present position paper provides neurologists, epileptologists, neurointensive care specialists, and emergency physicians with updated recommendations for the treatment of adult patients with status epilepticus. The aim is to standardize treatment recommendations in the care of this patient population.
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- 2020
11. Reply to Dr. Capovilla on 'Reply to the article 'Management of status epilepticus in adults. Position paper of the Italian League Against Epilepsy'
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Stefano Meletti, Roberto Michelucci, Massimo Mastrangelo, Monica Ferlisi, Paolo Tinuper, Nicola Specchio, Oriano Mecarelli, Fabio Minicucci, Stefano Sartori, Umberto Aguglia, Francesco Brigo, Minicucci F., Ferlisi M., Brigo F., Mecarelli O., Meletti S., Aguglia U., Michelucci R., Mastrangelo M., Specchio N., Sartori S., and Tinuper P.
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Adult ,medicine.medical_specialty ,Midazolam ,Diazepam ,Status epilepticus ,Humans ,Italy ,Epilepsy ,Status Epilepticus ,League ,Behavioral Neuroscience ,medicine ,Psychiatry ,business.industry ,Status epilepticu ,medicine.disease ,Neurology ,Position paper ,Neurology (clinical) ,medicine.symptom ,business ,Human ,medicine.drug - Abstract
n.a.
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- 2020
12. Clinical pathways of epileptic seizures and status epilepticus: results from a survey in Italy
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Alfredo Del Gaudio, Gaetano Zaccara, Francesco Rocco Pugliese, Monica Ferlisi, Giuseppe Citerio, Danilo Toni, Zaccara, G, Citerio, G, Del Gaudio, A, Ferlisi, M, Pugliese, F, and Toni, D
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Adult ,Male ,medicine.medical_specialty ,Neurology ,Dermatology ,Status epilepticus ,03 medical and health sciences ,Epilepsy ,0302 clinical medicine ,Status Epilepticus ,Clinical pathways ,Clinical pathway ,medicine ,Medical Staff, Hospital ,Humans ,030212 general & internal medicine ,epileptic seizures, status epilepticus ,Neurologists ,Acute symptomatic seizure ,Neuroradiology ,Unprovoked seizure ,business.industry ,Status epilepticu ,General Medicine ,Guideline ,Middle Aged ,medicine.disease ,Hospitals ,Clinical Practice ,Psychiatry and Mental health ,Italy ,Health Care Surveys ,Emergency medicine ,Critical Pathways ,Female ,Original Article ,Neurology (clinical) ,Neurosurgery ,Level of care ,medicine.symptom ,business ,Emergency Service, Hospital ,030217 neurology & neurosurgery - Abstract
Summary Objective Patients with seizures or status epilepticus (SE) access the hospital through emergency departments and may be admitted into different wards according to the level of care required. Clinicians with different expertise are in charge of taking critical therapeutic decisions. To date, very few studies have investigated the stage at which these patients are referred to neurologists or epileptologists and how guideline recommendations are applied in clinical practice. Methods A survey was used to investigate how patients with epileptic seizures or SE are managed in emergency and in subsequent hospital pathways in Italy. Results One hundred and seventy-seven physicians (mainly neurologists) from all parts of Italy filled in a questionnaire. Less than half of the participants (35%) answered that, in their hospital, patients with epilepsy were managed by epileptologists. The percentages were lower for patients presenting with acute seizures (21%) or SE (16%). Diagnostic, therapeutic, and assistance pathways (PDTA) for patients presenting with seizure(s) or SE were available for both conditions in about 50% of cases, while, in the rest of the hospitals, participants indicated informal agreements (about 25% of cases) or lack of any agreement (about 25% of cases) between clinicians. Professionals more often involved in PDTA were epileptologists/neurologists, emergency physicians, and intensivists. More than half ot the participants (55%) thought that organizational issues are the most important criticalities for such patients and need to be improved (61%). Significance There is a high variability in hospital clinical pathways for epilepsy in Italy.
- Published
- 2019
13. Super refractory status epilepticus in Lafora disease interrupted by vagus nerve stimulation: A case report
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Barbara Mostacci, Lorenzo Muccioli, Paolo Tinuper, Marco Zanello, Roberto Michelucci, Laura Licchetta, I. Minardi, M. Bandini, Francesca Bisulli, M. Zucchelli, Chiara Leta, Mostacci B., Bisulli F., Muccioli L., Minardi I., Bandini M., Licchetta L., Zucchelli M., Leta C., Michelucci R., Zanello M., and Tinuper P.
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Epilepsy ,business.industry ,General Neuroscience ,medicine.medical_treatment ,Status epilepticu ,Biophysics ,Status epilepticus ,medicine.disease ,Lafora disease ,lcsh:RC321-571 ,Anesthesia ,medicine ,Neurology (clinical) ,medicine.symptom ,business ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,Vagus nerve stimulation ,Super refractory - Abstract
We implanted a VNS device after more than two months from SRSE onset and multiple therapeutic attempts in a patient with Lafora disease and recurrent SE. We performed a very rapid stimulation parameter titration, without apparent side effects. We managed to withdraw anaesthetics 24 hours after reaching an assumed therapeutic setting. Therefore, according to the proposed efficacy criteria in SE [6], we assumed that the VNS implant was responsible for the SRSE interruption. No further SE nor GTCS occurred over the following nine months. The outcome on consciousness, however, was dismal, probably due both to the long duration of the status and of anaesthetic treatment and to the severity of the underlying disease. This was the first and sole VNS implantation acutely performed in our Centre for a RSE. Although this is a single case, our results support considering VNS acute implantation soon in the course of this condition, with the dual purpose of interrupting the status and preventing its recurrence
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- 2019
14. Intranasal Midazolam versus Rectal Diazepam for the Management of Canine Status Epilepticus: A Multicenter Randomized Parallel-Group Clinical Trial
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Antonella Gallucci, An Vanhaesebrouck, Gualtiero Gandini, Nick D. Jeffery, Sofie Bhatti, Mihai Musteata, Marios Charalambous, JS Siedenburg, Holger A. Volk, Simon R. Platt, Daisuke Hasegawa, L. Van Ham, Edward Ives, Andrea Tipold, Charalambous, M., Bhatti, S. F. M., Van Ham, L., Platt, S., Jeffery, N. D., Tipold, A., Siedenburg, J., Volk, H. A., Hasegawa, D., Gallucci, A., Gandini, G., Musteata, M., Ives, E., Vanhaesebrouck, A. E., Charalambous, M [0000-0002-6964-6307], Siedenburg, J [0000-0002-6993-4720], and Apollo - University of Cambridge Repository
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Male ,SURVIVAL-TIME ,Standard Article ,0403 veterinary science ,Status Epilepticu ,Epilepsy ,0302 clinical medicine ,Status Epilepticus ,Anticonvulsant ,Dog ,CLUSTER SEIZURES ,ACUTE SEIZURES ,Dog Diseases ,DRUG-DELIVERY ,education.field_of_study ,PEDIATRIC SEIZURES ,Benzodiazepine ,04 agricultural and veterinary sciences ,Standard Articles ,Neurology ,Anesthesia ,Rectal administration ,Veterinary (all) ,Anticonvulsants ,Female ,medicine.symptom ,Dog Disease ,CHILDHOOD SEIZURES ,040301 veterinary sciences ,medicine.drug_class ,Sedation ,Midazolam ,Population ,INTRAVENOUS DIAZEPAM ,Status epilepticus ,PLASMA BENZODIAZEPINE CONCENTRATIONS ,03 medical and health sciences ,Dogs ,Administration, Rectal ,medicine ,Animals ,Veterinary Sciences ,Adverse effect ,education ,Administration, Intranasal ,Diazepam ,General Veterinary ,business.industry ,Animal ,medicine.disease ,Epileptic seizures ,Clinical trial ,NASAL-MUCOSA ,Emergency ,Epileptic seizure ,RISK-FACTORS ,SMALL ANIMAL ,business ,030217 neurology & neurosurgery - Abstract
Background Intranasal administration of benzodiazepines has shown superiority over rectal administration for terminating emergency epileptic seizures in human trials. No such clinical trials have been performed in dogs. Objective To evaluate the clinical efficacy of intranasal midazolam (IN-MDZ), via a mucosal atomization device, as a first-line management option for canine status epilepticus and compare it to rectal administration of diazepam (R-DZP) for controlling status epilepticus before intravenous access is available. Animals Client-owned dogs with idiopathic or structural epilepsy manifesting status epilepticus within a hospital environment were used. Dogs were randomly allocated to treatment with IN-MDZ (n = 20) or R-DZP (n = 15). Methods Randomized parallel-group clinical trial. Seizure cessation time and adverse effects were recorded. For each dog, treatment was considered successful if the seizure ceased within 5 minutes and did not recur within 10 minutes after administration. The 95% confidence interval was used to detect the true population of dogs that were successfully treated. The Fisher's 2-tailed exact test was used to compare the 2 groups, and the results were considered statistically significant if P < .05. Results IN-MDZ and R-DZP terminated status epilepticus in 70% (14/20) and 20% (3/15) of cases, respectively (P = .0059). All dogs showed sedation and ataxia. Conclusions and Clinical Importance IN-MDZ is a quick, safe and effective first-line medication for controlling status epilepticus in dogs and appears superior to R-DZP. IN-MDZ might be a valuable treatment option when intravenous access is not available and for treatment of status epilepticus in dogs at home.
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- 2019
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- View/download PDF
15. Toward evidence-based severity assessment in rat models with repeated seizures: II. Chemical post-status epilepticus model
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Ines Koska, Roelof Maarten van Dijk, Isabel Seiffert, Valentina Di Liberto, Christina Möller, Rupert Palme, Rainer Hellweg, Heidrun Potschka, Koska I., van Dijk R.M., Seiffert I., Di Liberto V., Moller C., Palme R., Hellweg R., and Potschka H.
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behavior ,Animal ,rodent ,Pilocarpine ,3R ,Seizure ,Hippocampus ,Severity of Illness Index ,Rats ,Status Epilepticu ,Rats, Sprague-Dawley ,Disease Models, Animal ,Hippocampu ,Status Epilepticus ,Neurology ,Seizures ,stre ,Evidence-Based Practice ,Rat ,Animals ,Neurology (clinical) ,Stress, Psychological - Abstract
Objective: Considering the complexity of neuronal circuits and their epilepsy-associated alterations, epilepsy models cannot be completely replaced by in vitro experimental approaches. Decisions about ethical approval of in vivo studies require a thorough weighing of the animal's burden and the benefit regarding the expected gain in knowledge. Methods: Based on combined behavioral, biochemical, and physiological analyses, we assessed the impact on animal well-being and condition in different phases of the pilocarpine post–status epilepticus (SE) model in rats. Results: As a consequence of SE, increased levels of impairment were evident in the early postinsult phase and late chronic phase, whereas only mild impairment was observed in the interim phase. Parameters that stood out as sensitive indicators of animal distress include burrowing, which proved to be affected throughout all experimental phases, saccharin preference, fecal corticosterone metabolites, heart rate, and heart rate variability. Significance: The cumulative burden with temporary but not long-lasting phases of more pronounced impairment suggests a classification of severe as a basis for laboratory-specific prospective and retrospective evaluation. Among the parameters analyzed, burrowing behavior and saccharin preference stand out as candidate parameters that seem to be well suited to obtain information about animal distress in epileptogenesis models.
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- 2019
16. Synergistic action of CB1 and 5-HT2B receptors in preventing pilocarpine-induced status epilepticus in rats
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Maurizio Casarrubea, Giuseppe Di Giovanni, Gabriele Deidda, Massimo Pierucci, Roberto Colangeli, Roberto Di Maio, Colangeli, Roberto, Di Maio, Roberto, Pierucci, Massimo, Deidda, Gabriele, Casarrubea, Maurizio, and Di Giovanni, Giuseppe
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0301 basic medicine ,Male ,Cannabinoid receptor ,medicine.medical_treatment ,Pharmacology ,Settore BIO/09 - Fisiologia ,0302 clinical medicine ,Status Epilepticus ,5-HT2B ,EEG ,Status epilepticu ,Pilocarpine ,Calcium Channel Blockers ,Endocannabinoid system ,CB1 ,Clinical application ,Neurology ,medicine.symptom ,medicine.drug ,Receptor ,AM251 ,Agonist ,Serotonin ,medicine.drug_class ,Morpholines ,Cannabinoid receptors ,Clinical applications ,Status epilepticus ,Synergistic interactions ,Animals ,Benzoxazines ,Muscarinic Agonists ,Naphthalenes ,Rats ,Rats, Sprague-Dawley ,Receptor, Cannabinoid, CB1 ,Receptor, Serotonin, 5-HT2B ,Serotonin 5-HT2 Receptor Agonists ,lcsh:RC321-571 ,03 medical and health sciences ,medicine ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,Cannabinoid ,business.industry ,Antagonist ,030104 developmental biology ,Sprague-Dawley ,business ,030217 neurology & neurosurgery - Abstract
Endocannabinoids (eCBs) and serotonin (5-HT) play a neuromodulatory role in the central nervous system. Both eCBs and 5-HT regulate neuronal excitability and their pharmacological potentiation has been shown to control seizures in pre-clinical and human studies. Compelling evidence indicates that eCB and 5-HT systems interact to modulate several physiological and pathological brain functions, such as food intake, pain, drug addiction, depression, and anxiety. Nevertheless, there is no evidence of an eCB/5-HT interaction in experimental and human epilepsies, including status epilepticus (SE). Here, we performed video-EEG recording in behaving rats treated with the pro-convulsant agent pilocarpine (PILO), in order to study the effect of the activation of CB1/5-HT2 receptors and their interaction on SE. Synthetic cannabinoid agonist WIN55,212–2 (WIN) decreased behavioral seizure severity of PILO-induced SE at 2 mg/kg (but not at 1 and 5 mg/kg, i.p.), while 5-HT2B/2C receptor agonist RO60–0175 (RO; 1, 3, 10 mg/kg, i.p.) was devoid of any effect. RO 3 mg/kg was instead capable of potentiating the effect of WIN 2 mg/kg on the Racine scale score. Surprisingly, neither WIN 2 mg/kg nor RO 3 mg/kg had any effect on the incidence and the intensity of EEG seizures when administered alone. However, WIN+RO co-administration reduced the incidence and the severity of EEG SE and increased the latency to SE onset after PILO injection. WIN+RO effects were blocked by the selective CB1R antagonist AM251 and the 5-HT2BR antagonist RS127445, but not by the 5-HT2CR antagonist SB242084 or the 5-HT2AR antagonist MDL11,939. These data revealed a synergistic interaction between CB1R/5-HT2BR in the expression of PILO-induced SE.
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- 2019
17. Does emergent implantation of a vagal nerve stimulator stop refractory status epilepticus in children?
- Abstract
Purpose: Status Epilepticus can be a serious life threatening event in epileptic patients. The definition of refractory or super-refractory Status Epilepticus was based on the therapeutic response to anti-epileptic and anesthetic drugs. Vagal Nerve Stimulation showed efficacy in treating drug-resistant epilepsy but there are only few reports on emergentplacement of Vagal Nerve Stimulator for refractory or super-refractory Status Epilepticus. Methods: Among 49 children implanted at our Institution with Vagal Nerve Stimulation for drug-resistant epilepsy, the authors retrospectively identified those implanted for refractory or super-refractory Status Epilepticus, according with the current definitions. Results: 4 patients were operated upon at ages ranging 7 to 17 months and reached the programmed output current of 1 mA over a time ranging from 24 to 36 h (fast ramping-up). In 3 out of 4 patient we observed the abrupt of Status Epilepticus; one patient was refractory both to drugs and Vagal Nerve Stimulation and later died, without recovering from SE. At follow up, ranging from 24 to 45 months, the remaining 3 patients showed a decrease of the seizures frequency >80% without relapse of Status Epilepticus; in all the patients, output current and/or Duty Cycle were increased later. Conclusion: VNS can be effective in treating refractory or super-refractory Status Epilepticus.
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- 2018
18. Does emergent implantation of a vagal nerve stimulator stop refractory status epilepticus in children?
- Abstract
Purpose: Status Epilepticus can be a serious life threatening event in epileptic patients. The definition of refractory or super-refractory Status Epilepticus was based on the therapeutic response to anti-epileptic and anesthetic drugs. Vagal Nerve Stimulation showed efficacy in treating drug-resistant epilepsy but there are only few reports on emergentplacement of Vagal Nerve Stimulator for refractory or super-refractory Status Epilepticus. Methods: Among 49 children implanted at our Institution with Vagal Nerve Stimulation for drug-resistant epilepsy, the authors retrospectively identified those implanted for refractory or super-refractory Status Epilepticus, according with the current definitions. Results: 4 patients were operated upon at ages ranging 7 to 17 months and reached the programmed output current of 1 mA over a time ranging from 24 to 36 h (fast ramping-up). In 3 out of 4 patient we observed the abrupt of Status Epilepticus; one patient was refractory both to drugs and Vagal Nerve Stimulation and later died, without recovering from SE. At follow up, ranging from 24 to 45 months, the remaining 3 patients showed a decrease of the seizures frequency >80% without relapse of Status Epilepticus; in all the patients, output current and/or Duty Cycle were increased later. Conclusion: VNS can be effective in treating refractory or super-refractory Status Epilepticus.
- Published
- 2018
19. Does emergent implantation of a vagal nerve stimulator stop refractory status epilepticus in children?
- Author
-
Andrea Landi, Daniele Grioni, Erik P. Sganzerla, L. Fiori, Grioni, D, Landi, A, Fiori, L, and Sganzerla, E
- Subjects
0301 basic medicine ,Male ,Drug Resistant Epilepsy ,medicine.medical_treatment ,Stimulation ,Epilepsy ,0302 clinical medicine ,Status Epilepticus ,Retrospective Studie ,Anticonvulsant ,Medicine ,Child ,Status epilepticu ,Brain Wave ,Electroencephalography ,General Medicine ,Electrodes, Implanted ,Treatment Outcome ,Neurology ,Anesthesia ,Child, Preschool ,Anticonvulsants ,Female ,medicine.symptom ,Vagal nerve stimulation ,Vagus nerve stimulation ,medicine.drug ,Human ,Adolescent ,Vagus Nerve Stimulation ,Status epilepticus ,Follow-Up Studie ,Childhood ,Brain Waves ,Follow-Up Studies ,Humans ,Infant ,Retrospective Studies ,03 medical and health sciences ,Refractory ,Preschool ,Electrodes ,business.industry ,Retrospective cohort study ,medicine.disease ,nervous system diseases ,030104 developmental biology ,Anesthetic ,Implanted ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Purpose Status Epilepticus can be a serious life threatening event in epileptic patients. The definition of refractory or super-refractory Status Epilepticus was based on the therapeutic response to anti-epileptic and anesthetic drugs. Vagal Nerve Stimulation showed efficacy in treating drug-resistant epilepsy but there are only few reports on emergentplacement of Vagal Nerve Stimulator for refractory or super-refractory Status Epilepticus. Methods Among 49 children implanted at our Institution with Vagal Nerve Stimulation for drug-resistant epilepsy, the authors retrospectively identified those implanted for refractory or super-refractory Status Epilepticus, according with the current definitions. Results 4 patients were operated upon at ages ranging 7 to 17 months and reached the programmed output current of 1 mA over a time ranging from 24 to 36 h (fast ramping-up). In 3 out of 4 patient we observed the abrupt of Status Epilepticus; one patient was refractory both to drugs and Vagal Nerve Stimulation and later died, without recovering from SE. At follow up, ranging from 24 to 45 months, the remaining 3 patients showed a decrease of the seizures frequency >80% without relapse of Status Epilepticus; in all the patients, output current and/or Duty Cycle were increased later. Conclusion VNS can be effective in treating refractory or super-refractory Status Epilepticus.
- Published
- 2018
20. Guideline recommendations for diagnosis and clinical management of Ring14 syndrome - first report of an ad hoc task force
- Abstract
Background: Ring chromosome 14 syndrome is a rare chromosomal disorder characterized by early onset refractory epilepsy, intellectual disability, autism spectrum disorder and a number of diverse health issues. Results: The aim of this work is to provide recommendations for the diagnosis and management of persons affected by ring chromosome 14 syndrome based on evidence from literature and experience of health professionals from different medical backgrounds who have followed for several years subjects affected by ring chromosome 14 syndrome. The literature search was performed in 2016. Original papers, meta-analyses, reviews, books and guidelines were reviewed and final recommendations were reached by consensus. Conclusion: Conventional cytogenetics is the primary tool to identify a ring chromosome. Children with a terminal deletion of chromosome 14q ascertained by molecular karyotyping (CGH/SNP array) should be tested secondarily by conventional cytogenetics for the presence of a ring chromosome. Early diagnosis should be pursued in order to provide medical and social assistance by a multidisciplinary team. Clinical investigations, including neurophysiology for epilepsy, should be performed at the diagnosis and within the follow-up. Following the diagnosis, patients and relatives/caregivers should receive regular care for health and social issues. Epilepsy should be treated from the onset with anticonvulsive therapy. Likewise, feeding difficulties should be treated according to need. Nutritional assessment is recommended for all patients and nutritional support for malnourishment can include gastrostomy feeding in selected cases. Presence of autistic traits should be carefully evaluated. Many patients with ring chromosome 14 syndrome are nonverbal and thus maintaining their ability to communicate is always essential; every effort should be made to preserve their autonomy.
- Published
- 2017
21. Guideline recommendations for diagnosis and clinical management of Ring14 syndrome - first report of an ad hoc task force
- Abstract
Background: Ring chromosome 14 syndrome is a rare chromosomal disorder characterized by early onset refractory epilepsy, intellectual disability, autism spectrum disorder and a number of diverse health issues. Results: The aim of this work is to provide recommendations for the diagnosis and management of persons affected by ring chromosome 14 syndrome based on evidence from literature and experience of health professionals from different medical backgrounds who have followed for several years subjects affected by ring chromosome 14 syndrome. The literature search was performed in 2016. Original papers, meta-analyses, reviews, books and guidelines were reviewed and final recommendations were reached by consensus. Conclusion: Conventional cytogenetics is the primary tool to identify a ring chromosome. Children with a terminal deletion of chromosome 14q ascertained by molecular karyotyping (CGH/SNP array) should be tested secondarily by conventional cytogenetics for the presence of a ring chromosome. Early diagnosis should be pursued in order to provide medical and social assistance by a multidisciplinary team. Clinical investigations, including neurophysiology for epilepsy, should be performed at the diagnosis and within the follow-up. Following the diagnosis, patients and relatives/caregivers should receive regular care for health and social issues. Epilepsy should be treated from the onset with anticonvulsive therapy. Likewise, feeding difficulties should be treated according to need. Nutritional assessment is recommended for all patients and nutritional support for malnourishment can include gastrostomy feeding in selected cases. Presence of autistic traits should be carefully evaluated. Many patients with ring chromosome 14 syndrome are nonverbal and thus maintaining their ability to communicate is always essential; every effort should be made to preserve their autonomy.
- Published
- 2017
22. Guideline recommendations for diagnosis and clinical management of Ring14 syndrome - first report of an ad hoc task force
- Author
-
Sergio Amarri, Annarosa Soresina, Alessandro Vaisfeld, Giuseppe Gobbi, Giovanni Neri, Chiara Baldo, Tommaso Pippucci, Marco Crimi, Laura Zampini, Francesca Novara, Erto Melli, Pamela Magini, Berardo Rinaldi, Orsetta Zuffardi, Romana Rizzi, Rinaldi, B, Vaisfeld, A, Amarri, S, Baldo, C, Gobbi, G, Magini, P, Melli, E, Neri, G, Novara, F, Pippucci, T, Rizzi, R, Soresina, A, Zampini, L, Zuffardi, O, and Crimi, M
- Subjects
Myoclonus ,Abnormality of skin pigmentation ,Brain atrophy ,Autism Spectrum Disorder ,Ring chromosome ,Chromosome Disorders ,Autoimmunity ,Review ,Recommendations ,030105 genetics & heredity ,Optic neuropathy ,0302 clinical medicine ,Ring Chromosomes ,Pharmacology (medical) ,Pallor ,Feeding difficultie ,Diaphragmatic weakness ,Status epilepticus ,Retinal degeneration ,Abnormality of the immune system ,Dehydration ,Focal seizure ,General Medicine ,Dysphagia ,Recurrent infection ,Abnormality of the eye ,Autism spectrum disorder ,Cafe-au-lait spot ,Diaphragmatic weakne ,Focal seizures with impairment of consciousness or awarene ,Underdeveloped supraorbital ridge ,Feeding difficulties ,Downslanted palpebral fissures ,Arthriti ,Large forehead ,medicine.medical_specialty ,Best practices ,Epicanthus ,Cataract ,Autistic behavior ,Recurrent upper respiratory tract infection ,Ring14 syndrome ,Cytogenetics ,03 medical and health sciences ,Microphthalmia ,Humans ,Scoliosi ,Arthritis ,lcsh:R ,Absent speech ,Aggressive behavior ,Full cheek ,Glaucoma ,Guideline ,Pneumonia ,Recommendation ,medicine.disease ,Strabismus ,Short stature ,Ventriculomegaly ,Osteoporosis ,Stereotypy ,Focal seizures with impairment of consciousness or awareness ,Abnormality of the face ,030217 neurology & neurosurgery ,Recurrent pneumonia ,0301 basic medicine ,Pediatrics ,Autism ,Global developmental delay ,Intellectual disability ,lcsh:Medicine ,Best practice ,Encephalopathy ,Respiratory failure ,Epilepsy ,Blepharophimosi ,Behavioral abnormality ,Myopia ,Full cheeks ,Celiac disease ,Flexion contracture ,Facial asymmetry ,Genetics (clinical) ,Hypertelorism ,Status epilepticu ,Muscular hypotonia ,Seizure ,Anorexia ,Coloboma ,Caregivers ,Ring chromosome 14 syndrome ,Microcephaly ,Respiratory insufficiency ,Fever ,Milia ,Respiratory tract infection ,Underdeveloped supraorbital ridges ,Pain ,Blepharophimosis ,Hearing impairment ,Focal seizures ,Seizures ,Strabismu ,Scoliosis, Recurrent infections ,medicine ,Epicanthu ,Thin vermilion border ,Chromosomes, Human, Pair 14 ,Abnormality of retinal pigmentation ,Growth delay ,Increased body weight ,business.industry ,Osteopenia ,Malnutrition ,Osteoporosi ,Abnormality of the corpus callosum ,Astigmatism ,Caregiver ,Horizontal eyebrow ,Abnormality of vision ,Hyperactivity ,Recurrent upper respiratory tract infections ,Aspiration ,Downslanted palpebral fissure ,Abnormality of the retina ,business ,Constipation ,Myoclonu - Abstract
Background Ring chromosome 14 syndrome is a rare chromosomal disorder characterized by early onset refractory epilepsy, intellectual disability, autism spectrum disorder and a number of diverse health issues. Results The aim of this work is to provide recommendations for the diagnosis and management of persons affected by ring chromosome 14 syndrome based on evidence from literature and experience of health professionals from different medical backgrounds who have followed for several years subjects affected by ring chromosome 14 syndrome. The literature search was performed in 2016. Original papers, meta-analyses, reviews, books and guidelines were reviewed and final recommendations were reached by consensus. Conclusion Conventional cytogenetics is the primary tool to identify a ring chromosome. Children with a terminal deletion of chromosome 14q ascertained by molecular karyotyping (CGH/SNP array) should be tested secondarily by conventional cytogenetics for the presence of a ring chromosome. Early diagnosis should be pursued in order to provide medical and social assistance by a multidisciplinary team. Clinical investigations, including neurophysiology for epilepsy, should be performed at the diagnosis and within the follow-up. Following the diagnosis, patients and relatives/caregivers should receive regular care for health and social issues. Epilepsy should be treated from the onset with anticonvulsive therapy. Likewise, feeding difficulties should be treated according to need. Nutritional assessment is recommended for all patients and nutritional support for malnourishment can include gastrostomy feeding in selected cases. Presence of autistic traits should be carefully evaluated. Many patients with ring chromosome 14 syndrome are nonverbal and thus maintaining their ability to communicate is always essential; every effort should be made to preserve their autonomy.
- Published
- 2017
23. Novel neurofibromatosis type 2 mutation presenting with status epilepticus
- Author
-
Roberta Sestini, Jacopo C. DiFrancesco, Laura Papi, Elena Sala, Enrico Saracchi, Martino Bolognesi, Federica Cossu, Silvana Mariani, Carlo Ferrarese, DI FRANCESCO, J, Sestini, R, Cossu, F, Bolognesi, M, Sala, E, Mariani, S, Saracchi, E, Papi, L, and Ferrarese, C
- Subjects
Male ,Neurofibromatosis 2 ,Novel mutation ,Central nervous system ,Status epilepticus ,Biology ,Bioinformatics ,medicine.disease_cause ,law.invention ,Young Adult ,Epilepsy ,Status Epilepticus ,law ,otorhinolaryngologic diseases ,medicine ,Humans ,Neurofibromatosis type 2 ,Merlin ,Neurofibromin 2 ,Mutation ,FERM domain ,Status epilepticu ,Brain ,Electroencephalography ,General Medicine ,medicine.disease ,Pedigree ,Merlin (protein) ,medicine.anatomical_structure ,Spinal Cord ,Neurology ,NF2 ,Suppressor ,Neurology (clinical) ,medicine.symptom ,Neuroscience ,Human - Abstract
Neurofibromatosis type 2 (NF2) is a dominantly inherited syndrome caused by mutations of the tumour-suppressor NF2, which encodes the merlin protein. Mutations are associated with a predisposition to development of benign tumours in the central nervous system. Even though cerebral cortical lesions are frequently associated with seizures, epilepsy is rarely described in NF2. Here, we describe an adult case of NF2 in which the onset of symptoms was characterised by status epilepticus. In this patient, we identified the novel c.428_430delCTTdel mutation in NF2, involving the amino-terminal FERM domain, which is fundamental for the correct tumour suppressor function of the protein. Bioinformatic analyses revealed an important structural perturbation of the FERM domain, with a predicted impairment of the anti-tumour activity.
- Published
- 2014
24. Withdrawal of valproic acid treatment during pregnancy and seizure outcome: Observations from EURAP
- Author
-
Tomson, Torbjörn, Battino, Dina, Bonizzoni, Erminio, Craig, John, Lindhout, Dick, Perucca, Emilio, Sabers, Anne, Thomas, Sanjeev V, Vajda, Frank, for the EURAP Study Group, Bisulli, Francesca, Tinuper, Paolo, Tomson, Torbjörn, Battino, Dina, Bonizzoni, Erminio, Craig, John, Lindhout, Dick, Perucca, Emilio, Sabers, Anne, Thomas, Sanjeev V, Vajda, Frank, for the EURAP Study Group, Bisulli, Francesca, and Tinuper, Paolo
- Subjects
Adult ,Pediatrics ,medicine.medical_specialty ,Adolescent ,International Cooperation ,Status epilepticus ,Cohort Studies ,Status Epilepticu ,03 medical and health sciences ,Epilepsy ,Young Adult ,Status Epilepticus ,0302 clinical medicine ,Pregnancy ,medicine ,Anticonvulsant ,Humans ,030212 general & internal medicine ,Registries ,Young adult ,Pregnancy Trimesters ,Valproic Acid ,business.industry ,Bayes Theorem ,medicine.disease ,Seizure ,Pregnancy Complication ,Substance Withdrawal Syndrome ,Pregnancy Complications ,Observational Studies as Topic ,Neurology ,Anesthesia ,Anticonvulsants ,Observational study ,Female ,Neurology (clinical) ,Pregnancy Trimester ,medicine.symptom ,Cohort Studie ,business ,030217 neurology & neurosurgery ,medicine.drug ,Cohort study ,Human - Abstract
Based on data from the EURAP observational International registry of antiepileptic drugs (AEDs) and pregnancy, we assessed changes in seizure control and subsequent AED changes in women who underwent attempts to withdraw valproic acid (VPA) during the first trimester of pregnancy. Applying Bayesian statistics, we compared seizure control in pregnancies where VPA was withdrawn (withdrawal group, n = 93), switched to another AED (switch group, n = 38), or maintained (maintained-therapy group, n = 1,588) during the first trimester. The probability of primarily or secondarily generalized tonic-clonic seizures (GTCS) was lower in the maintained-therapy group compared with the other two groups, both in the first trimester and for the entire duration of pregnancy. GTCS were twice as common during pregnancy in the withdrawal (33%) and switch groups (29%) compared with the maintained-treatment group (16%). Limitations in the data and study design do not allow to establish a cause-effect relationship between treatment changes and seizure outcome, but these observations provide a signal that withdrawal of, or switch from, VPA during the first trimester could lead to loss of seizure control, and highlight the need for a specifically designed prospective observational study.
- Published
- 2016
25. Relevance of clinical context in the diagnostic-therapeutic approach to status epilepticus
- Author
-
Aguglia, Umberto, Sueri, Chiara, Gasparini, Sara, Beghi, Ettore, Labate, Angelo, Gambardella, Antonio, Specchio, Luigi M., Ferlazzo, Edoardo, Aloisi, Paolo, Belcastro, Vincenzo, Benna, Paolo, Bianchi, Amedeo, Bogliun, Graziella, Brigo, Francesco, Buttinelli, Carla, Campostrini, Roberto, Cantello, Roberto, Anna, Teresa Cantisani, Cianci, Vittoria, Congia, Socrate, Consoli, Domenico, Costanzo, Erminio, De Falco Fabrizio, A., De Maria, Giovanni, Bonaventura, Carlo Di, Di Francesco Jacopo, C., Elia, Maurizio, Carlo, Andrea Galimberti, Giallonardo Anna, Teresa, Gigli Gian, Luigi, Iannacchero, Rosario, Iudice, Alfonso, La Neve, Angela, Latella Maria, Adele, Le Piane, Emilio, Marciani Maria, Grazia, Marino, Daniela, Mecarelli, Oriano, Michelucci, Roberto, Minicucci, Fabio, Monti, Fabrizio, Mumoli, Laura, Paciello, Nicola, Paladin, Francesco, Palumbo, Pasquale, Pisani, Francesco, Pisani Laura, Rosa, Sartucci, Ferdinando, Sasanelli, Francesco, Sofia, Vito, Striano, Pasquale, Striano, Salvatore, Strigaro, Gionata, Tinuper, Paolo, Verri, Annapia, Villani, Flavio, Zaccara, Gaetano, Capovilla, Giuseppe, Ferlisi, Monica, Aguglia, U, Sueri, C, Gasparini, S, Beghi, E, Labate, A, Gambardella, A, Specchio, L.M, Ferlazzo, E, Epilepsy Study Group of the Italian Neurological Society and of the Subcommission on Status Epilepticus of the Italian League Against Epilepsy [, Tinuper, P., and ]
- Subjects
0301 basic medicine ,medicine.medical_specialty ,MEDLINE ,Context (language use) ,Status epilepticus ,Neurology ,Neurology (clinical) ,03 medical and health sciences ,Therapeutic approach ,0302 clinical medicine ,Text mining ,Status Epilepticus ,medicine ,Humans ,Relevance (information retrieval) ,Electroencephalography ,Intensive care medicine ,SE ,Epilepsy ,business.industry ,030104 developmental biology ,status epilepticu ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
n.a.
- Published
- 2016
26. Novel neurofibromatosis type 2 mutation presenting with status epilepticus
- Abstract
Neurofibromatosis type 2 (NF2) is a dominantly inherited syndrome caused by mutations of the tumour-suppressor NF2, which encodes the merlin protein. Mutations are associated with a predisposition to development of benign tumours in the central nervous system. Even though cerebral cortical lesions are frequently associated with seizures, epilepsy is rarely described in NF2. Here, we describe an adult case of NF2 in which the onset of symptoms was characterised by status epilepticus. In this patient, we identified the novel c.428-430delCTTdel mutation in NF2, involving the amino-terminal FERM domain, which is fundamental for the correct tumour suppressor function of the protein. Bioinformatic analyses revealed an important structural perturbation of the FERM domain, with a predicted impairment of the anti-tumour activity
- Published
- 2014
27. Refractory, life-threatening status epilepticus in a 3-year-old girl
- Author
-
Federico Zara, Pasquale Striano, Carlo Minetti, Salvatore Striano, Striano, Pasquale, Striano, Salvatore, Minetti, C, and Zara, F.
- Subjects
Pediatrics ,medicine.medical_specialty ,media_common.quotation_subject ,DNA Mutational Analysis ,Nerve Tissue Proteins ,Status epilepticus ,3 years old ,Sodium Channels ,methods ,Status Epilepticus ,Refractory ,diagnosis/drug therapy/genetics ,medicine ,life threating ,Humans ,genetics ,Girl ,Child ,Preschool ,media_common ,medicine.diagnostic_test ,business.industry ,Anticonvulsants ,therapeutic use, Child ,Preschool, DNA Mutational Analysis ,methods, Female, Humans, Magnetic Resonance Imaging, Mutation ,genetics, Nerve Tissue Proteins ,genetics, Sodium Channels ,genetics, Status Epilepticus ,Status epilepticu ,Magnetic resonance imaging ,Magnetic Resonance Imaging ,NAV1.1 Voltage-Gated Sodium Channel ,Child, Preschool ,therapeutic use ,Mutation ,Female ,Neurology (clinical) ,medicine.symptom ,business - Abstract
3-year-old girl was admitted for the first time to our hospital because of status epilepticus. The girl was born to healthy, unrelated parents, who had an unremarkable family history, and her birth parameters were within the normal range. The girl had started to walk and had used single words at around 12 months. At 6 months, she had a right hemiclonic seizure 48 hours after being given pentavalent (pertussis, tetanus, diphtheria, inactivated polio, and haemophilus) vaccination. An electroencephalogram was normal. Between 7 and 10 months, she had nine prolonged (20–30 min) clonic or hemiclonic seizures, involving alternating sides, which occurred during febrile illness. An electroencephalogram at 13 months showed generalised spike waves, slowed background activity, and photosensitivity. Despite therapy with phenobarbital, the convulsive seizures reoccurred during fever, and she had atypical absences and myoclonus at rest from 20 months old. Delayed psychomotor development, which involved motor and linguistic activities, was also evident. At 2 years and 9 months, the girl had five prolonged febrile or afebrile convulsive seizures. Valproate was added to her regimen, and seizure control was almost complete, apart from weekly atypical absences. However, owing to a mild increase in serum amylase concentrations (112 U/L [normal range 15–110]), her general practitioner replaced valproate with lamotrigine. The girl had intense myoclonus in the arms, neck, and lower limbs 6 weeks after starting lamotrigine (150 mg/day). The dose was lowered to 100 mg/day, and the myoclonus was dramatically reduced; 4 weeks later, the dose was increased to 200 mg/day, and the myoclonic jerks reoccurred, culminating within 5 days in a myoclonic state. On admission to our department, the patient had intense, continuous, erratic myoclonus that affected different parts of the body. An electroencephalogram showed slowed background activity and multifocal spikes. The patient was hypothermic (35·0°C) and had signs of respiratory insufficiency. Blood and CSF analysis showed severe metabolic acidosis and high concentrations of serum transaminases (alanine transaminase 259 U/L, aspartate transaminase 214 U/L [normal range ≤40]) and creatine kinase (897 U/L [normal range 30–180]). Brain MRI was unremarkable. The myoclonic status did not respond to oral clonazepam and intravenous lorazepam, and the patient was transferred to the intensive care unit where, after intubation and ventilation, thiopental was given
- Published
- 2008
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