4,729 results match your criteria EEG in Status Epilepticus


Encephalopathy Associated with Electrical Status Epilepticus of Sleep (ESES): A Practical Approach.

Indian J Pediatr 2020 Jul 6. Epub 2020 Jul 6.

Department of Pediatrics, Comprehensive Epilepsy Program, McMaster Children's Hospital, McMaster University, 1280 Main St W, Hamilton, ON, L8S4K1, Canada.

Encephalopathy associated with electrical status epilepticus of sleep (ESES) is an underdiagnosed epileptic encephalopathy syndrome. Though there is considerable controversy regarding the terminology of this condition, there is increasing acceptance of the term, 'encephalopathy associated with electrical status epilepticus of sleep,' as it implies a clinical component as well as EEG feature. Core EEG feature of sleep activation of epileptiform discharges temporarily associated with cognitive or behavioral regression in a child with epilepsy is sufficient to make a diagnosis of ESES. Read More

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http://dx.doi.org/10.1007/s12098-020-03422-9DOI Listing

Review of Transcranial Magnetic Stimulation in Epilepsy.

Clin Ther 2020 Jul 2. Epub 2020 Jul 2.

Neuromodulation Program, Department of Neurology, Division of Epilepsy and Clinical Neurophysiology, Boston Children's Hospital, Boston, MA, USA; FM Kirby Neurobiology Center, Department of Neurology, Boston Children's Hospital, Boston, MA, USA; Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Boston, MA, USA. Electronic address:

Purpose: Despite the availability of numerous pharmacologic and nonpharmacologic antiseizure therapies, a fraction of patients with epilepsy remain refractory to current treatment options, underscoring the need for novel drugs and neuromodulatory therapies. Transcranial magnetic stimulation (TMS), coupled with either electromyography or electroencephalography, enables rapid measurement of the cortical excitation/inhibition ratio, which is pathologically shifted toward excess excitability in patients with epilepsy. In this review, we summarize: (1) TMS protocols that have been deployed to identify promising compounds in the antiepilepsy drug (AED)-development pipeline, and (2) the therapeutic potential of TMS in the treatment of drug-resistant seizures. Read More

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http://dx.doi.org/10.1016/j.clinthera.2020.05.016DOI Listing

Validation of an algorithm of time-dependent electro-clinical risk stratification for electrographic seizures (TERSE) in critically ill patients.

Clin Neurophysiol 2020 Jun 23;131(8):1956-1961. Epub 2020 Jun 23.

Department of Neurology, Université Libre de Bruxelles - Hôpital Erasme, Bruxelles, Belgium; Department of Neurology and Comprehensive Epilepsy Center, Yale University, New Haven, CT, USA. Electronic address:

Objective: The clinical implementation of continuous electroencephalography (CEEG) monitoring in critically ill patients is hampered by the substantial burden of work that it entails for clinical neurophysiologists. Solutions that might reduce this burden, including by shortening the duration of EEG to be recorded, would help its widespread adoption. Our aim was to validate a recently described algorithm of time-dependent electro-clinical risk stratification for electrographic seizure (ESz) (TERSE) based on simple clinical and EEG features. Read More

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http://dx.doi.org/10.1016/j.clinph.2020.05.031DOI Listing

Evaluating the Clinical Impact of Rapid Response Electroencephalography: The DECIDE Multicenter Prospective Observational Clinical Study.

Crit Care Med 2020 Jun 29. Epub 2020 Jun 29.

Department of Neurology, Harvard Medical School, Boston, MA.

Objectives: To measure the diagnostic accuracy, timeliness, and ease of use of Ceribell rapid response electroencephalography. We assessed physicians' diagnostic assessments and treatment plans before and after rapid response electroencephalography assessment. Primary outcomes were changes in physicians' diagnostic and therapeutic decision making and their confidence in these decisions based on the use of the rapid response electroencephalography system. Read More

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http://dx.doi.org/10.1097/CCM.0000000000004428DOI Listing

Long-term prognosis related to deep sedation in refractory status epilepticus.

Acta Neurol Scand 2020 Jul 2. Epub 2020 Jul 2.

Epilepsy Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.

Objective: To evaluate long-term prognosis in patients with refractory status epilepticus according to the level of sedation reached during drug-induced coma.

Material & Methods: Longitudinal study of patients with status epilepticus who received anesthetics to induce therapeutic coma. Demographic data, clinical and electroencephalographic characteristics were collected, as well as variables related to sedation. Read More

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http://dx.doi.org/10.1111/ane.13302DOI Listing

Focal EEG changes indicating critical illness associated cerebral microbleeds in a Covid-19 patient.

Clin Neurophysiol Pract 2020 10;5:125-129. Epub 2020 Jun 10.

EEG and Epilepsy Unit, Division of Neurology, Geneva University Hospitals, Switzerland.

Objectives: We describe a patient suffering from Covid19-related acute respiratory distress syndrome (ARDS), highlighting the diagnostic role of the EEG in ICU.

History: A Covid-19 patient undergoing mechanical ventilation due to related acute respiratory distress syndrome (ARDS), presented altered mental status in the ICU. Video-EEG revealed a focal monomorphic theta slowing in bilateral frontal-central regions. Read More

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http://dx.doi.org/10.1016/j.cnp.2020.05.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7286251PMC

Long-Term Undiagnosed Nonconvulsive Status Epilepticus Identified by Urgent Electroencephalography with Hyperventilation Activation.

Case Rep Neurol 2020 May-Aug;12(2):153-159. Epub 2020 May 28.

Department of Neuropsychiatry, The University of Tokyo Hospital, Tokyo, Japan.

Nonconvulsive status epilepticus (NCSE) might be underdiagnosed in cases where clinical symptoms are ambiguous. If a patient exhibits ictal psychiatric symptoms such as NCSE presentation and is misdiagnosed as having a psychiatric disorder, the patient may be treated in psychiatry settings, where continuous electroencephalography (cEEG), the gold standard for NCSE diagnosis, is typically not used. Herein, we report our experience with a patient having NCSE who exhibited psychiatric symptoms and remained misdiagnosed for many years. Read More

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http://dx.doi.org/10.1159/000506828DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7315169PMC

Sulthiame add-on treatment in children with epileptic encephalopathy with status epilepticus: an efficacy analysis in etiologic subgroups.

Neurol Sci 2020 Jun 26. Epub 2020 Jun 26.

Department of Pediatrics, Division of Child Neurology, Ege University Medical Faculty, 35100, Bornova, Izmir, Turkey.

Purpose: Sulthiame (STM) has been recommended as an effective antiepileptic drug (AED) in children with epileptic encephalopathy with status epilepticus in sleep (ESES). The aim of this study is to evaluate the efficacy of STM add-on treatment in children with pattern of ESES with respect to the etiologic subgroup.

Methods: Twenty-nine children with ESES pattern with three different etiologic subgroups (epileptic syndromes: 14, structural/infectious: 9, unknown: 6) who were given STM as add-on treatment were included into the study. Read More

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http://dx.doi.org/10.1007/s10072-020-04526-yDOI Listing

Electroencephalography at the time of Covid-19 pandemic in Italy.

Neurol Sci 2020 Jun 26. Epub 2020 Jun 26.

Department of Human Neurosciencies, Sapienza University of Rome, Rome, Italy.

Objective: During the Covid-19 pandemic, government restrictions limited health care to urgent needs. Neurophysiology centers had to suddenly reschedule their activities, with a lack of specific recommendations about electroencephalography (EEG) execution. During the pandemic phase 1, we launched an online survey to understand the flaws and strengths of the EEG management in Italy at the time of Covid-19 pandemic. Read More

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http://dx.doi.org/10.1007/s10072-020-04546-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7316521PMC

Non-convulsive status epilepticus with right arm apraxia: A case report.

Epilepsy Behav Rep 2020 2;14:100371. Epub 2020 Jun 2.

Department of Neurology, Christian Doppler Klinik, University Hospital Paracelsus Medical University, Salzburg, Austria.

Non-convulsive SE (NCSE) is characterized by altered consciousness with or without slight motor manifestations or other phenomena such as aphasia, sensory, auditory, emotional, gustatory or other symptoms. A 69-year-old right-handed man developed the sudden onset of apraxia in his right arm. On admission, the patient was alert and well oriented. Read More

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http://dx.doi.org/10.1016/j.ebr.2020.100371DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7303554PMC

Characterization and Outcomes of Epileptic Seizures in Mexican Pediatric Patients With Anti-N-Methyl-D-Aspartate Receptor Encephalitis.

Cureus 2020 May 20;12(5):e8211. Epub 2020 May 20.

Pediatric Neurology, Instituto Nacional de Pediatría, Mexico CIty, MEX.

Introduction Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is one of the most common autoimmune encephalitides. The frequency of anti-NMDAR encephalitis is known to exceed the frequency of any individual viral encephalitis in young subjects. Epileptic seizures are a cardinal symptom in anti-NMDAR encephalitis; a significant amount of pediatric patients exhibit seizures as the first symptom of the disease, and most of them will develop them during the acute phase. Read More

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http://dx.doi.org/10.7759/cureus.8211DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7305580PMC

Ketamine as adjunct to midazolam treatment following soman-induced status epilepticus reduces seizure severity, epileptogenesis, and brain pathology in plasma carboxylesterase knockout mice.

Epilepsy Behav 2020 Jun 20;111:107229. Epub 2020 Jun 20.

U.S. Army Medical Research Institute of Chemical Defense, 8350 Ricketts Point Road, Aberdeen Proving Ground, MD 21010, United States of America. Electronic address:

Delayed treatment of cholinergic seizure results in benzodiazepine-refractory status epilepticus (SE) that is thought, at least in part, to result from maladaptive trafficking of N-methyl-d-aspartate (NMDA) and gamma-aminobutyric acid type A (GABA) receptors, the effects of which may be ameliorated by combination therapy with the NMDA receptor antagonist ketamine. Our objective was to establish whether ketamine and midazolam dual therapy would improve outcome over midazolam monotherapy following soman (GD) exposure when evaluated in a mouse model that, similar to humans, lacks plasma carboxylesterase, greatly reducing endogenous scavenging of GD. In the current study, continuous cortical electroencephalographic activity was evaluated in male and female plasma carboxylesterase knockout mice exposed to a seizure-inducing dose of GD and treated with midazolam or with midazolam and ketamine combination at 40 min after seizure onset. Read More

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http://dx.doi.org/10.1016/j.yebeh.2020.107229DOI Listing

Autoimmune encephalitis as an increasingly recognised cause of non-convulsive status epilepticus: A retrospective, multicentre evaluation of patient characteristics and electroencephalography (EEG) results.

Seizure 2020 Jun 12;80:153-156. Epub 2020 Jun 12.

Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK; Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary & Ecological Sciences,, University of Liverpool, UK; NIHR Health Protection Research Unit for Emerging and Zoonotic Infection, Liverpool, UK. Electronic address:

Purpose: Status epilepticus (SE) is a severe condition of unrelenting seizures requiring urgent identification and treatment. SE may be unprovoked, occurring in someone with epilepsy, or may be provoked by acute intracranial disease or metabolic derangement. Increasingly encephalitis, particularly autoimmune types, is reported to cause refractory seizures. Read More

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http://dx.doi.org/10.1016/j.seizure.2020.06.020DOI Listing
June 2020
2.059 Impact Factor

2-Deoxyglucose terminates pilocarpine-induced status epilepticus in neonatal rats.

Epilepsia 2020 Jun 19. Epub 2020 Jun 19.

Division of Pediatric Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Objective: Neonatal status epilepticus (SE) is a life-threatening medical emergency. Unfortunately, up to 50% of neonates with SE are resistant to current antiseizure drugs, highlighting the need for better treatments. This study aims to explore a novel metabolic approach as a potential alternative treatment to control neonatal SE, using the glycolytic inhibitor 2-deoxyglucose (2-DG). Read More

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http://dx.doi.org/10.1111/epi.16583DOI Listing

A multimodal diagnostic approach for lateralised rhythmic delta activity in the ictal-interictal continuum.

Epileptic Disord 2020 Jun;22(3):337-341

SOD Neurofisopatologia, Dipartimento Neuromuscoloscheletrico e Organi di Senso, AOU Careggi,, IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.

The ictal-interictal continuum represents a diagnostic challenge even for expert neurrophysiologists, often requiring an additional multimodal diagnostic workup to understand its clinical significance. Lateralised rhythmic delta activity (LRDA) is an ictal-interictal continuum pattern that has only recently been investigated and recognised as potentially ictogenic or sometimes even ictal. We describe a patient who presented with acute-onset aphasia, initially suspected of having a stroke; advanced brain imaging with CT-perfusion showed features suggesting regional left temporo-parietal hyperperfusion and an EEG revealed LRDA with fluctuations and intermixed sharp waves in the same areas. Read More

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http://dx.doi.org/10.1684/epd.2020.1169DOI Listing

Epilepsy and EEG Phenotype of SLC13A5 Citrate Transporter Disorder.

Child Neurol Open 2020 Jan-Dec;7:2329048X20931361. Epub 2020 Jun 8.

Division of Child Neurology, Department of Neurology, Stanford University School of Medicine, CA, USA.

Mutations in the SLC13A5 gene, a sodium citrate cotransporter, cause a rare autosomal recessive epilepsy (EIEE25) that begins during the neonatal period and is associated with motor and cognitive impairment. Patient's seizure burden, semiology, and electroencephalography (EEG) findings have not been well characterized. Data on 23 patients, 3 months to 29 years of age are reported. Read More

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http://dx.doi.org/10.1177/2329048X20931361DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7281881PMC

Predictors of outcome in refractory generalized convulsive status epilepticus.

Epilepsia Open 2020 Jun 22;5(2):248-254. Epub 2020 Apr 22.

Neurology Nobel Medical College Biratnagar Nepal.

Objective: Refractory status epilepticus is a serious condition in which seizure continues despite use of two antiepileptic medications. Retrospective studies have shown that 29%-43% of SE patients progress into RSE despite treatment. Mortality following RSE is high. Read More

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http://dx.doi.org/10.1002/epi4.12394DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7278539PMC

Phenobarbital as alternate anticonvulsant for organophosphate-induced benzodiazepine-refractory status epilepticus and neuronal injury.

Epilepsia Open 2020 Jun 14;5(2):198-212. Epub 2020 Apr 14.

Department of Neuroscience and Experimental Therapeutics College of Medicine Texas A&M University Health Science Center Bryan TX USA.

Objective: Organophosphates (OPs) such as diisopropylfluorophosphate (DFP) and soman are lethal chemical agents that can produce seizures, refractory status epilepticus (SE), and brain damage. There are few optimal treatments for late or refractory SE. Phenobarbital is a second-line drug for SE, usually after lorazepam, diazepam, or midazolam have failed to stop SE. Read More

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http://dx.doi.org/10.1002/epi4.12389DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7278559PMC

Clinical outcomes and treatments effectiveness in status epilepticus resolved by antiepileptic drugs: A five-year observational study.

Epilepsia Open 2020 Jun 2;5(2):166-175. Epub 2020 Mar 2.

Neurology Unit OCB Hospital Azienda Ospedaliera-Universitaria Modena Italy.

Objective: To evaluate clinical outcomes and treatment effectiveness of status epilepticus finally resolved by nonbenzodiazepine antiepileptic drugs (AEDs).

Methods: All consecutive SE episodes observed from September 1, 2013, to September 1, 2018, and resolved by AEDs were considered. Diagnosis and classification of SE followed the 2015 ILAE proposal. Read More

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http://dx.doi.org/10.1002/epi4.12383DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7278543PMC

Seizure Activity Across Scales From Neuronal Population Firing to Clonic Motor Semiology.

J Clin Neurophysiol 2020 May 26. Epub 2020 May 26.

Department of Neurology, Columbia University Medical Center, New York, New York, U.S.A.

The correlation of clinical semiology with neuronal firing in human seizures has not been well described. Similarly, the neuronal firing patterns underlying high-frequency oscillations during seizures remain controversial. Using implanted subdural electrodes and a microelectrode array in a patient with focal status epilepticus, in which 40 habitual focal motor seizures and 101 subclinical seizures were captured, the authors analyzed the association of EEG, high-frequency oscillations, and multiunit activity to facial motor semiology. Read More

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http://dx.doi.org/10.1097/WNP.0000000000000706DOI Listing

Resident Use of EEG Cap System to Rule Out Nonconvulsive Status Epilepticus.

J Clin Neurophysiol 2020 May 26. Epub 2020 May 26.

Division of Neurology, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada.

Background: Nonconvulsive status epilepticus (NCSE) requires an EEG for diagnosis and in many centers access may be limited. The authors aimed to test whether neurology residents can be trained to use and interpret full-montage EEGs using an EEG cap electrode system to detect NCSE while on-call.

Methods: Neurology residents were trained to interpret EEG recordings using the American Clinical Neurophysiology Society critical care EEG terminology. Read More

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http://dx.doi.org/10.1097/WNP.0000000000000702DOI Listing

Brivaracetam in absence status epilepticus.

Seizure 2020 May 24;80:3-4. Epub 2020 May 24.

Epilepsy Center - SC. Neurologia Universitaria, Policlinico Riuniti, Foggia, Italy.

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http://dx.doi.org/10.1016/j.seizure.2020.05.015DOI Listing
May 2020
2.059 Impact Factor

Thiamylal anaesthetic therapy for febrile refractory status epilepticus in children.

Seizure 2020 May 14;80:12-17. Epub 2020 May 14.

Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan. Electronic address:

Purpose: To evaluate barbiturate anaesthetic therapy using thiamylal for febrile refractory status epilepticus (fRSE) in children.

Methods: This was a review of a prospectively-collected database between April 2012-March 2016 for fRSE cases treated with thiamylal anaesthetic therapy in a single paediatric hospital in Japan. The sample comprised 23 children (median age, 23 months) with fRSE that underwent thiamylal anaesthetic therapy for convulsive seizures lasting longer than 60 min, sustained after intravenous administration of benzodiazepine and non-benzodiazepine anticonvulsants. Read More

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http://dx.doi.org/10.1016/j.seizure.2020.03.012DOI Listing

Current status of pediatric neurocritical care in Argentina.

Arch Argent Pediatr 2020 06;118(3):204-209

Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Ciudad Autónoma de Buenos Aires.

Introduction: Patients with neurocritical injuries account for 10-16 % of pediatric intensive care unit (PICU) admissions and frequently require neuromonitoring.

Objective: To describe the current status of neuromonitoring in Argentina.

Methods: Survey with 37 questions about neuromonitoring without including patients' data. Read More

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http://dx.doi.org/10.5546/aap.2020.eng.204DOI Listing

Acute Symptomatic Seizures in Critically Ill Patients with COVID-19: Is There an Association?

Neurocrit Care 2020 May 28. Epub 2020 May 28.

Cerebrovascular Center, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.

Background: The coronavirus disease of 2019 (COVID-19) emerged as a global pandemic. Historically, the group of human coronaviruses can also affect the central nervous system leading to neurological symptoms; however, the causative mechanisms of the neurological manifestations of COVID-19 disease are not well known. Seizures have not been directly reported as a part of COVID-19 outside of patients with previously known brain injury or epilepsy. Read More

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http://dx.doi.org/10.1007/s12028-020-01006-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7253233PMC

Continuous Electroencephalography Monitoring in Critically Ill Infants and Children.

Pediatr Neurol 2020 Jul 26;108:40-46. Epub 2020 Apr 26.

Department of Neurology, Washington University School of Medicine, St. Louis, Missouri.

Continuous video electroencephalography (CEEG) monitoring of critically ill infants and children has expanded rapidly in recent years. Indications for CEEG include evaluation of patients with altered mental status, characterization of paroxysmal events, and detection of electrographic seizures, including monitoring of patients with limited neurological examination or conditions that put them at high risk for electrographic seizures (e.g. Read More

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http://dx.doi.org/10.1016/j.pediatrneurol.2020.04.009DOI Listing

Aphasic status epilepticus of frontal origin treated by resective surgery.

Epilepsy Behav Rep 2020 23;14:100359. Epub 2020 Mar 23.

Department of Neurological Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-0012, Japan.

Aphasic status epilepticus (SE) is a clinical entity of SE, but it has not been well recognized. We report a 43-year-old female with a chronic drug-resistant epilepsy with aphasic SE, treated by resective surgery. The patient showed long-lasting weekly episodes of hypokinesia, slow verbal response, and dysphasia, which were diagnosed as symptoms of aphasic SE. Read More

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http://dx.doi.org/10.1016/j.ebr.2020.100359DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7229485PMC

New-Onset Refractory Status Epilepticus with Underlying Autoimmune Etiology: a Case Report.

SN Compr Clin Med 2020 28;2(1):103-107. Epub 2019 Nov 28.

3Department of Anesthesiology, Department of Hearing and Speech Sciences, Department of Biomedical Engineering, Vanderbilt University Medical Center, Nashville, TN USA.

Management of new-onset refractory status epilepticus and the approach to burst suppression variable is often challenging. We present the unusual case of a previously healthy 18-year-old male with new-onset status epilepticus admitted to the neurologic intensive care unit for 70 days. Despite treatment with multiple anti-epileptic drugs in addition to IV anesthetics, burst suppression was initially unsustainable and the patient remained in super-refractory status epilepticus. Read More

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http://dx.doi.org/10.1007/s42399-019-00185-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223986PMC
November 2019

Clinical and Electroencephalographic Features of the Seizures in Neuronal Surface Antibody-Associated Autoimmune Encephalitis.

Front Neurol 2020 5;11:280. Epub 2020 May 5.

Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, China.

To investigate clinical and electroencephalographic features of the seizures in different types of neuronal surface antibody (NSAb)-associated autoimmune encephalitis (AE). The clinical data of the seizures were analyzed in 18 patients with NSAb-associated AEs diagnosed in the First Affiliated Hospital of Dalian Medical University. From May 2013 to April 2019, a total of 18 cases of NSAb-associated AE were diagnosed, including 9 cases of leucine-rich glioma-inactivated 1 protein (LGI1) antibody-associated encephalitis, 7 cases of anti--methyl-d-aspartate receptor (NMDAR) encephalitis, and 2 cases of anti-γ-aminobutyric acid B receptor (GABAR) encephalitis. Read More

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http://dx.doi.org/10.3389/fneur.2020.00280DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7214674PMC

De Novo Status Epilepticus in patients with COVID-19.

Ann Clin Transl Neurol 2020 May 14. Epub 2020 May 14.

Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.

Neurological complications are increasingly recognized with SARS-CoV-2, the causative pathogen for COVID-19. We present a single-center retrospective case series reporting the EEG and outcome of de novo status epilepticus (SE) in two African-American women with laboratory-confirmed SARS-CoV-2 virus. SE was the initial presentation in one asymptomatic individual. Read More

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http://dx.doi.org/10.1002/acn3.51071DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7273010PMC

How to carry out and interpret EEG recordings in COVID-19 patients in ICU?

Clin Neurophysiol 2020 May 13. Epub 2020 May 13.

Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

There are questions and challenges regarding neurologic complications in COVID-19 patients. EEG is a safe and efficient tool for the evaluation of brain function, even in the context of COVID-19. However, EEG technologists should not be put in danger if obtaining an EEG does not significantly advance diagnosis or change management in the patient. Read More

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http://dx.doi.org/10.1016/j.clinph.2020.05.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7217782PMC

Prognostic Significance of Cyclic Seizures in Status Epilepticus.

J Clin Neurophysiol 2020 May 7. Epub 2020 May 7.

Department of Neurology, New York Presbyterian Queens, Flushing, New York, U.S.A.

Purpose: Status epilepticus (SE) is a commonly encountered neurologic condition associated with high mortality rates. Cyclic seizures (CS) are a common form of SE, but its prognostic significance has not been well established. In this retrospective study, the mortality of cyclic versus noncyclic forms (NCSs) of SE are compared. Read More

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http://dx.doi.org/10.1097/WNP.0000000000000714DOI Listing

Optimizing status epilepticus care during the COVID-19 pandemic.

Epilepsy Behav 2020 08 21;109:107124. Epub 2020 Apr 21.

Department of Neurology, Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, Baltimore, MD 21224, USA.

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http://dx.doi.org/10.1016/j.yebeh.2020.107124DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7172759PMC

Sleep slow wave homeostasis and cognitive functioning in children with electrical status epilepticus in sleep.

Sleep 2020 May 6. Epub 2020 May 6.

Division of Clinical Neurophysiology, Department of Neurology, University Children's Hospital Zurich, Zurich, Switzerland.

Study Objectives: Encephalopathy with electrical status epilepticus in sleep (ESES) is characterised by non-rapid eye movement (non-REM)-sleep-induced epileptiform activity and acquired cognitive deficits. The synaptic homeostasis hypothesis describes the process of daytime synaptic potentiation balanced by synaptic downscaling in non-REM-sleep and is considered crucial to retain an efficient cortical network. We aimed to study the overnight decline of slow waves, an indirect marker of synaptic downscaling, in patients with ESES and explore whether altered downscaling relates to neurodevelopmental and behavioural problems. Read More

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http://dx.doi.org/10.1093/sleep/zsaa088DOI Listing

Sudden Onset Fluent Aphasia: Stroke or Seizure?

Neurohospitalist 2020 Apr 28;10(2):121-126. Epub 2019 Jul 28.

Department of Neurology, Emory University, Atlanta, GA, USA.

Conventional understanding of acute onset language deficits indicates that fluent aphasias are due to perisylvian lesions in the dominant hemisphere, most often in the setting of acute stroke. Case studies and retrospective analyses, however, suggest the need to keep ictal phenomena as an alternative diagnostic possibility. The following case illustrates an epileptic mechanism of sudden onset fluent aphasia mimicking an acute stroke presentation. Read More

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http://dx.doi.org/10.1177/1941874419864757DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7191664PMC

The EEG diagnosis of NCSE: Concordance between clinical practice and Salzburg Criteria for NCSE.

Seizure 2020 Jul 24;79:1-7. Epub 2020 Apr 24.

Neurology Department, OCB Hospital, AOU Modena, Italy; PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy.

Purpose: To evaluate the concordance between the EEG diagnosis of non-convulsive status epilepticus (NCSE) made by the treating physician and the application of the Salzburg Consensus Criteria (SCC) on consecutive urgent EEG requested for acute alteration of consciousness not otherwise explained.

Methods: Retrospective evaluation of all urgent EEGs acquired between January 1st and March 31st 2018 in adolescents and adult patients (≥14 years old). The 'reference' was the neurologist who first evaluated the patient and reported the corresponding EEG diagnosis. Read More

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http://dx.doi.org/10.1016/j.seizure.2020.04.010DOI Listing

The role of EEG in patients with suspected epilepsy.

Epileptic Disord 2020 Apr;22(2):143-155

Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, USA.

Despite the advances in imaging, EEG remains a critical test for the diagnosis of epilepsy. Not only can it confirm the diagnosis, but it can also clarify the type of epilepsy. There are many different types of EEG recordings depending on duration, the presence of video, and inpatient or outpatient setting, each with its pros and cons. Read More

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http://dx.doi.org/10.1684/epd.2020.1151DOI Listing

Focal status epilepticus as unique clinical feature of COVID-19: A case report.

Seizure 2020 May 21;78:109-112. Epub 2020 Apr 21.

Neurologia, Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy; Neurologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.

SARS-CoV-2, a novel zoonotic coronavirus, is currently spreading all over the world, causing a pandemic disease defined coronavirus disease 2019 (COVID-19). The spectrum of COVID-19 ranges from asymptomatic or mild infection to rapidly progressive, acute respiratory distress syndrome and death [1].To the best of our knowledge, status epilepticus has never been described as initial presentation of COVID-19. Read More

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http://dx.doi.org/10.1016/j.seizure.2020.04.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7172719PMC

Implementation and Early Evaluation of a Quantitative Electroencephalography Program for Seizure Detection in the PICU.

Pediatr Crit Care Med 2020 Jun;21(6):543-549

Paediatric Intensive Care Unit, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom.

Objectives: To describe implementation and early evaluation of using quantitative electroencephalography for electrographic seizure detection by PICU clinician staff.

Design: Prospective observational study of electrographic seizure detection by PICU clinicians in patients monitored with quantitative electroencephalography. Quantitative electroencephalography program implementation included a continuous education and training package. Read More

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http://dx.doi.org/10.1097/PCC.0000000000002278DOI Listing

Etiological assessment of status epilepticus.

Rev Neurol (Paris) 2020 Jun 21;176(6):408-426. Epub 2020 Apr 21.

Explorations Neurophysiologiques, Département de Neurologie, Hôpital Pierre-Paul-Riquet, Purpan, CHU de Toulouse, Toulouse, France; Centre de Recherche Cerveau et Cognition, Université de Toulouse, Université Paul-Sabatier Toulouse, Toulouse, France; CerCo, UMR 5549, Centre National de la Recherche Scientifique, Toulouse Mind and Brain Institute, Toulouse, France.

Status epilepticus (SE) is a potentially serious condition that can affect vital and functional prognosis and requires urgent treatment. Etiology is a determining factor in the patient's functional outcome and in almost half of all cases justifies specific treatment to stop progression. Therefore, identifying and addressing the cause of SE is a key priority in SE management. Read More

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http://dx.doi.org/10.1016/j.neurol.2019.12.010DOI Listing

False alarms reduction in non-convulsive status epilepticus detection via continuous EEG analysis.

Physiol Meas 2020 06 10;41(5):055009. Epub 2020 Jun 10.

Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands. Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands. Academic Centre for Epilepsy Kempenhaeghe, Heeze, The Netherlands.

Objective: Frequent false alarms from computer-assisted monitoring systems may harm the safety of patients with non-convulsive status epilepticus (NCSE). In this study, we aimed at reducing false alarms in the NCSE detection based on preventing from three common errors: over-interpretation of abnormal background activity, dense short ictal discharges and continuous interictal discharges as ictal discharges.

Approach: We analyzed 10 participants' hospital-archived 127-hour electroencephalography (EEG) recordings with 310 ictal discharges. Read More

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http://dx.doi.org/10.1088/1361-6579/ab8cb3DOI Listing

Treatment of generalized convulsive status epilepticus: An international survey in the East Mediterranean Countries.

Seizure 2020 May 10;78:96-101. Epub 2020 Apr 10.

Comprehensive Epilepsy Program, Neurology Department, American University of Beirut Medical Center, Lebanon. Electronic address:

Purpose: Three Chapters of the Commission of the East Mediterranean Affairs (CEMA) of the ILAE conducted a survey to assess the availability of drugs used for the treatment of generalized convulsive status epilepticus (GCSE) across the CEMA countries and to evaluate the treatment choices of adult and pediatric neurologists for the treatment of this condition.

Method: The web-based survey consisted of two similar vignettes of GCSE in a child and an adult. The questions evaluated the sequential drugs of choice based on drug availability and with the assumption that all drugs were at the disposition of the neurologists. Read More

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http://dx.doi.org/10.1016/j.seizure.2020.03.016DOI Listing

Electropositive seizures and non-convulsive status epilepticus in a critically ill patient with prior skull defect.

Epileptic Disord 2020 Apr;22(2):219-223

University of Ottawa, Ottawa, Canada.

Epileptiform discharges captured on routine scalp EEG typically carry a surface negative dipole. We present a patient whose continuous EEG recording in the intensive care setting captured frequent electropositive non-convulsive seizures. Epileptiform discharges with positive polarity are common in the pediatric population but have rarely been reported in adult patients. Read More

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http://dx.doi.org/10.1684/epd.2020.1147DOI Listing

Critically ill benign EEG variants: Is there such a thing?

Clin Neurophysiol 2020 Jun 16;131(6):1243-1251. Epub 2020 Mar 16.

University of Manitoba, Max Rady College of Medicine, Section of Neurology, Department of Internal Medicine, GF-543, 820 Sherbrook Street, Health Sciences Centre, Winnipeg, MB R3A 1A9, Canada. Electronic address:

Despite growing use of critical care electroencephalography (ccEEG) to detect seizures and status epilepticus in the intensive care unit (ICU), integrating ccEEG findings with traditionally described benign EEG variants (BEVs) is a relatively new concept. BEV-like waveforms are now increasingly encountered in the ICU, and have also been explicitly included in proposed definitions of brief potentially ictal rhythmic discharges (BIRDs) in the ICU, bringing to the fore the question of if and which EEG patterns in critically ill patients can be safely deemed "benign". Though well-characterized as benign in healthy outpatients at low pre-test risk for neurologic disease, the significance of BEVs in the ICU remains largely unknown. Read More

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http://dx.doi.org/10.1016/j.clinph.2020.03.004DOI Listing

The chemical convulsant diisopropylfluorophosphate (DFP) causes persistent neuropathology in adult male rats independent of seizure activity.

Arch Toxicol 2020 Jun 18;94(6):2149-2162. Epub 2020 Apr 18.

Department of Molecular Biosciences, University of California, Davis, School of Veterinary Medicine, 1089 Veterinary Medicine Drive, Davis, CA, 95616, USA.

Organophosphate (OP) threat agents can trigger seizures that progress to status epilepticus, resulting in persistent neuropathology and cognitive deficits in humans and preclinical models. However, it remains unclear whether patients who do not show overt seizure behavior develop neurological consequences. Therefore, this study compared two subpopulations of rats with a low versus high seizure response to diisopropylfluorophosphate (DFP) to evaluate whether acute OP intoxication causes persistent neuropathology in non-seizing individuals. Read More

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http://dx.doi.org/10.1007/s00204-020-02747-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7305973PMC
June 2020
5.980 Impact Factor

MoCA as a cognitive assessment tool for absence status epilepticus.

Epileptic Disord 2020 Apr;22(2):229-232

Hospital da Luz, Neurology Department, Member of the ERN EpiCARE, Lisbon, Portugal.

De novo absence status is clinically characterized by a confusional syndrome and neurophysiologically by the presence of periodic spike/polyspike-and-wave discharges on EEG. The treatment should be started promptly, and fast recovery is usually seen. However, cognitive symptoms can be very difficult to detect, and no consensus exists on how cognitive improvement can be clinically monitored. Read More

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http://dx.doi.org/10.1684/epd.2020.1149DOI Listing

Praxis-induced reflex seizures in two Japanese cases with ring chromosome 20 syndrome.

Epileptic Disord 2020 Apr;22(2):214-218

Department of Paediatrics, Jichi Medical University, Shimotsuke, Japan.

Ring chromosome 20 syndrome is an epileptic and neurodevelopmental encephalopathy that occurs in children, characterised by a triad of refractory frontal lobe seizures, recurrent non-convulsive status epilepticus and frontal lobe-dominant paroxysmal discharges. However, details of other clinical features associated with ring chromosome 20 syndrome remain unknown. Here, we report two patients with ring chromosome 20 syndrome who had praxis-induced reflex seizures. Read More

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http://dx.doi.org/10.1684/epd.2020.1146DOI Listing

High-power, frontal-dominant ripples in absence status epilepticus during childhood.

Clin Neurophysiol 2020 Jun 19;131(6):1204-1209. Epub 2020 Mar 19.

Division of Neurology, Saitama Children's Medical Center, 2-1 Shin-toshin, Chuou-ku, Saitama-city, Saitama 330-8777, Japan; Department of Pediatrics, Jikei University School of Medicine, 3-19-18 Nishi-shinbashi, Minato-ku, Tokyo 105-8471, Japan.

Objective: Absence status epilepticus (ASE) is a form of non-convulsive status epilepticus characterized by ongoing or intermittent epileptic activity accompanied by behavioral and cognitive changes. Herein, we assessed high-frequency oscillations in the ripple band in patients with ASE and typical absence seizures.

Methods: We enrolled five patients with ASE, 26 patients with childhood absence epilepsy (CAE), and 15 patients with juvenile absence epilepsy (JAE). Read More

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http://dx.doi.org/10.1016/j.clinph.2020.02.024DOI Listing

Urethane attenuates early neuropathology of diisopropylfluorophosphate-induced status epilepticus in rats.

Neurobiol Dis 2020 Jul 10;140:104863. Epub 2020 Apr 10.

Department of Pharmacology and Chemical Biology, Emory University, 1510 Clifton Road NE, Atlanta, GA 30322, United States of America.

Seizures can be evident within minutes of exposure to an organophosphorus (OP) agent and often progress to status epilepticus (SE) resulting in a high mortality if left untreated. Effective medical countermeasures are necessary to sustain patients suffering from OP poisoning and to mitigate the ensuing brain injury. Here, the hypothesis was tested that a single subanesthetic dose of urethane prevents neuropathology measured 24 h following diisopropylfluorophosphate (DFP)-induced SE. Read More

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http://dx.doi.org/10.1016/j.nbd.2020.104863DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7266093PMC