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Neurol Clin Pract 2021 Apr;11(2):e170-e173

Child Neuropsychiatry (FD, TLB, FD, GC), Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona; Clinical and Experimental Medicine PhD Program (TLB), University of Modena and Reggio Emilia; Child Neuropsychiatry Unit (FD, E. Fontana, E. Fiorini, MM, GC), and Pediatric Intensive Care Unit (PB), University-Hospital of Verona; and Center for Research on Epilepsies in Pediatric Age (CREP) (BDB), Verona, Italy.

New-onset refractory status epilepticus (NORSE) is rare condition, and sharing knowledge is vital in its management, based on strict collaboration between multiple specialists, continuous EEG (c-EEG) monitoring, and prompt therapy modification. The coronavirus disease 2019 (COVID-19) pandemic challenged many of these established practices because of "social distancing" measures, making it necessary to work around physical restrictions. We report a case of a 10-year-old with NORSE admitted in a pediatric intensive-care unit and monitored with c-EEG and amplitude-integrated EEG. Read More

Zhongguo Dang Dai Er Ke Za Zhi 2021 Apr;23(4):356-362

First Clinical Medical College, Shanxi Medical University, Taiyuan 030000, China.

Objective: To systematically evaluate the efficacy and safety of levetiracetam (LEV) versus phenytoin (PHT) as second-line drugs for the treatment of convulsive status epilepticus (CSE) in children.

Methods: English and Chinese electronic databases were searched for the randomized controlled trials comparing the efficacy and safety of LEV and PHT as second-line drugs for the treatment of childhood CSE. RevMan 5. Read More

Neuroscience 2021 Apr 6. Epub 2021 Apr 6.

Institute of Pharmacology, Toxicology, and Pharmacy, Ludwig-Maximilians-University Munich, Germany. Electronic address:

Experimental and clinical data suggest an impact of serotonergic signaling on seizure susceptibility and epilepsy-associated psychiatric comorbidities. Previous µPET studies revealed increased binding of 5-HT receptor ligand [F]MPPF in two rat models with spontaneous recurrent seizures. These findings raised the question whether these alterations are due to altered 5-HT receptor expression or a modification of extracellular serotonin concentrations. Read More

Neuroscience 2021 Apr 6. Epub 2021 Apr 6.

United States Army Medical Research Institute of Chemical Defense, Medical Toxicology Research Division, Neuroscience Department, 2900 Ricketts Point Rd, Aberdeen Proving Ground, MD 21010, USA.

Benzodiazepines are the primary treatment option for organophosphate (OP)-induced status epilepticus (SE), but these antiseizure drugs (ASDs) lose efficacy as treatment is delayed. In the event of a mass civilian or military exposure, significant treatment delays are likely. New ASDs that combat benzodiazepine-resistant, OP-induced SE are critically needed, particularly if they can be efficacious after a long treatment delay. Read More

Hum Genet 2021 Apr 9. Epub 2021 Apr 9.

Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland.

We investigated the clinical, genetic, and pathological characteristics of a previously unknown severe juvenile brain disorder in several litters of Parson Russel Terriers. The disease started with epileptic seizures at 6-12 weeks of age and progressed rapidly to status epilepticus and death or euthanasia. Histopathological changes at autopsy were restricted to the brain. Read More

Case Rep Orthop 2021 25;2021:5525316. Epub 2021 Mar 25.

Department of Orthopedic Surgery and Traumatology, Saint Georges University Medical Center, Balamand University, P.O. Box 166378, Achrafieh, Beirut 1100 2807, Lebanon.

Proximal humerus fracture is a common orthopedic presentation, with bimodal age distribution. On the other hand, bilateral proximal humerus fracture dislocation is a rarely reported pathology, especially when it is not the result of direct trauma. We present a case of a 71-year-old female patient found to have simultaneous bilateral 4-part proximal humerus fractures following status epilepticus treated surgically with bilateral reverse shoulder arthroplasty with constraint and soft tissue release. Read More

Brain Res 2021 Apr 5:147468. Epub 2021 Apr 5.

The Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China. Electronic address:

Status epilepticus (SE) is a neurological emergency. The pathological hallmark of neuronal damage after epileptic seizures could be the chain reaction of oxygen free radicals. Hydroxylated fullerenes (HFs) are novel and effective free radical scavengers, which play an important role in various neurological diseases. Read More

JCI Insight 2021 Apr 8. Epub 2021 Apr 8.

Department of Neuropharmacology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Yamanashi, Japan.

Extensive activation of glial cells during a latent period has been well documented in various animal models of epilepsy. However, it remains unclear whether activated glial cells contribute to epileptogenesis; i.e. Read More

Drugs 2021 Apr 8. Epub 2021 Apr 8.

Comprehensive Epilepsy Center, Department of Neurology, Yale University School of Medicine, New Haven, CT, USA.

Most seizures in critically ill patients are nonconvulsive. A significant number of neurological and medical conditions can be complicated by nonconvulsive seizures (NCSs) and nonconvulsive status epilepticus (NCSE), with brain infections, hemorrhages, global hypoxia, sepsis, and recent neurosurgery being the most prominent etiologies. Prolonged NCSs and NCSE can lead to adverse neurological outcomes. Read More

Front Neurol 2021 22;12:588989. Epub 2021 Mar 22.

Department of Neurosurgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, United States.

Sedation is a ubiquitous practice in ICUs and NCCUs. It has the benefit of reducing cerebral energy demands, but also precludes an accurate neurologic assessment. Because of this, sedation is intermittently stopped for the purposes of a neurologic assessment, which is termed a neurologic wake-up test (NWT). Read More

Epilepsy Behav 2021 Apr 4:107934. Epub 2021 Apr 4.

Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Clinical Neuroscience, Sahlgrenska Academy, Gothenburg University, Sweden; Wallenberg Center of Molecular and Translational Medicine, Gothenburg University, Sweden. Electronic address:

Pediatr Neurosurg 2021 Apr 7:1-8. Epub 2021 Apr 7.

Division of Pediatric Neurosurgery, Ibaraki Children's Hospital, Mito, Japan.

Background And Objective: Acute encephalopathy is a life-threatening brain dysfunction in children, often associated with a preceding infection and diffuse noninflammatory brain edema. At present, the role of decompressive craniectomy (DC) over the swollen area of the brain is unclear. The risk factors for predicting clinical deterioration also need clarification. Read More

Toxicol Appl Pharmacol 2021 Apr 3:115519. Epub 2021 Apr 3.

Department of Pharmacology, Israel Institute for Biological, Chemical and Environmental Sciences, Ness-Ziona 74100, Israel. Electronic address:

The development of refractory status epilepticus (SE) induced by sarin intoxication presents a therapeutic challenge. In our current research we evaluate the efficacy of a delayed combined triple treatment in ending the abnormal epileptiform seizure activity (ESA) and the ensuing of long-term neuronal insult. SE was induced in male Sprague-Dawley rats by exposure to 1. Read More

Epilepsy Res 2021 Mar 24;173:106625. Epub 2021 Mar 24.

Department of Neurology, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt.

Objective: No data exist regarding the impact of the lockdown due to the COVID-19 pandemic on the risk factors of sudden unexpected death in epilepsy (SUDEP). This study aimed to stratify risk factors of SUDEP in relation to COVID-19 lockdown, among patients with epilepsy (PWE) in Cairo University epilepsy unit (CUEU). Therefore, we can detect risk factors and mitigate such factors in the second wave of the virus. Read More

Epilepsia 2021 Apr 5. Epub 2021 Apr 5.

Univ. Grenoble Alpes, Grenoble Institut Neurosciences, Inserm, U1216, Grenoble 38000, France.

Objective: Improving the identification of the epileptogenic zone and associated seizure-spreading regions represents a significant challenge. Innovative brain-imaging modalities tracking neurovascular dynamics during seizures may provide new disease biomarkers.

Methods: With use of a multi-parametric magnetic resonance imaging (MRI) analysis at 9. Read More

JAMA Neurol 2021 Apr 5. Epub 2021 Apr 5.

Department of Neurology, Goethe-University Frankfurt, Frankfurt am Main, Germany.

Importance: Status epilepticus (SE) is associated with poor clinical outcomes and high cost. Increased levels of refractory SE require treatment with additional medications and carry increased morbidity and mortality, but the associations between SE refractoriness, clinical outcomes, and cost remain poorly characterized.

Objective: To examine differences in clinical outcomes and costs associated with hospitalization for SE of varying refractoriness. Read More

Biomed Res Int 2021 17;2021:7973123. Epub 2021 Mar 17.

Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Chongqing 400016, China.

Purpose: Previous studies have demonstrated that immune and inflammatory factors play an important role in recurrent seizures. The PD-1-PD-L pathway plays a central and peripheral immunosuppressive role by regulating multiple signaling pathways during the inflammatory and immunologic processes. This study is aimed at assessing PD-1 levels in cerebrospinal fluid (CSF) and serum samples from patients with intractable epilepsy. Read More

Cureus 2021 Mar 1;13(3):e13624. Epub 2021 Mar 1.

Emergency Medicine, King Fahad University Hospital, Imam Abdulrahman Bin Faisal University, Dammam, SAU.

Moyamoya disease (MMD) is a rare cerebrovascular occlusion condition characterized by ‎progressive stenosis in the terminal portion of the internal carotid arteries on both sides. The measured incidence of MMD is 0.086 per 100,000 people. Read More

Cureus 2021 Feb 28;13(2):e13612. Epub 2021 Feb 28.

Pediatrics, Emergency Clinical Hospital for Children, Cluj-Napoca, ROU.

In this report, we present the case of a one-year-old female patient with a history of febrile seizures, which was characterized by multiple seizures during hot baths and more than one episode of status epilepticus. Dravet syndrome was suspected due to the clinical context of the seizures and was confirmed by genetic testing. The brain MRI was found to be normal. Read More

Front Neurol 2021 17;12:648911. Epub 2021 Mar 17.

Jincheng People's Hospital Affiliated to Shanxi Medical University, Jincheng, China.

Anti--methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune disease associated with the NMDA receptor. This paper describes a patient who presented with bilateral hearing loss as the initial symptom of anti-NMDAR encephalitis. We describe a 31-year-old young female with anti-NMDAR encephalitis who presented with bilateral severe hearing loss after brief loss of consciousness and then accompanied by other symptoms, such as generalized tonic-clonic seizures, manic episodes, excessive salivation, severe cognitive impairment, and complex non-convulsive status epilepticus. Read More

Curr Treat Options Neurol 2021 31;23(5):14. Epub 2021 Mar 31.

Department of Neurology, 1 Gustave L. Levy Place, Box 1136, New York, NY 10029 USA.

Purpose Of Review: This review presents an overview of the known neurocritical care complications of severe acute respiratory virus 2 (SARS-CoV-2). We present readers with a review of the literature of severe neurologic complications of SARS-CoV-2 and cases from our institution to illustrate these conditions.

Recent Findings: Neurologic manifestations are being increasingly recognized in the literature. Read More

Brain Sci 2021 Mar 26;11(4). Epub 2021 Mar 26.

Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, 60020 Ancona, Italy.

Objectives: The study aimed to explore the clinical predictors of pharmaco-resistance in patients with post-stroke epilepsy (PSE).

Methods: Patients with epilepsy secondary to cerebral infarct or spontaneous intracerebral hemorrhage were included. The study outcome was the occurrence of pharmaco-resistance defined as the failure of adequate trials of two tolerated and appropriately chosen and used antiseizure medication schedules, whether as monotherapies or in combination, to achieve sustained seizure freedom. Read More

Int J Mol Sci 2021 Mar 22;22(6). Epub 2021 Mar 22.

Department of Medicinal Chemistry, Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9, 30-688 Cracow, Poland.

Status epilepticus (SE) is a frequent medical emergency that can lead to a variety of neurological disorders, including cognitive impairment and abnormal neurogenesis. The aim of the presented study was the evaluation of potential neuroprotective properties of a new pyrrolidine-2,5-dione derivatives compound C11, as well as the assessment of the impact on the neurogenesis and cognitive functions of C11 and levetiracetam (LEV) after pilocarpine (PILO)-induced SE in mice. The results indicated a protective effect of C11 (500, 1000, and 2500 ng/mL) on astrocytes under trophic stress conditions in the MTT (3-[4,5-dimethylthiazole-2-yl]-2,5-diphenyltetrazolium bromide) test. Read More

Cells 2021 Mar 1;10(3). Epub 2021 Mar 1.

Department of Physiology, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania.

Temporal lobe epilepsy (TLE) is characterized by changes in interneuron numbers in the hippocampus. Deep brain stimulation (DBS) is an emerging tool to treat TLE seizures, although its mechanisms are not fully deciphered. We aimed to depict the effect of amygdala DBS on the density of the most common interneuron types in the CA1 hippocampal subfield in the lithium-pilocarpine model of epilepsy. Read More

J Clin Med 2021 Mar 2;10(5). Epub 2021 Mar 2.

Department of Neurology, University Hospital Frankfurt, Goethe University, 60528 Frankfurt, Germany.

Local anesthetics are commonly administered by nuchal infiltration to provide a temporary interscalene brachial plexus block (ISB) in a surgical setting. Although less commonly reported, local anesthetics can induce central nervous system toxicity. In this case study, we present three patients with acute central nervous system toxicity induced by local anesthetics applied during ISB with emphasis on neurological symptoms, key neuroradiological findings and functional outcome. Read More

Seizure 2021 Mar 17;88:29-35. Epub 2021 Mar 17.

Department of Neurology, Neuro Intensive Care Unit, Hôpital Pitié-Salpêtrière, APHP.Sorbonne, Paris, France. Electronic address:

Introduction: Mechanically ventilated patients admitted to the intensive care unit (ICU) for generalized convulsive status epilepticus (GCSE) are a heterogeneous population. Our objective was to evaluate the number of patients who fulfilled the diagnostic criteria for refractory GCSE and describe their initial management and prognosis.

Methods: This multicenter retrospective study was conducted in four French ICUs in Pitié-Salpêtrière University Hospital in Paris and in the Hospital of Jossigny. Read More

Toxicol Appl Pharmacol 2021 Mar 30;419:115515. Epub 2021 Mar 30.

Neuroscience Department, Medical Toxicology Research Division, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD 21010-5400, USA. Electronic address:

Exposure to organophosphorus nerve agents (NAs) like sarin (GB) and soman (GD) can lead to sustained seizure activity, or status epilepticus (SE). Previous research has shown that activation of A1 adenosine receptors (A1ARs) can inhibit neuronal excitability, which could aid in SE termination. Two A1AR agonists, 2-Chloro-N6-cyclopentyladenosine (CCPA) and N-Bicyclo(2. Read More

Am J Med Genet A 2021 Apr 2. Epub 2021 Apr 2.

Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA.

Biallelic loss-of-function (LoF) of SLC13A5 (solute carrier family 13, member 5) induced deficiency in sodium/citrate transporter (NaCT) causes autosomal recessive developmental epileptic encephalopathy 25 with hypoplastic amelogenesis imperfecta (DEE25; MIM #615905). Many pathogenic SLC13A5 single nucleotide variants (SNVs) and small indels have been described; however, no cases with copy number variants (CNVs) have been sufficiently investigated. We describe a consanguineous Iraqi family harboring an 88. Read More

Swiss Med Wkly 2021 Mar 16;151:w20477. Epub 2021 Mar 16.

Department of Neurology, Lausanne University Hospital and University of Lausanne, Switzerland.

Background: Continuous EEG (cEEG) is increasingly used in critically ill patients, but it is more resource-intensive than routine EEG (rEEG). In the US, cEEG generates increased hospitalisation charges. This study analysed hospital-related reimbursement for participants in a Swiss multicentre randomised controlled trial that assessed the relationship of cEEG versus repeated rEEG with outcome. Read More

J Healthc Eng 2021 15;2021:6684818. Epub 2021 Mar 15.

Department of Neonatology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250033, China.

Analyzing and discussing the relationship between brain injury in preterm infants and related risk factors can provide evidence for perinatal prevention and early intervention of brain injury in preterm infants, thereby improving the quality of life of preterm infants. This paper selects term preterm infants diagnosed with preterm infant asphyxia in the NICU of a university's First Affiliated Hospital from January 2018 to February 2019 as the research object. In addition, healthy term infants born at the same time in the obstetric department of this hospital are selected as the control group. Read More