Epilepsy & behavior : E&B
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Epilepsy & behavior : E&B · Aug 2015
Ketamine in refractory convulsive status epilepticus in children avoids endotracheal intubation.
The purpose of this study was to report on the efficacy and safety of intravenous ketamine (KE) in refractory convulsive status epilepticus (RCSE) in children and highlight its advantages with particular reference to avoiding endotracheal intubation. ⋯ Ketamine is effective in treating RCSE and represents a practical alternative to conventional anesthetics for the treatment of RCSE. Its use avoids the pitfalls and dangers of endotracheal intubation, which is known to worsen RCSE prognosis. This article is part of a Special Issue entitled "Status Epilepticus".
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Millions of people surf the Internet every day as a source of health-care information looking for materials about symptoms, diagnosis, treatments and their possible adverse effects, or diagnostic procedures. Google is the most popular search engine and is used by patients and physicians to search for online health-related information. This study aimed to evaluate changes in Google search behavior occurring in English-speaking countries over time for the term "status epilepticus" (SE). ⋯ Most people use search engines to look for the term SE to obtain information on its definition, subtypes, and management. The greatest search volume occurred not only in developed countries but also in developing countries where raising awareness about SE still remains a challenging task and where there is reduced public knowledge of epilepsy. Health information seeking (the extent to which people search for health information online) reflects the health-related information needs of Internet users for a specific disease. Google Trends shows that Internet users have a great demand for information concerning some aspects of SE (definition, subtypes, symptoms, treatment, and guidelines). Policy makers and neurological scientific societies have the responsibility to try to meet these information needs and to better target public information campaigns on SE to the general population. This article is part of a Special Issue entitled "Status Epilepticus".
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Epilepsy & behavior : E&B · Aug 2015
Incidence of recurrent seizures following hospital discharge in patients with LPDs (PLEDs) and nonconvulsive seizures recorded on continuous EEG in the critical care setting.
Continuous EEG (cEEG) has helped to identify nonconvulsive seizures (NCS) and nonconvulsive status epilepticus (NCSE) along with lateralized periodic patterns (LPDs or PLEDs) in ICU patients with much higher frequency than previously appreciated, but understanding their implications may be more complex. The aim of this study was to investigate the incidence of recurrent seizures after hospital discharge and their associated factors in patients with PLEDs and NCS in the critical care setting. ⋯ Almost every other patient with PLEDs and/or NCS on cEEG had seizures after ICU discharge. A quarter of patients on cEEG in the ICU with PLEDs alone had seizures after discharge, and after excluding prior epilepsy, 17% of patients with PLEDs had seizures on follow-up. This was dramatically increased with the recording of PLEDs with NCS, with 60% of patients having seizures after discharge from the ICU and 48% of patients after excluding prior epilepsy. Patients with NCS on cEEG alone had 63% chance of seizure recurrence that dropped to 38% with exclusion of prior epilepsy. Future studies are needed to define the postdischarge outcomes including seizure recurrence in this patient population. This article is part of a Special Issue entitled "Status Epilepticus".
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Epilepsy & behavior : E&B · Jun 2015
ReviewMinimally invasive surgical approaches for temporal lobe epilepsy.
Surgery can be a highly effective treatment for medically refractory temporal lobe epilepsy (TLE). The emergence of minimally invasive resective and nonresective treatment options has led to interest in epilepsy surgery among patients and providers. Nevertheless, not all procedures are appropriate for all patients, and it is critical to consider seizure outcomes with each of these approaches, as seizure freedom is the greatest predictor of patient quality of life. ⋯ Stereotactic laser thermo-ablation allows destruction of the mesial temporal structures with low complication rates and minimal recovery time, and outcomes are also under study. Finally, while neuromodulatory devices such as responsive neurostimulation, vagus nerve stimulation, and deep brain stimulation have a role in the treatment of certain patients, these remain palliative procedures for those who are not candidates for resection or ablation, as complete seizure freedom rates are low. Further development and investigation of both established and novel strategies for the surgical treatment of TLE will be critical moving forward, given the significant burden of this disease.
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Epilepsy & behavior : E&B · Jun 2015
Validation of the Chinese version of the Neurological Disorders Depression Inventory for Epilepsy (C-NDDI-E) in West China.
We aimed to validate the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) for Chinese people with epilepsy (PWE). ⋯ The C-NDDI-E is a valuable instrument for screening MDD in Chinese PWE.