Article
Neurosciences
Julia E. Morgan, Sara C. Wilson, Benjamin J. Travis, Kathryn H. Bagri, Kathleen T. Pagarigan, Hannah M. Belski, Cecelia Jackson, Kevin M. Bounader, Jessica M. Coppola, Eden N. Hornung, James E. Johnson, Hilary S. McCarren
Summary: Nerve agent-induced status epilepticus poses challenges in treatment, with current guidelines showing limited effectiveness. Aggressive treatment with a three-line approach is necessary for positive outcomes in NA poisoning-related SE patients.
FRONTIERS IN NEUROSCIENCE
(2021)
Article
Critical Care Medicine
Ayham Alkhachroum, Saptharishi Lalgudi Ganesan, Johannes P. Koren, Julie Kromm, Nina Massad, Renz A. Reyes, Michael R. Miller, David Roh, Sachin Agarwal, Soojin Park, Jan Claassen
Summary: The study found that both qEEG experts and novices had high sensitivity but low specificity in identifying seizures in patients with SRSE. qEEG could be a useful tool for qEEG experts to estimate seizure burden in patients with SRSE.
NEUROCRITICAL CARE
(2022)
Review
Medicine, General & Internal
Yazeed S. Alolayan, Kelly McKinley, Ritwik Bhatia, Ayham Alkhachroum
Summary: RSE is defined as continuous status epilepticus that persists despite administering at least two appropriately dosed parenteral medications, while SRSE is status epilepticus that persists at least 24 h after adding at least one appropriately dosed continuous anesthetic. Other therapeutic interventions include immunotherapy, neuromodulation, ketogenic diet, or even surgical intervention, with continuous EEG monitoring being essential for diagnosis and treatment.
JOURNAL OF CLINICAL MEDICINE
(2021)
Review
Biochemistry & Molecular Biology
Tzu-Hsin Huang, Ming-Chi Lai, Yu-Shiue Chen, Chin-Wei Huang
Summary: Status epilepticus (SE) is a neurological emergency with high mortality rate. The downregulation of GABAA receptors and upregulation of NMDA and AMPA receptors are the most widely accepted hypothesis underlying BZD resistance.
Review
Clinical Neurology
Natasha E. Schoeler, Zoe Simpson, Runming Zhou, Suresh Pujar, Christin Eltze, J. H. Cross
Summary: Ketogenic diet therapies show potential efficacy and safety in children with super-refractory status epilepticus, with around two-thirds achieving cessation of SE. However, the specific effects are influenced by various factors and further research is needed.
FRONTIERS IN NEUROLOGY
(2021)
Review
Geriatrics & Gerontology
Batool F. Kirmani, Katherine Au, Lena Ayari, Marita John, Padmashri Shetty, Robert J. Delorenzo
Summary: Super-refractory status epilepticus is a life-threatening neurological emergency with high morbidity and mortality, resistant to normal treatment protocols. There is a lack of robust published data regarding the safety and effectiveness of various therapies, emphasizing the need for large randomized multicenter trials to compare newer therapies for this challenging condition.
Review
Clinical Neurology
Siew-Na Lim, Tony Wu, Wei-En Johnny Tseng, Hsing- Chiang, Mei-Yun Cheng, Wey-Ran Lin, Chia-Ni Lin
Summary: Perampanel shows effectiveness and satisfactory safety profile in the emergency treatment of established refractory and super-refractory status epilepticus. Patients with unique types and causes of SE, particularly nonconvulsive status epilepticus, may have a better response to perampanel treatment.
JOURNAL OF NEUROLOGY
(2021)
Article
Multidisciplinary Sciences
Yi-Ting Fang, Tsung-Lin Lee, Yi-Hsien Tu, Sheng-Hsiang Lin, Miao-Er Chien, Chin-Wei Huang, Kuei-Sen Hsu, Yi-Jen Wu
Summary: This study investigated factors associated with mortality in patients with super-refractory status epilepticus (SRSE) and found that deceased patients were mostly young or middle-aged without known systemic diseases or epilepsy. All deceased patients experienced generalized convulsive status epilepticus and failure of anesthetic tapering-off, significantly higher than survivors. Deceased patients had significantly higher renal and cardiac complications and metabolic acidosis than survivors. Careful control of multi-anesthetic use is recommended to avoid systemic complications and mortality in SRSE management.
SCIENTIFIC REPORTS
(2022)
Review
Neurosciences
Ioannis Stavropoulos, Ho Lim Pak, Gonzalo Alarcon, Antonio Valentin
Summary: This systematic review presents literature data on the potential uses of clinical neuromodulation techniques, including electroconvulsive therapy, vagus nerve stimulation, and deep brain stimulation, for the management of super-refractory status epilepticus (srSE) in children. Although limited by the small number of published pediatric cases and lack of controlled clinical trials, the existing data and potential benefits suggest that these techniques could be considered at earlier stages to prevent long-term neurological complications.
Article
Clinical Neurology
Stefan Kunst, Mikel L. Rojo, Moritz O. Schmidbauer, Johann Pelz, Annekatrin Mueller, Jens Minnerup, Lennart Meyer, Dominik Madzar, Caroline Reindl, Marie Madlener, Michael Malter, Bernhard Neumann, Konstantinos Dimitriadis, IGNITE Study Group
Summary: This study aimed to evaluate the efficacy and safety of phenobarbital (PB) for the treatment of super-refractory status epilepticus (SRSE). The results showed that PB treatment achieved a high rate of seizure control, but the clinical outcomes at discharge were poor due to the severity of the patients' conditions.
Article
Critical Care Medicine
Henning R. Stetefeld, Alexander Schaal, Franziska Scheibe, Julia Nichtweiss, Felix Lehmann, Marcus Mueller, Stefan T. Gerner, Hagen B. Huttner, Sebastian Luger, Hannah Fuhrer, Julian Boesel, Silvia Schoenenberger, Konstantinos Dimitriadis, Bernhard Neumann, Kornelius Fuchs, Gereon R. Fink, Michael P. Malter
Summary: Isoflurane was effective in stopping RSE/SRSE, but achieving remission remained difficult. Side effects, such as hypotension and infection, were common but did not impact discharge outcomes.
NEUROCRITICAL CARE
(2021)
Article
Behavioral Sciences
Matthew R. Woodward, Seshagiri Doddi, Christopher Marano, William Regenold, Jennifer Pritchard, Stephanie Chen, Megan Margiotta, Wan-Tsu W. Chang, Ayham Alkhachroum, Nicholas A. Morris
Summary: This study retrospectively analyzed a group of SRSE patients treated with ECT and evaluated the changes in cEEG. The results showed that ECT treatment resulted in the resolution of SRSE and improved cEEG patterns. This study provides new insights and evidence for the treatment of SRSE.
EPILEPSY & BEHAVIOR
(2023)
Article
Clinical Neurology
Theodore Sheehan, Marta Amengual-Gual, Alejandra Vasquez, Nicholas S. Abend, Anne Anderson, Brian Appavu, Ravindra Arya, Cristina Barcia Aguilar, J. Nicholas Brenton, Jessica L. Carpenter, Kevin E. Chapman, Justice Clark, Raquel Farias-Moeller, William D. Gaillard, Marina Gainza-Lein, Tracy A. Glauser, Joshua L. Goldstein, Howard P. Goodkin, Rejean M. Guerriero, Linda Huh, Michele Jackson, Kush Kapur, Robert Kahoud, Yi-Chen Lai, Tiffani L. McDonough, Mohamad A. Mikati, Lindsey A. Morgan, Edward J. Novotny, Adam P. Ostendorf, Eric T. Payne, Katrina Peariso, Juan Piantino, Latania Reece, James J. Riviello, Tristan T. Sands, Kumar Sannagowdara, Renee Shellhaas, Garnett Smith, Robert C. Tasker, Dmitry Tchapyjnikov, Alexis A. Topjian, Mark S. Wainwright, Angus Wilfong, Korwyn Williams, Bo Zhang, Tobias Loddenkemper
Summary: This study evaluated benzodiazepine administration patterns in pediatric patients with refractory convulsive status epilepticus before transitioning to non-Benzodiazepine antiseizure medication (ASM). Findings include over one-third of patients receiving more than two benzodiazepines before transitioning, and delays in treatment initiation reducing the likelihood of multiple benzodiazepine doses. Patients with out-of-hospital seizure onset were more likely to receive additional benzodiazepines beyond 30 and 45 minutes, and intermittent SE was a risk factor for more benzodiazepines administered beyond 45 minutes.
Article
Clinical Neurology
Francesco Brigo, Gianni Turcato, Simona Lattanzi, Niccoloo Orlandi, Giulia Turchi, Arian Zaboli, Giada Giovannini, Stefano Meletti
Summary: This study aimed to identify predictors of progression to super-refractory status epilepticus (SRSE) and the risk of 30-day mortality in patients with SRSE using a machine learning technique. The study found that acute symptomatic hypoxic etiology and younger age were major predictors of progression to SRSE, while older age was associated with an increased risk of short-term mortality in patients with SRSE.
JOURNAL OF THE NEUROLOGICAL SCIENCES
(2022)
Review
Neurosciences
Laveena Singla, Manan Shah, Debra Moore-Hill, Peter Rosenquist, Klepper Alfredo Garcia
Summary: This study reports the first case of successful treatment of super refractory status epilepticus (SRSE) in pregnancy using electroconvulsive therapy (ECT). While most antiepileptic drugs (AEDs) pose risks during pregnancy, ECT could be a potential therapy for treating status epilepticus in pregnant individuals.
INTERNATIONAL JOURNAL OF NEUROSCIENCE
(2023)
Article
Clinical Neurology
A. Strzelczyk, L. Lagae, G. Kurlemann, S. Flege, T. Bast, T. Polster, M. Pringsheim, S. von Spiczak, P. Hipp, S. Schubert-Bast
Summary: Dravet syndrome (DS) is a rare and treatment-resistant epilepsy syndrome with high morbidity and mortality. The study aimed to identify factors impacting disease burden on patients and caregivers. Despite individualized combination therapies, most patients with DS are not seizure-free, and the quality of life for patients and their families is lower than the general population. New treatment and care concepts are needed to improve the care of patients with DS and alleviate the burden on caregivers.
ZEITSCHRIFT FUR EPILEPTOLOGIE
(2022)
Article
Clinical Neurology
Adam Strzelczyk, Susanne Schubert-Bast
Summary: Dravet syndrome is a severe developmental and epileptic encephalopathy that is difficult to treat. Three adjunct medications have been approved for the treatment of seizures in patients with Dravet syndrome. The choice of medication depends on various factors, including availability, patient characteristics, and caregiver preferences. It is important to consider the potential interactions and side effects of different medications.
Article
Clinical Neurology
Laurent M. Willems, Maja Hochbaum, Katharina Frey, Juliane Schulz, Katja Menzler, Lisa Langenbruch, Stjepana Kovac, Ilka Immisch, Felix Podewils, Mario Hamacher, Kai Siebenbrodt, Felix Rosenow, Jens-Peter Reese, Adam Strzelczyk
Summary: This study quantified the costs of illness (COI) related to epilepsy in Germany among adults and identified factors driving these costs. It found high economic impacts associated with disease severity, disability, and disease-related loss of productivity among adult patients with epilepsy. The identified cost drivers can be used for future cost-containment strategies.
Article
Clinical Neurology
Joseph Sullivan, Nicola Specchio, Orrin Devinsky, Stephane Auvin, M. Scott Perry, Adam Strzelczyk, Antonio Gil-Nagel, David Dai, Bradley S. Galer, Arnold R. Gammaitoni
Summary: The study demonstrates that adjunctive use of fenfluramine can significantly reduce day-to-day seizure burden in patients with DS, providing prolonged periods of convulsive seizure-free days, which may help reduce the physical and emotional disease toll while improving health-related quality of life for patients and caregivers.
Article
Behavioral Sciences
Laurent M. Willems, Susanne Knake, Felix Rosenow, Jens-Peter Reese, Nadine Conradi, Adam Strzelczyk
Summary: This study aimed to compare the reliability of the commonly used HRQOL screening questionnaire EQ-5D-3L with QOLIE-31. The findings showed that EQ-5D-3L index values are not suitable for severely affected patients with epilepsy, and QOLIE-31 remains the gold standard for HRQOL assessment in epilepsy patients.
EPILEPSY & BEHAVIOR
(2022)
Article
Behavioral Sciences
Susanne Schubert-Bast, Lara Kay, Andreas Simon, Geoffrey Wyatt, Rowena Holland, Felix Rosenow, Adam Strzelczyk
Summary: This study identified a small number of patients with probable Dravet syndrome (DS) in Germany, but they were associated with significant healthcare costs. The majority of healthcare expenses were attributed to inpatient care, medication, and services and devices. Medication use and healthcare costs were significantly correlated in patients with probable DS.
EPILEPSY & BEHAVIOR
(2022)
Article
Clinical Neurology
Johann Philipp Zoellner, Jennifer Wichert, Susanne Schubert-Bast, Elke Hattingen, Felix Rosenow, Adam Strzelczyk
Summary: The study aimed to investigate the conflicting pathophysiological hypotheses of reversible splenial lesion syndrome (RESLES) by comparing local glucose uptake in patients with RESLES and patients without RESLES. The results showed no significant difference in local glucose metabolism between the two groups, supporting the hypothesis that RESLES is an intercellular, intramyelinic edema rather than a typical intracellular cytotoxic edema.
EUROPEAN JOURNAL OF NEUROLOGY
(2022)
Article
Clinical Neurology
Konstantin Kohlhase, Lisa Marie Tako, Johann Philipp Zoellner, Rejane Golbach, Waltraud Pfeilschifter, Helmuth Steinmetz, Felix Rosenow, Adam Strzelczyk
Summary: This retrospective analysis of patients with acute ischaemic stroke caused by large vessel occlusion found no association between mechanical thrombectomy or systemic thrombolysis and an increased risk of acute symptomatic seizures.
JOURNAL OF NEUROLOGY
(2022)
Article
Immunology
Hans Urban, Eike Steidl, Elke Hattingen, Katharina Filipski, Markus Meissner, Martin Sebastian, Agnes Koch, Adam Strzelczyk, Marie-Therese Forster, Peter Baumgarten, Michael W. Ronellenfitsch, Joachim P. Steinbach, Martin Voss
Summary: The use of ICIs in metastatic cancer patients has shown significant survival benefits, but it can also lead to neurological immune related adverse events. In this retrospective analysis, we found that cerebral pseudoprogression occurred in 3.2% of patients receiving ICI treatment, highlighting the importance of vigilance in diagnosis and treatment.
FRONTIERS IN IMMUNOLOGY
(2022)
Article
Clinical Neurology
Martin A. Schaller-Paule, Christian Foerch, Ferdinand O. Bohmann, Sriramya Lapa, Bjoern Misselwitz, Konstantin Kohlhase, Felix Rosenow, Adam Strzelczyk, Laurent M. Willems
Summary: This study aimed to assess predictive factors for poststroke pneumonia (PSP) in patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO), with a focus on the impact of intravenous thrombolysis (IVT) and endovascular treatment (EVT) on the risk of PSP. The study found that EVT and combined EVT plus IVT were significant independent risk factors for PSP, while male sex, age >= 65 years, dysphagia, impaired consciousness at arrival, diabetes, and atrial fibrillation were also significantly associated risk factors.
FRONTIERS IN NEUROLOGY
(2022)
Article
Clinical Neurology
Claire Taylor, Catrin Tudur-Smith, Pete Dixon, Christine Linehan, Aleksei Gunko, Jakob Christensen, Mike Pearson, Torbjorn Tomson, Anthony Marson
Summary: This study conducted an audit of care provided to seizure patients in emergency departments across Europe and found significant variability in various aspects of care. The study recommends the development of guidelines for the management and referral of seizure patients in emergency departments, the establishment of a simple and easily implementable referral process, ensuring timely access to seizure services, and the implementation of a monitoring system for key indices of epilepsy care.
EUROPEAN JOURNAL OF NEUROLOGY
(2022)
Article
Clinical Neurology
Susanne Schubert-Bast, Clara Lenders, Matthias Kieslich, Felix Rosenow, Adam Strzelczyk
Summary: This study aims to provide data on inpatient costs and cost-driving factors in children and adolescents with status epilepticus. The results show that the treatment of status epilepticus is associated with high hospital costs and prolonged duration. Patients with disabilities are at higher risk for an unfavorable course of status epilepticus.
SEIZURE-EUROPEAN JOURNAL OF EPILEPSY
(2022)
Article
Clinical Neurology
Lars Egil Roberg, Olav Monsson, Simon Bang Kristensen, Svein Magne Dahl, Line Bedos Ulvin, Kjell Heuser, Erik Tauboll, Adam Strzelczyk, Susanne Knake, Lydia Bechert, Felix Rosenow, Dagmar Beier, Sandor Beniczky, Thomas Kroigard, Christoph Patrick Beier
Summary: The study aimed to improve the prediction of long-term mortality after status epilepticus diagnosis. The findings showed that age, long duration, and nonconvulsive type of status epilepticus in coma were associated with the development of new neurological deficits, which could predict long-term mortality. Accounting for risk factors for new neurological deficits using the ACD score is a reliable method of predicting long-term outcome in patients with status epilepticus causes that were not damaging or were less damaging to the brain.
Article
Clinical Neurology
Lisa Marie Tako, Adam Strzelczyk, Felix Rosenow, Waltraud Pfeilschifter, Helmuth Steinmetz, Rejane Golbach, Jan Hendrik Schaefer, Johann Philipp Zoellner, Konstantin Kohlhase
Summary: The study aimed to analyze predictors of acute symptomatic seizures (ASz) in patients with ischemic stroke caused by large arterial vessel occlusion (LVO). The research found that the National Institutes of Health Stroke Scale (NIHSS) score 24 hours after admission was the strongest predictor of ASz. Within the first 24 hours after stroke, patients were more likely to experience generalized tonic-clonic seizures, whereas seizures with impaired awareness and non-convulsive status epilepticus were more frequent beyond 24 hours.
FRONTIERS IN NEUROLOGY
(2022)
Article
Clinical Neurology
Catrin Mann, Edna Zinger, Bettina Schmitz, Theodor May, Felix Rosenow, Margarete Pfaefflin, Juliane Schulz, Katja Menzler, Lisa Langenbruch, Laura Bierhansl, Susanne Knake, Mario Hamacher, Annika Suess, Felix von Podewils, Susanne Schubert-Bast, Adam Strzelczyk
Summary: This study investigated the knowledge among women with epilepsy (WWE) regarding their condition and whether epilepsy-specific knowledge has improved over the last 15 years. The results showed that there are still considerable knowledge deficits among WWE, particularly among those with less education and older patients. The knowledge regarding the more pronounced effects of epilepsy in older WWE, including interactions with menopause and osteoporosis, is still limited.
SEIZURE-EUROPEAN JOURNAL OF EPILEPSY
(2022)
