Article
Clinical Neurology
Simona Lattanzi, Giada Giovannini, Niccolo Orlandi, Francesco Brigo, Eugen Trinka, Stefano Meletti
Summary: This study aimed to evaluate whether differences in clinical outcomes exist according to treatments received and seizure activity resolution in patients with refractory status epilepticus (RSE). The study found that different types of RSE are associated with higher mortality rates and functional deterioration at discharge.
JOURNAL OF NEUROLOGY
(2023)
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)
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
Medicine, General & Internal
Annacarmen Nilo, Giada Pauletto, Simone Lorenzut, Giovanni Merlino, Lorenzo Verriello, Francesco Janes, Francesco Bax, Gian Luigi Gigli, Mariarosaria Valente
Summary: This study retrospectively analyzed 40 stroke patients with PSSE, including 14 cases of early-onset SE and 26 cases of late-onset SE. Early-onset SE was associated with more severe stroke and worse prognosis compared to late-onset SE.
JOURNAL OF CLINICAL MEDICINE
(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
Yiwen Pan, Yu Feng, Weifeng Peng, Yang Cai, Jing Ding, Xin Wang
Summary: This study provides strong support for the new definition of status epilepticus (SE). Patients meeting t2 of SE tend to have a significantly higher risk of mortality and unfavorable functional outcomes compared to those who only reached t1 of SE. Furthermore, patients are more likely to experience seizure recurrence after undergoing an episode of SE.
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)
Article
Clinical Neurology
Fatemeh Mohammad Alizadeh Chafjiri, Latania Reece, Lillian Voke, Asaf Landschaft, Justice Clark, Amir A. Kimia, Tobias Loddenkemper
Summary: This study compared the identification of refractory status epilepticus (rSE) cases through human electronic health record (EHR) review and a natural language processing (NLP)-assisted rSE screen followed by manual review. The NLP-assisted model showed higher sensitivity compared to human review in identifying rSE cases through EHRs.
Article
Anesthesiology
Abhyuday Kumar, Amarjeet Kumar, Neeraj Kumar, Ajeet Kumar
Summary: This article presents a case of RSE caused by propofol, which was successfully managed during surgery with subsequent uneventful postoperative outcomes.
KOREAN JOURNAL OF ANESTHESIOLOGY
(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.
Article
Clinical Neurology
Isabelle Beuchat, Felix Rosenow, Christoph Kellinghaus, Eugen Trinka, Iris Unterberger, Stephan Rueegg, Raoul Sutter, Christian Tilz, Zeljko Uzelac, Andrea O. Rossetti, Adam Strzelczyk
Summary: This study retrospectively analyzed determinants of refractory status epilepticus (RSE) development and outcomes in a large multicenter cohort. The results showed that treatment deviation from guidelines and higher severity of status epilepticus were associated with RSE development, while lower severity, absence of acute etiology, adequate first-line benzodiazepine dose, shorter durations of status epilepticus and hospitalization, and lack of intubation were associated with better outcomes.
Article
Critical Care Medicine
Zachary S. Daniels, Nina Srdanovic, Karen Rychlik, Craig Smith, Joshua Goldstein, Alfred L. George
Summary: This study aimed to describe the prevalence of midazolam treatment failure in children with refractory status epilepticus (RSE) and define a threshold dose associated with diminishing frequency of seizure cessation. The results showed an association between the maximum midazolam dose and seizure cessation, with patients more likely to fail treatment when administered at higher doses.
PEDIATRIC CRITICAL CARE MEDICINE
(2022)
Article
Critical Care Medicine
Zachary S. Daniels, Nina Srdanovic, Karen Rychlik, Craig Smith, Joshua Goldstein, Alfred L. George
Summary: This study aimed to describe the prevalence of midazolam treatment failure in children with refractory status epilepticus (RSE) and determine a threshold dose associated with decreasing seizure cessation frequency. The results showed that patients were more likely to fail treatment when administered midazolam at higher doses, and treatment above 525μg/kg/hr was associated with diminishing frequency of seizure cessation.
PEDIATRIC CRITICAL CARE MEDICINE
(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)
Article
Neurosciences
Doodipala Samba Reddy, Marcus Zaayman, Ramkumar Kuruba, Xin Wu
Summary: Status epilepticus (SE) is a medical emergency characterized by continuous seizure activity that leads to severe neuronal damage, morbidity, or death. The induction of SE can be caused by various triggers, such as chemoconvulsants like pilocarpine and organophosphates like DFP and soman. These agents share a common feature of cholinergic crisis leading to refractory SE, but their comparative profiles are still unclear. Results from this study revealed distinct convulsant and neuronal injury patterns following exposure to cholinergic agonists, OP pesticides, and nerve agents, highlighting the importance of understanding different SE models for the development of new anticonvulsant therapies.
Editorial Material
Clinical Neurology
Wolfgang Muhlhofer, Brianna Paul, George Lin, Nilika Singhal
Editorial Material
Clinical Neurology
Yee-Leng Tan, Wolfgang Muhlhofer, Robert Knowlton
Review
Clinical Neurology
Wolfgang Muhlhofer, Yee-Leng Tan, Susanne G. Mueller, Robert Knowlton
Review
Clinical Neurology
Wolfgang Muhlhofer, Jerzy P. Szaflarski
CURRENT NEUROLOGY AND NEUROSCIENCE REPORTS
(2018)
Article
Biochemistry & Molecular Biology
Tamer Rabie, Wolfgang Muehlhofer, Thomas Bruckner, Anna Schwab, Alexander T. Bauer, Manfred Zimmermann, Dieter Bonke, Hugo H. Marti, Johannes Schenkel
JOURNAL OF MOLECULAR NEUROSCIENCE
(2010)
Article
Behavioral Sciences
Alexandra T. Issa Roach, Ganne Chaitanya, Kristen O. Riley, Wolfgang Muhlhofer, Sandipan Pati
EPILEPSY & BEHAVIOR
(2020)
Article
Clinical Neurology
Alexandra T. Issa Roach, Diana Pizarro, Hrishikesh D. Deshpande, Sandipan Pati, Jerzy P. Szaflarski, Kristen O. Riley, Wolfgang Muhlhofer, James T. Houston
EPILEPSY & BEHAVIOR CASE REPORTS
(2019)
Article
Clinical Neurology
Diana Pizarro, Emilia Toth, Auriana Irannejad, Kristen O. Riley, Zeenat Jaisani, Wolfgang Muhlhofer, Roy Martin, Sandipan Pati
EPILEPSY & BEHAVIOR CASE REPORTS
(2018)
Article
Anesthesiology
W. G. Muhlhofer, R. Zak, T. Kamal, B. Rizvi, L. P. Sands, M. Yuan, X. Zhang, J. M. Leung
BRITISH JOURNAL OF ANAESTHESIA
(2017)
Meeting Abstract
Clinical Neurology
Wolfgang Muhlhofer, Michael Manchak, Adam Kelly