Article
Clinical Neurology
Marina Gainza-Lein, Cristina Barcia Aguilar, Juan Piantino, Kevin E. Chapman, Ivan Sanchez Fernandez, Marta Amengual-Gual, Anne Anderson, Brian Appavu, Ravindra Arya, James Nicholas Brenton, Jessica L. Carpenter, Justice Clark, Raquel Farias-Moeller, William D. Gaillard, Tracy A. Glauser, Joshua L. Goldstein, Howard P. Goodkin, Linda Huh, Robert Kahoud, Kush Kapur, Yi-Chen Lai, Tiffani L. McDonough, Mohamad A. Mikati, Lindsey A. Morgan, Anuranjita Nayak, Edward Novotny, Adam P. Ostendorf, Eric T. Payne, Katrina Peariso, Latania Reece, James Riviello, Kumar Sannagowdara, Tristan T. Sands, Theodore Sheehan, Robert C. Tasker, Dmitry Tchapyjnikov, Alejandra Vasquez, Mark S. Wainwright, Angus Wilfong, Korwyn Williams, Bo Zhang, Tobias Loddenkemper
Summary: This study aimed to describe long-term clinical and developmental outcomes in pediatric refractory status epilepticus (RSE) and identify factors related to new neurological deficits after RSE. The results showed that about one third of patients without prior epilepsy developed recurrent unprovoked seizures after the RSE episode, while in previously normally developing patients, 39% presented with new deficits during follow-up, with longer electroclinical RSE duration as a predictor.
Article
Anesthesiology
Jennifer J. Lee, Giselle D. Jaconia, Lena S. Sun, Katherine Biagas, Maryam Y. Naim, Sue R. Beers, C. David Mintz, Heidi A. B. Smith
Summary: The design and conduct of pediatric sedation studies in critically ill patients have been historically challenging due to the complexity of the pediatric intensive care unit environment and the difficulty of establishing equipoise. Clinical trials are important in advancing knowledge in this field, but there is a lack of such studies in the literature. Considering ground-level factors and system limitations is crucial for successful trial planning and execution.
JOURNAL OF NEUROSURGICAL ANESTHESIOLOGY
(2023)
Article
Clinical Neurology
Laura MacDarby, Martina Healy, Gerard Curley, John C. McHugh
Summary: Evidence suggests that EEG plays an important role in diagnosing patients in the pediatric intensive care unit, even in the absence of 24/7 access. Seizures are relatively common in patients, with a high percentage being subclinical, and adverse EEG findings are associated with poor clinical outcomes. High utilization of antiepileptic drugs was observed regardless of EEG seizure detection status.
JOURNAL OF CLINICAL NEUROPHYSIOLOGY
(2021)
Article
Emergency Medicine
Dilek Cavusoglu, Elif Esra Sinmaz, Nihal Olgac Dundar, Fulya Kamit Can, Ayse Berna Anil, Berrak Sarioglu
Summary: Phenytoin remains one of the most effective antiepileptic drugs, and prompt treatment to shorten the duration of status epilepticus may prevent neurological complications.
PEDIATRIC EMERGENCY CARE
(2021)
Article
Clinical Neurology
Olav S. Monsson, Lars E. Roberg, Joanna Gesche, Christoph P. Beier, Thomas Kroigard
Summary: The study aimed to compare long-term survival and short-term neurological deficits in adult patients with non-convulsive status epilepticus (NCSE) based on different diagnostic criteria. The results showed that the fast diagnostic criterion was significantly associated with decreased mortality 2 years following NCSE, but did not affect functional outcome.
SEIZURE-EUROPEAN JOURNAL OF EPILEPSY
(2022)
Article
Clinical Neurology
Tian Sang, Ying Wang, Ye Wu, Qiao Guan, ZhiXian Yang
Summary: This study investigated the neonatal electroencephalography background activity and electrographic seizures in patients in the pediatric intensive care unit. It found that more than one-third of patients experienced electrographic seizures, and abnormal EEG background activity was associated with unfavorable in-hospital outcomes.
FRONTIERS IN NEUROLOGY
(2022)
Article
Critical Care Medicine
Samuel Snider, Michael W. K. M. Fong, Neal Nolan, Andres Rodriguez Ruiz, Wei Wang, Suzette LaRoche, Lawrence Hirsch, Jong Lee
Summary: This study aimed to identify clinical diagnoses and rhythmic and periodic electroencephalogram patterns (RPPs) associated with status epilepticus (SE) and seizures. Factors independently associated with SE included cardiac arrest, clinical seizures before continuous electroencephalogram (cEEG), brain neoplasms, and specific EEG patterns. These findings are important for tailoring cEEG monitoring for critically ill patients.
CRITICAL CARE MEDICINE
(2023)
Article
Clinical Neurology
Markus Breu, Chiara Hafele, Sarah Glatter, Petra Trimmel-Schwahofer, Johann Golej, Christoph Male, Martha Feucht, Anastasia Dressler
Summary: This study aimed to evaluate the use of the ketogenic diet for treating super-refractory status epilepticus in pediatric patients and found a 50% initial response rate to KD treatment in patients with severe etiologies such as Alpers syndrome. The ketogenic diet was initiated early in the course of SRSE, and sufficient levels of ketosis were achieved early in most patients, particularly with combined enteral and parenteral feedings.
FRONTIERS IN NEUROLOGY
(2021)
Article
Pediatrics
Eleonore S. V. de Sonnaville, Marsh K. Konigs, Cornelieke S. H. Aarnoudse-Moens, Job B. M. van Woensel, Jaap Oosterlaan, Hennie Knoester
Summary: This study aimed to investigate the long-term impact of pediatric intensive care unit (PICU) admission on daily life functioning and the potential mediating role of neurocognitive outcome. The study compared children aged 6-12 years with previous PICU admission for bronchiolitis requiring mechanical ventilation to healthy peers. The results showed that children admitted to the PICU had poorer academic performance and school-related quality of life compared to the control group. Lower intelligence was found to contribute to academic difficulties after PICU admission. The findings highlight the importance of monitoring daily life and neurocognitive functioning after PICU admission.
JOURNAL OF PEDIATRICS
(2023)
Article
Clinical Neurology
Marc Rodrigo-Gisbert, Laura Gomez-Dabo, Manuel Quintana, Daniel Campos-Fernandez, Sofia Lallana, Elena Fonseca, Laura Abraira, Manuel Toledo, Estevo Santamarina
Summary: This study aimed to evaluate the risk of long-term seizure recurrence after status epilepticus (SE) and the potential risk factors associated with it. The results showed that progressive symptomatic etiology, delay in treatment initiation, and superrefractory SE were associated with a higher risk of seizure recurrence. On the other hand, older patients and acute symptomatic etiology had a lower risk of seizure recurrence.
Article
Clinical Neurology
Salman Rashid, Monisha Goyal, Kathryn Lalor, Khaled Al-Robaidi, Vivek Shukla, Fazlur Rahman, Manimaran Ramani
Summary: This study investigated the seizure risk in asymptomatic preterm infants with high-grade intraventricular hemorrhage who underwent long-term video electroencephalographic monitoring. The findings showed that approximately 16% of these infants had seizures, and those with seizures were younger and more likely to be remonitored.
PEDIATRIC NEUROLOGY
(2024)
Article
Clinical Neurology
Sofie Drevsholt Jorgensen, Preben Kidmose, Kaare Mikkelsen, Maxine Blech, Martin Christian Hemmsen, Mike Lind Rank, Troels Wesenberg Kjaer
Summary: The interest in using sleep as a clinical biomarker is increasing, but the standard method of sleep assessment is costly and time-consuming. A reliable wearable device is needed to make sleep analysis more accessible. In this case study, the ear-electroencephalography platform was tested and found to be reliable and unobtrusive for long-term sleep recording. Measurements of non-rapid eye movement sleep duration and transition probability between sleep stages showed promise in quantifying differences in sleep architecture between shifting sleep conditions. This study highlights the potential of the ear-electroencephalography platform for clinical adaptation.
JOURNAL OF SLEEP RESEARCH
(2023)
Article
Pediatrics
Dilek Cavusoglu, Nihal Olgac Dundar, Fulya Kamit, Ayse Berna Anil, Pinar Arican, Neslihan Zengin, Pinar Gencpinar
Summary: This prospective cohort study aimed to identify nonconvulsive seizures (NCS) and nonconvulsive status epilepticus (NCSE) in a pediatric intensive care unit (PICU). The findings revealed that among the 35 patients who underwent continuous electroencephalographic monitoring, one case had NCSE and four cases had NCS. The etiology of NCSE was associated with antiepileptic drug withdrawal, while the etiology of NCS included electrical injury, head trauma, subarachnoid hemorrhage, and pneumonia. The study also suggested that younger age, epilepsy, acute structural brain abnormalities, abrupt cessation of antiepileptic drugs, and clinically overt seizures before NCSE/NCS are associated with a significant risk for NCS/NCSE. The occurrence of electrographic seizure in cases of electrical injury is a potential risk factor, although no such case has been reported yet.
CLINICAL PEDIATRICS
(2023)
Article
Emergency Medicine
Ekin Soydan, Yigithan Guzin, Sevgi Topal, Gulhan Atakul, Mustafa Colak, Pinar Seven, Ozlem Sarac Sandal, Gokhan Ceylan, Aycan Unalp, Hasan Agin
Summary: This study retrospectively investigated the clinical features and treatment of seizures in children admitted to the pediatric intensive care unit (PICU) with status epilepticus (SE). It was found that continuous electroencephalographic monitoring is important for the recognition and intervention of seizures. However, no superiority of second-line or combined treatments was demonstrated in patients with SE.
PEDIATRIC EMERGENCY CARE
(2023)
Article
Clinical Neurology
Caroline Reindl, Dominik Madzar, Hajo M. Hamer
Summary: Status epilepticus refers to persistent or repetitive seizures that, if left untreated, can cause neuronal damage, neurological deficits, and death. Motor symptoms are usually indicative of status epilepticus, but nonconvulsive status epilepticus often goes unnoticed clinically and requires electroencephalography (EEG) recording for diagnosis. Treatment involves four steps, with intensive medical care necessary from the third step onwards for difficult-to-treat cases. Timely initiation of treatment and proper medication dosage are crucial for successful treatment. There is limited evidence for the later stages of treatment, and intensive medical measures carry the risk of complications that may worsen the prognosis. In nonconvulsive status epilepticus, the use of anesthetics must be carefully considered due to potential complications with mechanical ventilation.