Seizure : the journal of the British Epilepsy Association
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Seizures are a common reason for visiting the Emergency Department (ED). There is a growing body of literature highlighting disparities in seizure care related to race and ethnicity. Our goal was to identify racial and clinical characteristics of patients presenting to the ED with seizures and to determine factors associated with repeat ED visits for seizure. ⋯ Clinical factors differed between black and white patients presenting to the ED for seizure care. Black patients were more likely to have multiple seizure visits to the ED when compared to white patients. This may suggest a disparity in access to care related to race between these two groups.
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Recent reports have documented the appearance of Brugada-type ST elevation in cases of overdose of antiepileptic drugs (AEDs). However, little is known about changes on electrocardiographs (ECGs) during AED use at therapeutic doses. AEDs may cause Brugada-type ST elevation or J-wave-like intraventricular conduction delays through an ion channel-blocking effect. In the present study, we sought to elucidate ECG abnormalities in patients on AED therapy. ⋯ ST-T abnormalities were frequently seen in patients using AEDs. The presence of Brugada-type ST elevation was associated with polytherapy with sodium channel-blocking AEDs.
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Clinical Trial Observational Study
Intravenous lacosamide in clinical practice-Results from an independent registry.
This non-interventional study was conducted to evaluate the efficacy and tolerability of intravenous lacosamide (LCM-iv) under routine conditions in daily clinical practice as a prospective registry. ⋯ This large and independent multicenter registry on the use of LCM-iv in clinical practice demonstrates that LCM-iv is well-tolerated and highly efficacious when given in emergency situations, including patients experiencing SE. It is advisable to perform an electrocardiogram prior to LCM-iv administration.
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An acute symptomatic seizure is a clinical seizure occurring at the time of or in close temporal association with a brain insult. We report an acute symptomatic seizure occurring during a surgical procedure in a patient who did not have a prior history of epilepsy and who did not have a lesion associated with an increased risk of epilepsy. To characterize the incidence and clinical features of intraoperative seizures during craniotomy under general anesthesia, we reviewed cases where continuous EEG was acquired during craniotomy. ⋯ This is the first report of an acute symptomatic seizure secondary to a neurosurgical procedure. Overall, 0.5% of patients monitored experienced seizures, indicating that intraoperative seizures are rare, and EEG monitoring during craniotomies is of low yield in detecting seizures.
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The aim of this study was to assess factors associated with the use of topiramate (TPM) in refractory status epilepticus (RSE). ⋯ After multivariate adjustment, no significant differences were observed between episodes treated with and without TPM in baseline characteristics, treatment, and outcome. Regarding the latter, this study does therefore not yield evidence for a particular efficacy of TPM in RSE.