Status Epilepticus after Electroconvulsive Therapy

1989 ◽  
Vol 155 (1) ◽  
pp. 119-121 ◽  
Author(s):  
Allan I. F. Scott ◽  
William Riddle
Keyword(s):  
Status Epilepticus ◽  
Electroconvulsive Therapy ◽  
Rare Complication ◽  
Eeg Monitoring ◽  
Prolonged Seizure ◽  
Intravenous Diazepam ◽  
The Status ◽  
Motor Movements

Status epilepticus is a rare complication of ECT. We describe a patient who suffered a prolonged seizure which required termination with intravenous diazepam. The status epilepticus was not accompanied by motor movements, and the diagnosis was made only because of simultaneous EEG monitoring. The incidence of status epilepticus after ECT may be underestimated.

Loss of Limb Following Intravenous Diazepam

PEDIATRICS ◽  
1974 ◽  
Vol 53 (1) ◽  
pp. 112-114
Author(s):  
Sanford Schneider ◽  
John W. Mace
Keyword(s):  
Cardiac Arrest ◽  
Status Epilepticus ◽  
Side Effects ◽  
Venous Thrombosis ◽  
Intravenous Administration ◽  
Seizure Activity ◽  
Significant Morbidity ◽  
Prolonged Seizure ◽  
Intravenous Diazepam

Since its introduction for the control of status epilepticus in 1965, parenterally administered diazepam has proven to be extremely effective in halting prolonged seizure activity. Reported side effects have been minimal and usually not associated with significant morbidity. However, apnea, bradycardia, hypotension, cardiac arrest, and conversion of atypical spike and wave status epilepticus to graudmal status have been reported. Additionally, thrombophlebitis following intravenous administration has been associated with diazepam. Langdon et al. recently stated that 3.5% of patients receiving diazepam intravenously Prior to esophagogastroscopy developed thrombophlebitis. In several patients venous thrombosis was marked and tender cords were palpable many months after injection.

Nonconvulsive Generalised Status Epilepticus Following Electroconvulsive Therapy

2000 ◽  
Vol 34 (2) ◽  
pp. 334-336 ◽  
Author(s):  
Alexander Srzich ◽  
John Turbott
Keyword(s):  
Differential Diagnosis ◽  
Status Epilepticus ◽  
Electroconvulsive Therapy ◽  
Mental State ◽  
Clinical Picture ◽  
Major Depressive Episode ◽  
Major Depressive ◽  
Intravenous Diazepam ◽  
Confusional States ◽  
Electroencephalogram Eeg

Objective: To describe a case of nonconvulsive generalised status epilepticus (NGS) following electroconvulsive therapy (ECT). Clinical picture: A 40-year-old woman suffering from a major depressive episode was treated with ECT following treatment with clonazepam, haloperidol and paroxetine. After her fifth treatment she became acutely confused. An electroencephalogram (EEG) at the time was consistent with NGS. Treatment and outcome: Initially intravenous diazepam and phenytoin were administered with an improvement in both her mental state and EEG. An oral anti-convulsant was continued. Conclusions: NGS is a rare though treatable cause of confusional states following ECT and should be considered in the differential diagnosis.

scholarly journals Monitoring electroconvulsive therapy by electroencephalogram: an update for ECT practitioners

2007 ◽  
Vol 13 (4) ◽  
pp. 298-304 ◽  
Author(s):  
Allan I. F. Scott
Keyword(s):  
Electroconvulsive Therapy ◽  
Seizure Activity ◽  
Eeg Monitoring ◽  
The Real ◽  
End Point ◽  
The Status ◽  
Published Research ◽  
Electroencephalogram Eeg

The purpose of this article is to update practitioners on the latest published research into the prevalence of prolonged cerebral seizure activity following electroconvulsive therapy (ECT). This research is drawing attention to the real practical challenges of recording and reading an electroencephalogram (EEG) tracing in the ECT clinic. In particular, determination of the seizure end-point is not always practicable and this poses a major problem in the detection and management of prolonged cerebral seizure activity. Some practical tips are suggested, and an update is given on the status of EEG monitoring in the assessment of seizure adequacy.

scholarly journals Status epilepticus from GABABR antibody positive encephalitis due to de novo mixed small cell and adenocarcinoma of the prostate

2020 ◽  
Vol 13 (11) ◽  
pp. e238172 ◽  
Author(s):  
Christopher Kwan ◽  
Aaron Sia ◽  
Cullen O'Gorman
Keyword(s):  
Status Epilepticus ◽  
De Novo ◽  
Locally Advanced ◽  
Small Cell ◽  
Gamma Aminobutyric Acid ◽  
Transrectal Biopsy ◽  
The Status ◽  
Adenocarcinoma Of The Prostate ◽  
Receptor Antibodies

We present a case study of a 67-year-old man who presented with a new onset of recurrent tonic-clonic seizures. He had tested positive to gamma-aminobutyric acid B receptor antibodies in his blood and cerebrospinal fluid, and subsequent CT imaging and transrectal biopsy confirmed the presence of a locally advanced mixed small cell and Gleason 9 adenocarcinoma of the prostate. His seizures remained resistant to treatment with multiple antiepileptic drugs, including sodium valproate, clobazam, topiramate, carbamazepine, phenytoin and lacosamide. He progressed to status epilepticus, which required intravenous immunoglobulin and steroids, followed by plasma exchange 1 week later. The status epilepticus was refractory and required multiple admissions to the intensive care unit.

Low Morbidity and Mortality of Status Epilepticus in Children

PEDIATRICS ◽  
1989 ◽  
Vol 83 (3) ◽  
pp. 323-331
Author(s):  
Joseph Maytal ◽  
Shlomo Shinnar ◽  
Solomon L. Moshé ◽  
Luis A. Alvarez
Keyword(s):  
Status Epilepticus ◽  
Age Groups ◽  
Neurologic Disease ◽  
Neurologic Disorder ◽  
Patients Âgés ◽  
Symptomatic Group ◽  
Younger Age ◽  
The Status ◽  
Neurologic Sequelae ◽  
History Of

In an ongoing study of status epilepticus, 193 children with status epilepticus of varying causes have been followed up for a mean period of 13.2 months. Of these, 97 patients were recruited prospectively. The patients' ages ranged from 1 month to 18 years (mean, 5.0 years). The cause of the status epilepticus was classified as idiopathic in 46 cases, remote symptomatic in 45, febrile in 46, acute symptomatic in 45, and progressive neurologic in 11. The mortality and incidence of sequelae following status epilepticus was low and primarily a function of etiology. Seven children died within 3 months of having the seizure. New neurologic deficits were found in 17 (9.1%) of the 186 survivors. All of the deaths and 15 of the 17 sequelae occurred in the 56 children with acute or progressive neurologic insults. Only two of the 137 children with other causes sustained any new deficits (P < .001). Duration of the status epilepticus affected outcome only within the acute symptomatic group (P < .05). Neurologic sequelae occurred in 29% of infants younger than 1 year of age, 11% of children 1 to 3 years of age, and 6% of children older than 3 years of age. However, this was a reflection of the greater incidence of acute neurologic disease in the younger age groups. Within each cause, age did not affect outcome. Of the 193 children, 61 (32%) had a history of prior unprovoked seizures. Of the 125 surviving children with no history of prior unprovoked seizures, 37 (30%) had subsequent unprovoked seizures. It is concluded that the morbidity of aggressively treated status epilepticus in children, in the absence of an acute neurologic insult or progressive neurologic disorder, is low.

Noncompliance Contributing to Apparent Drug Failure in Status Epilepticus

PEDIATRICS ◽  
1974 ◽  
Vol 53 (6) ◽  
pp. 938-940
Author(s):  
John T. Wilson
Keyword(s):  
Status Epilepticus ◽  
Plasma Levels ◽  
Seizure Activity ◽  
Drug Level ◽  
Continuous Control ◽  
Drug Plasma ◽  
Intravenous Diazepam ◽  
Grand Mal ◽  
History Of ◽  
Drug Plasma Levels

The case to be described illustrates apparent drug failure because of noncompliance in the drug delivery system, and the sequelae of this mishap. In connection with investigation of this case further occurrences of noncompliance were found. This incident also brings into focus the importance of plasma drug level determinations for effective application of therapy. CASE REPORT A 7-year-old, 26-kg, black girl was admitted with a 16-month history of nonprogressive neurologic disease accompanied by clinical and EEG evidence of petit mal and grand mal epilepsy which responded to diphenylhydantoin (DPH), phenobarbital or ethosuximide (Zarontin) treatment. Generalized convulsions had been infrequent for four months, but, before the present admission, a marked increase in grand mal seizures was noted. On the day of admission (day 1), recurrent generalized seizure activity progressed to status epilepticus within six hours. Intravenous diazepam (Valium [0.18/mg/kg]) controlled the seizures. Primidone (Mysoline), 250 mg tid, and ethosuximide, 500 mg tid were prescribed as maintenance anticonvulsants in an attempt to allay further progression to status epilepticus. For the next several days her seizures could be controlled only with paraldehyde (0.36 mg/kg intravenously), although administration of other drugs was continued. Assays of drug plasma levels did not become available until day 6. They disclosed that plasma levels of diazepam and demethyldiazepam were high (289 and 50 ng/ml, respectively) one hour after dosing with 0.18 mg/kg. This indicated that diazepam was not effective for continuous control of seizures, but this information was not acted upon immediately. The most striking finding was that primidone was not detected in plasma, although the prescibed dosage was 250 mg tid.

Is Electroencephalographic Monitoring of Electroconvulsive Therapy Clinically Useful?

1989 ◽  
Vol 154 (2) ◽  
pp. 229-231 ◽  
Author(s):  
R. G. McCreadie ◽  
K. Phillips ◽  
A. D. T. Robinson ◽  
G. Gilhooly ◽  
W. Crombie
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Clinical Efficacy ◽  
Electroconvulsive Therapy ◽  
National Health ◽  
Medical Staff ◽  
Eeg Monitoring ◽  
Future Work

Electroencephalographic (EEG) monitoring was carried out in 169 bilateral and 114 unilateral applications of electroconvulsive therapy (ECT), given to 51 patients in an everyday setting within the National Health Service by junior medical staff. In 2.5% of bilateral and 8% of unilateral applications there was disagreement between clinical and EEG assessment as to whether a fit had occurred. When an EEG fit was said to have occurred only if it lasted longer than 25 seconds, then disagreement rose to 7% in bilateral and 28% in unilateral applications; disagreement was higher with unilateral applications, as they produced more short fits than bilateral applications. If future work shows duration of seizure is clearly associated with clinical efficacy, it is suggested the case for routine EEG monitoring is greatly strengthened.

Time to Detection of the First Seizure in Patients With Nonconvulsive Status Epilepticus in the Neurological Intensive Care Unit

2019 ◽  
Vol 51 (1) ◽  
pp. 70-73
Author(s):  
Nese Dericioglu ◽  
Ethem Murat Arsava ◽  
Mehmet Akif Topcuoglu
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Status Epilepticus ◽  
Eeg Monitoring ◽  
Neurological Intensive Care Unit ◽  
Neurological Intensive Care ◽  
Eeg Recordings ◽  
Gcs Score ◽  
Early Seizure ◽  
Video Eeg

Video-EEG monitoring is often used to detect nonconvulsive status epilepticus (NCSE) in critical care patients. Short recording durations may fail to detect seizures. In this study, we investigated the time required to record the first ictal event, and whether it could be correlated with some clinical or EEG parameters. Video-EEG recordings of patients who were followed up in our neurological intensive care unit were evaluated retrospectively. The EEG recordings of patients with NCSE were reviewed to determine the timing of the first seizure occurrence. Demographic data and EEG findings were obtained from patient charts and EEG reports. Possible correlations between the presence of periodic discharges (PD), Glasgow Coma Scale (GCS) score and early seizure detection (defined as a seizure within the first hour of recording) were explored statistically. Out of 200 patients who underwent video-EEG monitoring, we identified 30 cases (15%; 18 male, 12 female; age 24-86 years; mean recording duration 99 hours) with NCSE. The first seizure was recorded within 0 to 1 hour in 22 patients (73%) and within 1 to 12 hours in 6 patients (22%). Interictal PDs were identified in 19 patients (63%). GCS score was ≤8 in 16 patients (53%). There was no correlation between early seizure detection and PDs (p=1.0) or GCS score ( P = .22). In our study, >90% of the seizures were captured within 12 hours. This finding suggests that most of the NCSE cases can be identified even in centers with limited resources. The presence or absence of PDs or GCS score does not predict the timing of the first seizure.

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