Comparative analysis of patients with new onset refractory status epilepticus preceded by fever (febrile infection-related epilepsy syndrome) versus without prior fever: An interim analysis.

Febrile infection-related epilepsy syndrome (FIRES) is a subset of new onset refractory status epilepticus (NORSE) that involves a febrile infection prior to the onset of the refractory status epilepticus. It is unclear whether FIRES and non-FIRES NORSE are distinct conditions. Here, we compare 34 patients with FIRES to 30 patients with non-FIRES NORSE for demographics, clinical features, neuroimaging, and outcomes.

Characteristics and Attendance of Patients Eligible for the PASS Clinic: A Transition of Care Model After Acute Symptomatic Seizures.

Background And Objectives: Most acute symptomatic seizure (ASyS) patients stay on antiseizure medications (ASM) long-term, despite low epilepsy development risk. The Post-Acute Symptomatic Seizure (PASS) clinic is a transition of care model for ASyS patients who individualize ASM management with the goal of a safe deprescription. We evaluated patients discharged on ASMs after a witnessed or suspected ASyS to analyze their PASS clinic visit attendance and its predictors.

Outpatient EEG in Routine Clinical Care of Patients With Stroke-Related Acute Symptomatic Seizure Concerns.

Purpose: Acute symptomatic seizures (ASyS) after stroke contribute the highest risk to poststroke epilepsy (PSE) development. We investigated the use of outpatient EEG (oEEG) among stroke patients with ASyS concerns.

Methods: Adults with acute stroke, ASyS concerns (underwent cEEG), and outpatient clinical follow-up were included (study population).

Impact of acute symptomatic seizures and their management on patient-reported outcomes after stroke.

Objective: Acute symptomatic seizures (ASyS) after stroke are not uncommon. However, the impact of ASyS and its management with anti-seizure medications (ASMs) on patient-reported outcome measures (PROMs) remains poorly investigated. The objective of our study is to evaluate the association between PROMs and ASyS and ASMs following stroke.

Indications for continuous electroencephalographic (cEEG) monitoring: What do they tell us?

Objective: While studies have explored clinical and EEG predictors of seizures on continuous EEG (cEEG), the role of cEEG indications as predictors of seizures has not been studied. Our study aims to fill this knowledge gap.

Methods: We used the prospective cEEG database at Cleveland Clinic for the 2016 calendar year.

Acute Symptomatic Seizure Associated With Chronic Antiseizure Medication Use After Stroke.

Background And Objective: Patients with acute symptomatic seizures (ASyS) after stroke are discharged on antiseizure medications (ASMs) and stay on them for an extended period. We analyzed the current ASM management practice, 6 months, and at the last follow-up after stroke-related ASyS concerns to identify chronic and long-term ASM use predictors.

Methods: A single-center, retrospective cohort study of adults who underwent continuous EEG monitoring for ASyS concerns after stroke (April 1, 2012 to March 31, 2018) with at least 6 months of follow-up was performed.

Personalized model to predict seizures based on dynamic and static continuous EEG monitoring data.

Background/objective: Early recognition of patients who may be at risk of developing acute symptomatic seizures would be useful. We aimed to determine whether continuous electroencephalography (cEEG) data using machine learning techniques such as neural networks and decision trees could predict seizure occurrence in hospitalized patients.

Methods: This was a single center retrospective cohort analysis of cEEG data in patients aged 18-90 years who were admitted and underwent cEEG monitoring between 2010 and 2019 limited to 72 h excluding those who were seizing at the onset of recording.

Acute epileptiform abnormalities are the primary predictors of post-stroke epilepsy: a matched, case-control study.

Stroke patients who underwent continuous EEG (cEEG) monitoring within 7 days of presentation and developed post-stroke epilepsy (PSE; cases, n = 36) were matched (1:2 ratio) by age and follow-up duration with ones who did not (controls, n = 72). Variables significant on univariable analysis [hypertension, smoking, hemorrhagic conversion, pre-cEEG convulsive seizures, and epileptiform abnormalities (EAs)] were included in the multivariable logistic model and only the presence of EAs on EEG remained significant PSE predictor [OR = 11.9 (1.

Risk factors that predict delayed seizure detection on continuous electroencephalogram (cEEG) in a large sample size of critically ill patients.

Objective: Majority of seizures are detected within 24 hours on continuous EEG (cEEG). Some patients have delayed seizure detection after 24 hours. The purpose of this research was to identify risk factors that predict delayed seizure detection and to determine optimal cEEG duration for various patient subpopulations.

Characterization of Postanoxic Tonic Eyelid Opening: A Poorly Recognized Prognostic Sign.

Background: Postanoxic myoclonus is a known poor prognostic sign, and other postanoxic spontaneous movements have been reported but poorly described. We aim to describe the electroclinical phenomenon of postanoxic eyelid openings in context of its possible prognostic value.

Methods: We collected clinical data on postcardiac arrest patients with suspicious eyelid movements noted on continuous EEG monitoring.

Long-term continuation of anti-seizure medications after acute stroke.

Objective: To investigate the factors associated with the long-term continuation of anti-seizure medications (ASMs) in acute stroke patients.

Methods: We performed a retrospective cohort study of stroke patients with concern for acute symptomatic seizures (ASySs) during hospitalization who subsequently visited the poststroke clinic. All patients had continuous EEG (cEEG) monitoring.

Long-term electro-clinical profile of sudden cardiac arrest survivors.

Objective: Recent research has explored the use of continuous EEG (cEEG) monitoring for prognostication of spontaneous cardiac arrest (SCA). However, there is limited literature on the long-term (post-hospital discharge) electrographic findings among SCA survivors and their clinical correlates. Our study aims to fill this critical knowledge gap.

Continuous electroencephalography characteristics and acute symptomatic seizures in COVID-19 patients.

Objective: As concerns regarding neurological manifestations in COVID-19 (coronavirus disease 2019) patients increase, limited data exists on continuous electroencephalography (cEEG) findings in these patients. We present a retrospective cohort study of cEEG monitoring in COVID-19 patients to better explore this knowledge gap.

Methods: Among 22 COVID-19 patients, 19 underwent cEEGs, and 3 underwent routine EEGs (<1 h).

Seizure Risk in Patients Undergoing 30-Day Readmission After Continuous EEG Monitoring.

Purpose: The use of continuous electroencephalographic (cEEG) monitoring has improved the understanding of the seizure risk during acute hospitalization. However, the immediate posthospitalization seizure risk in these patients remains unknown. Patients undergoing 30-day readmission after initial cEEG monitoring were analyzed to fill this knowledge gap.

Patient-Reported Outcomes (PROs) in Acute Symptomatic Seizure (ASyS) Versus Patients With Established Epilepsy.

Purpose: Acute symptomatic seizures (ASyS) are common in critically ill patients. It is unknown how ASyS affect posthospitalization self-reported health compared to patients with established epilepsy.

Methods: This is a retrospective cohort study from 2010 to 2018.

Post-acute symptomatic seizure (PASS) clinic: A continuity of care model for patients impacted by continuous EEG monitoring.

Objective: We present a model for the outpatient care of patients undergoing continuous electroencephalography (cEEG) monitoring during a hospitalization, named the post-acute symptomatic seizure (PASS) clinic. We investigated whether establishing this clinic led to improved access to epileptologist care.

Methods: As part of the PASS clinic initiative, electronic health record (EHR) provides an automated alert to the inpatient care team discharging adults on first time antiepileptic drug (AED) after undergoing cEEG monitoring.

Perisylvian vulnerability to postencephalitic epilepsy.

Objective: Postencephalitic epilepsy is often resistant to antiseizure medications, leading to evaluation for epilepsy surgery. Characterizing its localization carries implications for optimal surgical approach. We aimed to determine whether a prior history of encephalitis is associated with specific epileptogenic networks among patients with drug resistant epilepsy undergoing stereotactic EEG (SEEG).

Acute Symptomatic Seizures in Critically Ill Patients with COVID-19: Is There an Association?

Background: The coronavirus disease of 2019 (COVID-19) emerged as a global pandemic. Historically, the group of human coronaviruses can also affect the central nervous system leading to neurological symptoms; however, the causative mechanisms of the neurological manifestations of COVID-19 disease are not well known. Seizures have not been directly reported as a part of COVID-19 outside of patients with previously known brain injury or epilepsy.

Determinants and outcome of repeat continuous electroencephalogram monitoring-A case-control study.

Objective: A retrospective, single-center study to analyze the determinants of a repeat continuous EEG (cEEG) monitoring during hospitalization and its outcomes using a matched case-control study design.

Methods: Adults with a repeat cEEG session (cases) were matched by age (±3 years), gender, and mental status to patients with a single cEEG (controls) during hospitalization. Several clinical and EEG characteristics were analyzed to identify predictors of repeat cEEG.

Predictors of Seizure Recurrence after Acute Symptomatic Seizures in Ischemic Stroke Patients.

Purpose: Seizure is a well-recognized complication of both remote and acute ischemic strokes. Predictors of seizure recurrence and epilepsy in patients with ischemic stroke who develop acute symptomatic seizures (ASyS) on continuous electroencephalography (cEEG) have not been well studied.

Methods: We present a five-year retrospective study of acute and remote ischemic stroke patients who developed ASyS on cEEG.

Electroencephalographic biomarkers of epilepsy development in patients with acute brain injury: a matched, parallel cohort study.

Objective: This study was designed to investigate if highly epileptic electroencephalogram (EEG) findings in patients with acute brain injury increase the long-term risk of epilepsy development.

Methods: Adults patients, lacking epilepsy history, with electrographic seizures or lateralized periodic discharges (LPDs) (cases) were identified and matched based on age, mental status, and etiology with the ones lacking any epileptiform activity (controls) on continuous EEG (cEEG) during hospitalization. The primary outcome of clinical seizures after hospital discharge and their antiepileptic drug (AED) status was determined using a telephonic interview.

Super-Refractory Status Epilepticus Treated with High Dose Perampanel: Case Series and Review of the Literature.

Introduction: Acute symptomatic seizures are frequent in the critically ill patient and can be difficult to treat. The novel anticonvulsant perampanel may be effective in the treatment of status epilepticus considering its mechanism of action of being an AMPA antagonist. We present four cases of super refractory status epilepticus treated with high dose perampanel.

Monitoring for seizures in the intensive care unit.

Acute symptomatic seizures have been known to occur in critically ill patients for many years. It was not until the widespread use of continuous EEG (cEEG) in the critically ill did we appreciate the incidence of electrographic seizures and status epilepticus in the ICU (Newey and Kinzy, 2018). Many of the seizures that occur are without any apparent clinical signs at the time of the recording.

FDG-PET and MRI in the Evolution of New-Onset Refractory Status Epilepticus.

Background And Purpose: New-onset refractory status epilepticus is a clinical condition characterized by acute and prolonged pharmacoresistant seizures without a pre-existing relevant neurologic disorder, prior epilepsy, or clear structural, toxic, or metabolic cause. New-onset refractory status epilepticus is often associated with antineuronal antibodies and may respond to early immunosuppressive therapy, reflecting an inflammatory element of the condition. FDG-PET is a useful diagnostic tool in inflammatory and noninflammatory encephalitis.