Publications by authors named "Theodore Sheehan"

Seizure detection is vital for managing epilepsy as seizures can lead to injury and even death, in addition to impacting quality of life. Prompt detection of seizures and intervention can help prevent injury and improve outcomes for individuals with epilepsy. Wearable sensors show promising results for automated detection of certain seizures, but they have limitations such as patient tolerance, impracticality for newborns, and the need for recharging.

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Introduction: Although most cases of pediatric convulsive status epilepticus start in the prehospital setting, many patients do not receive treatment. The use of prehospital seizure rescue medications by caregivers is crucial, but studies suggest a lack of proper training on medication use.

Methods: We created a novel proof of principle mannequin and simulation for training proper administration of rectal diazepam, with a scoring paradigm to standardize and assess the educational process.

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A seizure likelihood biomarker could improve seizure monitoring and facilitate adjustment of treatments based on seizure risk. Here, we tested differences in patient-specific 24-h-modulation patterns of electrodermal activity (EDA), peripheral body temperature (TEMP), and heart rate (HR) between patients with and without seizures. We enrolled patients who underwent continuous video-EEG monitoring at Boston Children's Hospital to wear a biosensor.

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Patient-generated health data provide a great opportunity for more detailed ambulatory monitoring and more personalized treatments in many diseases. In epilepsy, robust diagnostics applicable to the ambulatory setting are needed as diagnosis and treatment decisions in current clinical practice are primarily reliant on patient self-reports, which are often inaccurate. Recent work using wearable devices has focused on methods to detect and forecast epileptic seizures.

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Article Synopsis
  • * Out of 293 children studied, many received multiple doses of BZDs, especially if seizures started outside of the hospital and if they delayed treatment — with 57.3% receiving BZDs beyond 30 minutes after the onset.
  • * The findings suggest that more timely escalation from BZDs to non-BZD ASMs is needed, particularly for patients whose seizures began before they arrived at the hospital.
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Introduction: Generalized tonic-clonic seizures (GTCS) are associated with elevated electrodermal activity (EDA) and postictal generalized electroencephalographic suppression (PGES), markers that may indicate sudden unexpected death in epilepsy (SUDEP) risk. This study investigated the association of GTCS semiology, EDA, and PGES in children with epilepsy.

Methods: Patients admitted to the Boston Children's Hospital long-term video-EEG monitoring unit wore a sensor that records EDA.

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Objective: Tracking seizures is crucial for epilepsy monitoring and treatment evaluation. Current epilepsy care relies on caretaker seizure diaries, but clinical seizure monitoring may miss seizures. Wearable devices may be better tolerated and more suitable for long-term ambulatory monitoring.

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Article Synopsis
  • The study aimed to examine long-term outcomes in pediatric patients experiencing refractory status epilepticus (RSE) and to identify factors linked to new neurological deficits following RSE.
  • Data from 276 patients showed a 4% in-hospital mortality rate, with 62.9% of patients later developing unprovoked seizures and 39.3% of those with normal development before RSE acquiring new neurological deficits.
  • Longer durations of electroclinical RSE were associated with higher risks of new deficits, and the study highlights that about one-third of previously seizure-free patients experienced recurrent seizures post-RSE.
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CSNK2B has recently been implicated as a disease gene for neurodevelopmental disability (NDD) and epilepsy. Information about developmental outcomes has been limited by the young age and short follow-up for many of the previously reported cases, and further delineation of the spectrum of associated phenotypes is needed. We present 25 new patients with variants in CSNK2B and refine the associated NDD and epilepsy phenotypes.

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Article Synopsis
  • Pediatric patients with refractory status epilepticus experience delays in treatment, which varies depending on the day of the week or whether it's a holiday.
  • A study analyzing 329 patients found that time to the first benzodiazepine (BZD) was longer during weekdays compared to weekends/holidays, with significant differences in time for non-BZD antiseizure medications, especially for cases that began in the hospital.
  • Findings suggest that improving the response time for treatments during weekdays may enhance patient outcomes, highlighting the need for policies addressing treatment disparities based on the day of the week.
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