Periodic epileptiform discharges (PEDs) are frequently encountered during continuous electroencephalography monitoring in the intensive care unit. Their implications and management are variable and highly dependent on the clinical context. This article is intended for the nonneurologist intensivist, reviews basic terminology and clinical implications (including causes, prognosis, and association with seizures), and suggests an approach to management. Several case vignettes are included to illustrate the clinical variability associated with PEDs.

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066613513411DOI Listing

Publication Analysis

Top Keywords

periodic epileptiform
8
epileptiform discharges
8
nonneurologist intensivist
8
clinical implications
8
discharges clarified
4
clarified nonneurologist
4
clinical
4
intensivist clinical
4
implications current
4
current management
4

Similar Publications

Contemporary studies report nonconvulsive status epilepticus (NCSE) in Creutzfeldt-Jakob disease (CJD), based on benzodiazepine (BZP)-responsive epileptiform discharges on the electroencephalogram (EEG), with the following false syllogism: (1) intravenous (IV) administration of BZPs usually suppress ictal activity in NCSE; (2) in CJD, periodic sharp wave complexes (PSWCs) are suppressed by IV BZPs; (3) therefore, these patients have NCSE. This is a simplistic and invalid conclusion, because authors of 20th-century science reports have clearly shown that IV BZPs, short-acting barbiturates, and drugs with no antiseizure effects, such as chloral hydrate and IV naloxone, suppress PSWCs, but patients fall asleep with no clinical improvement. In contrast, IV methylphenidate transiently improves both the EEG and clinical states.

View Article and Find Full Text PDF

Background: Local anesthetic systemic toxicity (LAST) is a rare but potentially life-threatening complication. Under general anesthesia, neurological signs are often masked, delaying diagnosis and increasing the risk of sudden cardiovascular collapse. Therefore, early detection methods are critically needed.

View Article and Find Full Text PDF

Introduction: Creutzfeldt-Jakob disease (CJD) is a rare, rapidly progressive, fatal, neurodegenerative disease classified as prion diseases. There are many subtypes of this disease, but information about clinical presentation and investigation findings in Thailand is scarce.

Objective: To describe the clinical presentation, radiological and electroencephalographic characteristics of CJD encountered at Siriraj hospital in the past 10 years (between January 1, 2006 and December 31, 2015).

View Article and Find Full Text PDF

Awareness and driving safety during awake interictal epileptiform discharges in idiopathic generalised epilepsies: A systematic review.

Epilepsy Behav

December 2024

Department of Medicine, St. Vincent's Hospital Melbourne (The University of Melbourne), Fitzroy, VIC 3065, Australia; Seer Medical, 278 Queensberry St, Melbourne, VIC 3000, Australia. Electronic address:

Idiopathic generalised epilepsies (IGEs) are a family of epileptic syndromes that commonly occur in childhood or adolescence and can persist into adulthood. Whilst people with IGE may consider themselves seizure free, they often experience interictal epileptiform discharges (IEDs) that may be associated with unrecognised periods of impaired awareness. As such, the presence of long IEDs associated with unrecognised loss of awareness pose a major challenge in allowing these individuals to drive safely, particularly since not all IEDs are associated with impaired awareness.

View Article and Find Full Text PDF

Objective: Rapid EEG devices (REDs) have demonstrated substantial benefit regarding reduced time to performance of study and diagnosis in cases where urgent EEG is needed to evaluate patients for potentially revealing nonconvulsive status epilepticus and seizures. However, urgent EEG is also important in identifying cases regarding the need for initiation of antiseizure medication as well as triaging the use of continuous EEG monitoring. Some forms of REDs have a reduced montage (RRME) with electrode derivations that are one-half of standard recordings.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!