Background: Neurosurgical brain interventions may result in lesions that can cause epilepsy. Diagnosis may be delayed in some situations. Meanwhile, violent behavior can occur during postictal delirium states. Although benign behavioral manifestations are well documented in literature, violent offenses in post-neurosurgical epilepsy have been rarely reported. Here we describe 2 such cases, focusing on management and emphasizing the need for prevention.
Case Description: Both patients were suffering from post-neurosurgical epilepsy and offended during postictal delirium states. The first patient had generalized epilepsy and committed an attempted rape. The second patient had temporal lobe epilepsy and committed an attempted homicide. Both patients were well managed using anticonvulsant medication after the offenses.
Conclusions: Early diagnosis and regular follow-up are measures to take into consideration to prevent violent behavior in patients with post-neurosurgical epilepsy.
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http://dx.doi.org/10.1016/j.wneu.2018.04.112 | DOI Listing |
Front Med (Lausanne)
July 2022
Department of Critical Care Medicine, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Introduction: Post-neurosurgical central nervous system (CNS) infection caused by multidrug-resistant (MDR)/extensively drug-resistant (XDR) Gram-negative bacteria remains a major clinical challenge. This study describes our experience of treating such patients with combined intraventricular (IVT) and intravenous (IV) polymyxin B administration.
Methods: This retrospective study included six patients with post-neurosurgical CNS infections of carbapenem-resistant (CRAB) or carbapenem-resistant (CRKP).
World J Pediatr
March 2022
Pediatric Intensive Care Unit, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, No. 45 Nanlishi Road, Beijing, 100045, China.
Background: Early post-traumatic seizures (EPTS) refer to epileptic seizures occurring within one week after brain injury. This study aimed to define the risk factors of EPTS and the protective factors that could prevent its occurrence.
Methods: This is a single-center retrospective study in the PICU, Beijing Children's Hospital.
Front Neurosci
November 2019
Developmental Imaging, Murdoch Children's Research Institute, Melbourne, VIC, Australia.
Background: Optic radiation (OR) tractography may help predict and reduce post-neurosurgical visual field deficits. OR tractography methods currently lack pediatric and surgical focus.
Purpose: We propose a clinically feasible OR tractography strategy in a pediatric neurosurgery setting and examine its intra-rater and inter-rater reliability/agreements.
World Neurosurg
July 2018
Razi Hospital, Forensic Psychiatry Department, Cité des Orangers, La Manouba, Tunisia; University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia.
Background: Neurosurgical brain interventions may result in lesions that can cause epilepsy. Diagnosis may be delayed in some situations. Meanwhile, violent behavior can occur during postictal delirium states.
View Article and Find Full Text PDFInfez Med
June 2005
Department of Clinical and Experimental Medicine, Division of Infectious Diseases, University of Bologna "Alma Mater Studiorum", S. Orsola Hospital, Bologna, Italy.
The progressive emergence of antimicrobial-resistant Gram-positive cocci especially in the setting of surgery and intensive care, recommends particular attention in making sound therapeutic choices to overcome both microbial resistances and haemato-encephalic barriers to effective local drug penetration. As in other Western countries, the occurrence of methicillin-resistant Staphylococcus aureus is particularly high also in Italy, especially when high-risk patients and/or settings are involved. In treating post-neurosurgical central nervous system infections (cerebral abscess and meningitis), a key issue is represented by the low cerebrospinal fluid concentration of the two available glycopeptide antibiotics (vancomycin and teicoplanin), usually recommended as first-line therapy of resistant Gram-positive cocci.
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