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Immediate Postoperative Activation of Vagus Nerve Stimulation (VNS) for Super-refractory Status Epilepticus: A Case Report.
Cureus
December 2024
Clinical Research, National Institute of Neurology and Neurosurgery, Mexico City, MEX.
Anti-NMDA (N-methyl-D-aspartate) receptor encephalitis (ANRE) is a rare autoimmune condition targeting brain receptors, often linked to ovarian tumors in young women. In severe cases, it can lead to status epilepticus, but in sporadic cases, it may progress to super-refractory status epilepticus (SRSE), a dangerous state of continuous or repetitive seizures demanding urgent medical attention that continues or recurs more than 24 hours after the initiation of anesthetic therapy. We present a case report of anti-NMDA receptor limbic encephalitis-triggered SRSE terminated with vagus nerve stimulation (VNS) and titrated to high stimulation parameters in the immediate postoperative period.
View Article and Find Full Text PDFKetamine Versus Midazolam as the First-Line Continuous Infusion for Status Epilepticus in Children with Cardiac Disease.
Neurocrit Care
January 2025
Division of Neurology, Children's National Hospital, Washington, DC, USA.
Background: The treatment of status epilepticus (SE) in children with cardiac disease is challenging given their often-tenuous hemodynamic state. We aim to determine whether ketamine is safe and effective in children with cardiac disease as the first-line continuous infusion for the treatment of refractory SE (RSE) and to compare ketamine to midazolam for the treatment of RSE in this population.
Methods: This is a single-center retrospective cohort study of pediatric patients with cardiac disease and RSE admitted to the cardiac intensive care unit at a tertiary children's hospital between January 1, 2017 and June 30, 2023.
Predisposing Factors of Progression from Refractory Status Epilepticus to Super-Refractory Status Epilepticus in ICU-Admitted Patients: Multicenter Retrospective Cohort Study in a Resource-Limited Setting.
Neurocrit Care
January 2025
Faculty of Psychology, Chulalongkorn University, Bangkok, Thailand.
Background: Super-refractory status epilepticus (SRSE) is an extremely serious neurological emergency. Risk factors and mechanisms involved in transition from refractory status epilepticus (RSE) to SRSE are insufficiently studied.
Methods: This was a multicenter retrospective cohort study of consecutive patients diagnosed and treated for RSE at two reference hospital over 5 years in Ecuador.
Low-Cost Strategies for the Development of Neurocritical Care in Resource-Limited Settings.
Neurocrit Care
January 2025
Division of Neurosurgery, Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil.
This review explores low-cost neurocritical care interventions for resource-limited settings, including economical devices, innovative care models, and disease-specific strategies. Devices like inexpensive ventilators, wearable technology, smartphone-based ultrasound, brain4care, transcranial Doppler, and smartphone pupillometry offer effective diagnostic and monitoring capabilities. Initiatives such as intermediate care units, minimally equipped stroke units, and tele-neurocritical care have demonstrated benefits by reducing hospital stays, preventing complications, and improving clinical and economic outcomes.
View Article and Find Full Text PDFEarly-phase EEG power spectrum analysis may differentiate acute encephalopathy with biphasic seizures and late reduced diffusion from prolonged febrile seizures.
Epilepsy Res
January 2025
Department of Pediatric Neurology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan. Electronic address:
Background: Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is clinically characterized by biphasic seizures associated with mild to severe neurological sequelae and is the most common subtype of acute encephalopathy in Japan, accounting for around 30 % of cases. The present study retrospectively analyzed the utility of electroencephalography (EEG) in determining the optimal method of diagnosing AESD at the early stage.
Methods: This study explores early power value differences to differentiate acute encephalopathy from prolonged febrile seizure (FS).
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