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| http://dx.doi.org/10.3389/fnagi.2022.1063702 | DOI Listing |
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When patients with Creutzfeldt-Jakob disease are misdiagnosed as having nonconvulsive status epilepticus.
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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.
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El Niño-Southern Oscillation (ENSO) exhibits a strong asymmetry between warm El Niño and cold La Niña in amplitude and temporal evolution. An El Niño often leads to a heat discharge in the equatorial Pacific conducive to its rapid termination and transition to a La Niña, whereas a La Niña persists and recharges the equatorial Pacific for consecutive years preconditioning development of a subsequent El Niño, as occurred in 2020-2023. Whether the multiyear-long heat recharge increases the likelihood of a transition to a strong El Niño remains unknown.
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