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When patients with Creutzfeldt-Jakob disease are misdiagnosed as having nonconvulsive status epilepticus.
Epilepsia
January 2025
Epilepsy Unit, Hôpital Gui de Chauliac, Montpellier, France.
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 PDFAssessment of language lateralization in epilepsy patients using the super-selective Wada test.
Acta Neurochir (Wien)
February 2024
Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai, 980-8575, Japan.
Article Synopsis
- - The study evaluates the super-selective Wada test (ssWada) as a safer and more effective alternative to the classical Wada test (cWada) for assessing language dominance in patients with epilepsy, as cWada has significant adverse effects in 10-30% of cases.
- - Data from 17 patients revealed that ssWada identified language dominance accurately, showing 12 left, 3 right, and 2 bilateral cases, while adverse effects were much lower than those seen with cWada.
- - The ssWada demonstrated a high accuracy rate of over 90% in determining language dominance with minimal side effects, making it a promising tool for assessing patients’ language facilities.
Liquid Chromatography-Tandem Mass Spectrometry for Quantitation of Serum Pentobarbital.
Methods Mol Biol
December 2023
Department of Pathology, University of Mississippi Medical Center, Jackson, MS, USA.
Pentobarbital is a short-acting barbiturate with anticonvulsant and sedative-hypnotic properties. Pentobarbital may be used to induce sedation, control seizures, induce coma, and to manage patients with traumatic brain injury. In traumatic brain injury, use of pentobarbital is known to reduce both cerebral blood flow and oxygen consumption, which reduces intracranial pressure and cerebral ischemia.
View Article and Find Full Text PDFMethohexital - Induced lateralized periodic discharges during Wada test.
Clin Neurophysiol Pract
July 2021
Comprehensive Epilepsy Program, Department of Neurology, University of Michigan, Ann Arbor, MI, USA.
Objective: The Wada test is used to evaluate language lateralization and memory performance after inactivation of an isolated cerebral hemisphere. Methohexital a short-acting barbiturate has a history of use to induce interictal discharges during intraoperative corticography. We report a new finding of activation of lateralized periodic discharges (LPDs) after Methohexital injection.
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