Refractory Status Epilepticus in a Patient With Aducanumab-Induced Amyloid-Related Imaging Abnormalities.

Objective: To report a case of fatal super-refractory status epilepticus associated with amyloid-related imaging abnormalities (ARIA).

Methods: We describe the history, neuroimaging, EEG, and brain pathology findings of a 75-year-old patient with mild cognitive impairment due to Alzheimer disease (homozygous ε4 apolipoprotein status) and a remote history of 3 asymptomatic ARIA episodes, who developed super-refractory status epilepticus related to severe ARIA.

Results: The patient was participating in an extended open-label trial of aducanumab when she was admitted to hospital for focal seizures and ARIA in 2 noncontiguous regions of the left frontal and occipital lobes.

ICU-Electroencephalogram Unit Improves Outcome in Status Epilepticus Patients: A Retrospective Before-After Study.

Objectives: Continuous electroencephalogram (cEEG) monitoring is recommended for status epilepticus (SE) management in ICU but is still underused due to resource limitations and inconclusive evidence regarding its impact on outcome. Furthermore, the term "continuous monitoring" often implies continuous recording with variable intermittent review. The establishment of a dedicated ICU-electroencephalogram unit may fill this gap, allowing cEEG with nearly real-time review and multidisciplinary management collaboration.

The Role of Electroencephalography in Children with Acute Altered Mental Status of Unknown Etiology: A Prospective Study.

Introduction:  Acute altered mental status (AAMS) is often a challenge for clinicians, since the underlying etiologies cannot always easily be inferred based on the patient's clinical presentation, medical history, or early examinations. The aim of this study is to evaluate the role of electroencephalogram (EEG) as a diagnostic tool in AAMS of unknown etiology in children.

Materials And Methods:  We conducted a prospective study involving EEG assessments on children presenting with AAMS between May 2017 and October 2019.

Fluoxetine accelerates epileptogenesis and magnifies disease severity in a rat model of acquired epilepsy.

Objective: Many people with epilepsy experience comorbid anxiety and depression, and antidepressants remain a primary treatment for this. Emerging evidence suggests that these agents may modulate epileptogenesis to influence disease severity. Here, we assessed how treatment with the selective serotonin reuptake inhibitor (SSRI) antidepressant fluoxetine impacts epileptogenic, behavioral, and pathological sequelae following status epilepticus.

Endoscope-Assisted Evacuation of an Acute Subdural Hematoma in an Elderly Patient With Refractory Nonconvulsive Status Epilepticus: An Illustrative Case.

Traumatic brain injuries lead to post-traumatic seizures (PTS), with acute subdural hematomas (ASDH) posing a particularly elevated risk. The development of refractory nonconvulsive status epilepticus (NCSE) in such cases, especially in older patients, requires immediate and effective management. This case report highlights the improvement of refractory NCSE in an elderly patient with ASDH through endoscope-assisted evacuation.

Subacute encephalopathy with seizures in alcoholics (SESA) syndrome: Relevant questions.

Objective: The aim of this article is to answer three relevant issues: i/What epileptic condition is referred to as subacute encephalopathy with seizures in alcoholics (SESA) syndrome; ii/ Why it can be important to distinguish SESA syndrome in clinical practice and iii/ What do we know about its pathophysiology.

Methods: We reviewed all cases published in the English language from the initial description of the syndrome to the present. All met the previously established criteria for SESA syndrome were included in our analysis.

Overview of clinical and physiologic aspects of status epilepticus in the developmental and epileptic encephalopathies.

The Developmental and Epileptic Encephalopathies are a group of severe epilepsies which onset in early life and are characterized by recurrent, drug-resistant seizures and multiple comorbidities including intellectual disability, behavior and sleep problems, gait concerns, amongst others. Both convulsive and nonconvulsive status epilepticus are frequently seen, however the exact risk and type of status epilepticus depends on the underlying syndrome or etiology. The baseline degree of developmental impairment and EEG features characterized by background slowing and persistent, and at times, near-continuous high-amplitude epileptiform discharges can make a clearcut diagnosis of nonconvulsive status epilepticus, in a timely manner, very challenging.

Subacute encephalopathy with seizures in alcoholics (SESA) syndrome.

Purpose: To describe four patients with subacute encephalopathy with seizures in alcoholics (SESA) syndrome and to review its clinical, electroencephalogram (EEG), neuroimaging and diagnostic criteria.

Methods: We conducted a retrospective analysis of a series of prospectively collected patients who met the previously established criteria for SESA syndrome. Subsequently, we reviewed all cases published in the English language from the initial description to the present.

Dissociation Between the Epileptogenic Lesion and Primary Seizure Onset Zone in the Tetanus Toxin Model of Temporal Lobe Epilepsy.

Despite extensive temporal lobe epilepsy (TLE) research, understanding the specific limbic structures' roles in seizures remains limited. This weakness can be attributed to the complex nature of TLE and the existence of various TLE subsyndromes, including non-lesional TLE. Conventional TLE models like kainate and pilocarpine hinder precise assessment of the role of individual limbic structures in TLE ictogenesis due to widespread limbic damage induced by the initial status epilepticus.

Sequential levetiracetam and phenytoin in electroencephalographic neonatal seizures unresponsive to phenobarbital: a multicenter prospective observational study in India.

Background: Although levetiracetam and phenytoin are widely used antiseizure medications (ASM) in neonates, their efficacy on seizure freedom is unclear. We evaluated electroencephalographic (EEG) seizure freedom following sequential levetiracetam and phenytoin in neonatal seizures unresponsive to phenobarbital.

Methods: We recruited neonates born ≥35 weeks and aged <72 h who had continued electrographic seizures despite phenobarbital, from three Indian hospitals, between 20 June 2020 and 31 July 2022.

Indications, results and consequences of electroencephalography in neurocritical care: A retrospective study.

Purpose: Electrocencephalography (EEG) is a tool to assess cerebral cortical activity. We investigated the indications and results of routine EEG recordings in neurocritical care patients and corresponding changes in anti-seizure medication (ASM).

Materials And Methods: This was a single-center, retrospective cohort study.

Utility and rationale for continuous EEG monitoring: a primer for the general intensivist.

This review offers a comprehensive guide for general intensivists on the utility of continuous EEG (cEEG) monitoring for critically ill patients. Beyond the primary role of EEG in detecting seizures, this review explores its utility in neuroprognostication, monitoring neurological deterioration, assessing treatment responses, and aiding rehabilitation in patients with encephalopathy, coma, or other consciousness disorders. Most seizures and status epilepticus (SE) events in the intensive care unit (ICU) setting are nonconvulsive or subtle, making cEEG essential for identifying these otherwise silent events.

NCSE-coma in older adults: Clinical data, initial EEG, and hospital outcome.

Introduction: The clinical-EEG profile and prognosis in nonconvulsive status epilepticus (NCSE-coma) - with preceding SE and without preceding SE - have not been fully established yet.

Objective: To evaluate the initial EEG, clinical characteristics, and hospital outcome of older adults with NCSE-coma.

Methodology: Clinical variables, immediate prognosis, initial EEG data, and scores on the Status Epilepticus Severity Score (STESS) and the SACE score were evaluated according to the type of NCSE-coma (with and without preceding seizure/SE) in 51 older adult patients treated in the emergency department.

Improving Quality of Care for Status Epilepticus: Putting Protocols into Practice.

Purpose Of Review: Timely treatment of status epilepticus (SE) improves outcomes, however gaps between recommended and implemented care are common. This review analyzes obstacles and explores interventions to optimize effective, evidence-based treatment of SE.

Recent Findings: Seizure action plans, rescue medications, and noninvasive wearables with seizure detection capabilities can facilitate early intervention for prolonged seizures in the home and school.

Relationship between continuous EEG monitoring findings and prognostic factors in patients with status epilepticus.

Background And Purpose: Little information is available regarding the use of continuous electroencephalography (cEEG) monitoring findings to predict the prognosis of patients with status epilepticus, which could aid in prognostication. This study investigated the relationship between cEEG monitoring findings and various prognostic indicators in patients with status epilepticus.

Methods: We reviewed the clinical profiles and cEEG monitoring data of 28 patients with status epilepticus over a ten-year period.

Electroencephalographic and Behavioral Effects of Intranasal Administration of a Na, K-ATPase-Activating Antibody after Status Epilepticus.

Status epilepticus (SE) is a medical emergency associated with high mortality and morbidity. Na, K-ATPase, is a promising therapeutic target for SE, given its critical role in regulation of neuron excitability and cellular homeostasis. We investigated the effects of a Na, K-ATPase-activating antibody (DRRSAb) on short-term electrophysiological and behavioral consequences of pilocarpine-induced SE.

A systematic review of electroencephalographic findings in Lennox-Gastaut syndrome.

Lennox-Gastaut syndrome (LGS) is a severe form of childhood onset epileptic encephalopathy characterized by multiple drug-resistant seizures, cognitive impairment, and diffuse slow spike and wave (SSW), and generalized paroxysmal fast activity (GPFA) on electroencephalogram (EEG). Systematic review following the Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) guidelines was done to investigate EEG findings in LGS. PubMed and MEDLINE were systematically searched for English-language studies published until15th may 2023.

Clinical and paraclinical features of first unprovoked seizures in the elderly.

Purpose: The prevalence of unprovoked seizures and epilepsy rises significantly in later life stages. This study examines various factors in elderly patients (over 65 years) with their first unprovoked seizures, comparing findings with younger patients.

Methods: We analyzed electronic medical records of individuals with first unprovoked seizures retrospectively.