Generalized periodic discharges and 'triphasic waves': A blinded evaluation of inter-rater agreement and clinical significance.

Objectives: Generalized periodic discharges (GPDs) are associated with nonconvulsive seizures. Triphasic waves (TWs), a subtype of GPDs, have been described in relation to metabolic encephalopathy and not felt to be associated with seizures. We sought to establish the consistency of use of this descriptive term and its association with seizures.

Neurocritical care: status epilepticus review.

Status epilepticus (SE) is a life-threatening medical and neurologic emergency requiring prompt recognition and treatment. SE may be classified into convulsive and nonconvulsive, based on the presence of rhythmic jerking of the extremities. Refractory status epilepticus is defined as ongoing seizures failing to respond to first- and second-line anticonvulsant drug therapy and carries a high morbidity and mortality.

Management of acute stroke and transient ischemic stroke-an integrated, systematic approach from the emergency department to the inpatient setting to discharge.

In the past two decades, we have seen major advances in the treatment of transient ischemic attack (TIA) and acute ischemic stroke. Unfortunately, these advances have not benefited the majority of TIA and stroke patients. Reasons vary and include the failure of patients and providers to recognize the severity of early symptoms, resulting in critical delays in treatment.

How I treat patients with EEG patterns on the ictal-interictal continuum in the neuro ICU.

Refractory status epilepticus (RSE) is associated with a high risk of poor outcome and treated by most neurointensivists with continuous intravenous antiepileptic medications (cIV-AEDs). Continuous EEG monitoring has allowed us to unveil a number of epileptiform patterns of less certain significance. These have been labeled ictal to interictal continuum (IIC), many of which are associated with poor outcome.