Code blue: seizures.
Epilepsy Behav. 2011 Jun;21(2):189-90
Authors: Hoerth MT, Drazkowski JF, Noe KH, Sirven JI
Abstract
Eyewitnesses frequently perceive seizures as life threatening. If an event occurs on the …

[Read more →]

Related Articles

The role of EEG in epilepsy: a critical review.

Epilepsy Behav. 2009 May;15(1):22-33

Authors: Noachtar S, Rémi J

Electroencephalography (EEG) is the most specific method to define epileptogenic cortex. Its sensitivity and specificity depend on several factors such as age and recording procedures, for example, sleep recordings and activation procedures (hyperventilation, photic stimulation). EEG reveals characteristic findings in several epilepsy syndromes. Rarely, epileptiform discharges are recorded in healthy, particularly young individuals. Ictal video/EEG recording is considered to be critical in localizing the epileptogenic zone. A careful analysis of the first clinical signs and symptoms of a seizure and of the evolution of the seizure symptomatology can provide important localizing clues. Although surface EEG recordings are less sensitive than invasive studies, they provide the best overview and, therefore, the most efficient way to define the approximate localization of the epileptogenic zone. Invasive recordings are used in patients in whom the epileptogenic zone either cannot be located with noninvasive diagnostic methods or is adjacent to eloquent cortex. The most commonly used invasive electrodes are stereotactically implanted depth electrodes and subdural strip or grid electrodes. Foramen ovale and epidural electrodes are of intermediate invasiveness, but less sensitive. Invasive electrodes are subject to sampling errors if misplaced and should be used only after exhaustive noninvasive evaluations have (1) failed to localize the epileptogenic zone and (2) led to a testable hypothesis regarding this localization. Invasive EEG studies are associated with additional risks that are justifiable only if there is a good chance of obtaining essential localizing information and on a potentially resectable area.

PMID: 19248841 [PubMed - indexed for MEDLINE]

[Read more →]

Related Articles

Status epilepticus: a critical review.

Epilepsy Behav. 2009 May;15(1):10-4

Authors: Knake S, Hamer HM, Rosenow F

Status epilepticus (SE) is a major neurological emergency with an incidence of about 20/100,000 and a mortality between 3 and 40% depending on etiology, age, status type, and status duration. Generalized tonic-clonic SE, in particular, requires immediate, aggressive, and effective treatment to stop seizure activity, and to prevent neuronal damage and systemic complications and death. Benzodiazepines and phenytoin/fosphenytoin are traditionally used as first-line drugs and are effective in about 60% of all episodes. However, a notable portion of patients remain in SE. For those, narcotics and induction of general anesthesia are used as second-line treatment. Therefore, there is a need for more effective first-line treatment options. Recently, valproic acid was approved for the treatment of status epilepticus in some European countries, and two of the newer antiepileptic drugs have become available for intravenous use: Levetiracetam (LEV) and lacosamide (LCM) should be evaluated in prospective controlled trials as possible treatment options. Standardized protocols for the management of SE are useful to improve immediate care.

PMID: 19236943 [PubMed - indexed for MEDLINE]

[Read more →]