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17

New AAN/AES Guideline on First Unprovoked Seizure in Adults

Experts recommend clinicians approach patients on an individualized basis in terms of whether to treat with an antiepileptic drug following a first unprovoked seizure.  
medscape.com
almost 5 years ago
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23

Seizure, “Answers”

1. Which benzodiazepine do you prefer for the treatment of status epilepticus (SE)? Which do you prefer for pediatric patients? An epileptic seizure (ES) is defined as an abrupt disruption in brain function secondary to abnormal neuronal firing, and is characterized by changes in sensory perception and or motor activity. The clinical manifestation of a…  
emlyceum.com
almost 5 years ago
Em basic
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5

seizures

 
embasic.org
almost 5 years ago
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12

Mental disorders and physical diseases co-occur in teenagers

Every third teenager has suffered from one mental disorder and one physical disease. These co-occurrences come in specific associations: More often than average, depression occurs together with diseases of the digestive system, eating disorders with seizures and anxiety disorders together with arthritis, heart disease as well as diseases of the digestives system. These findings were reported by researchers from the University of Basel and the Ruhr-Universität Bochum in the scientific journal Psychosomatic Medicine  
eurekalert.org
almost 5 years ago
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12

Lab Case 55 – Interpretation

2. AMS – seizure, trauma, alcohol intoxication/withdrawal/ Wernicke’s, severe hyponatraemia, sepsis (intracranial/ other), drugs/ toxins, CVA etc  
emergucate.com
almost 5 years ago
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17

Podcast #11: All Seizures Stop…Eventually (Magnesium and Eclampsia)

A healthy 23 year old woman presents 37 weeks pregnant seizing. She has no history of seizures, drugs, trauma, illness, etc.  You are addressing the A, B, Cs and the nurses asks “what med do you want to stop the seizure”?  
thesgem.com
almost 5 years ago
Sinaiem dark
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tca-abc-ekg-qrs

You are on your PEM shift overnight when a 9 year old boy with history of behavior disorder, BIBEMS only moments (<30min) after witnessed ingestion of 500mg of his grandmother’s amitriptyline. On arrival, ABC’s intact, and the patient is sleepy but easily arousable. Normal vitals for his age. An EKG is performed, which appears normal. QRS 92 and the terminal R wave in aVR is <3mm. You are just about to given charcoal when the patient has a tonic-clonic seizure.  
sinaiem.org
over 4 years ago
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Lab Case 56 – Interpretation

<10%  Background level in smoker 10%     mild H 20%     dizziness, N, dyspnoea, throbbing headache 30%     Vertigo, ataxia, visual disturbance 40%     confusion, coma, seizures, syncope 50%     CVS, Respiratory failure, arrhythmia, seizures, death  
emergucate.com
over 4 years ago
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Yoga for epilepsy | Cochrane

Epilepsy is a disorder in which recurrent seizures are caused by abnormal electrical discharges in the brain. Most seizures can be controlled by antiepileptic drugs but sometimes seizures develop which are resistant to those drugs. People may also wish to try non-drug treatments such as yoga. Between 25% and 40% of people with epilepsy treated with AED have uncontrolled seizure, experience adverse effect from medication, suffer from stigmatisation and have a higher degree of psychiatric disorders as compared with people with other chronic illnesses. For those who have epilepsy and related problems it is important to develop, evaluate, and implement a complementary treatment model in the everyday treatment of epilepsy.  
cochrane.org
over 4 years ago
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14

A Girl with Seizures - Now@NEJM

In the latest Case Record of the Massachusetts General Hospital, a 9-year-old girl presented to the emergency department with loss of consciousness and a seizure. She had returned from a trip to Puerto Rico 3 weeks earlier. Unilateral inguinal lymphadenopathy was present, and rapidly progressive encephalopathy developed.  
blogs.nejm.org
over 4 years ago
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30

Recognition of Common Childhood Malignancies - American Family Physician

Although cancer has an annual incidence of only about 150 new cases per 1 million U.S. children, it is the second leading cause of childhood deaths. Early detection and prompt therapy have the potential to reduce mortality. Leukemias, lymphomas and central nervous system tumors account for more than one half of new cancer cases in children. Early in the disease, leukemia may cause nonspecific symptoms similar to those of a viral infection. Leukemia should be suspected if persistent vague symptoms are accompanied by evidence of abnormal bleeding, bone pain, lymphadenopathy or hepatosplenomegaly. The presenting symptoms of a brain tumor may include elevated intracranial pressure, nerve abnormalities and seizures. A spinal tumor often presents with signs and symptoms of spinal cord compression. In children, lymphoma may present as one or more painless masses, often in the neck, accompanied by signs and symptoms resulting from local compression, as well as signs and symptoms of systemic disturbances, such as fever and weight loss. A neuroblastoma may arise from sympathetic nervous tissue anywhere in the body, but this tumor most often develops in the abdomen. The presentation depends on the local effects of the solid tumor and any metastases. An abdominal mass in a child may also be due to Wilms' tumor. This neoplasm may present with renal signs and symptoms, such as hypertension, hematuria and abdominal pain. A tumor of the musculoskeletal system is often first detected when trauma appears to cause pain and dysfunction out of proportion to the injury. Primary care physicians should be alert for possible presenting signs and symptoms of childhood malignancy, particularly in patients with Down syndrome or other congenital and familial conditions associated with an increased risk of cancer.  
aafp.org
over 4 years ago
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The use of lacosamide in partial epilepsy: Does it work and is it harmful? | Cochrane

Lacosamide is an antiepileptic drug that can be added along with others to treat people who have certain types of epileptic seizures. This drug may be beneficial for people who are taking other antiepileptic medication but continue to have seizures. This review looked at how well lacosamide works when added to a patient's daily medication and also looked at some of the harms or side effects of the drug.  
cochrane.org
over 4 years ago
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Surgery for epilepsy | Cochrane

Focal epilepsies are caused by abnormal electrical discharges in specific (localised) parts of the brain. In most people the resulting epileptic seizures can be controlled with medication. In up to 30% of people these seizures are not controlled by medication. If the site of origin of these signals (the epileptogenic zone) can be located from the description of the seizures, or from magnetic resonance imaging (MRI) (a medical imaging scan that uses strong magnetic fields and radio waves to produce detailed images of the inside of the body) and electroencephalography (EEG) findings (recording of electrical activity along the scalp) the person should be offered the chance of having the epileptogenic zone removed. We studied the factors (characteristics of the people undergoing surgery and details of surgery type) that might be linked to the best chance of surgical cure of epileptic seizures.  
cochrane.org
over 4 years ago
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Are there any differences in survival between people with low grade glioma having early compared with delayed radiotherapy at the time of progression? | Cochrane

The issue Low grade gliomas are brain tumours that predominantly affect young adults. They grow at slower rates and are typically associated with a favourable prognosis compared with high grade gliomas. One of the most common presenting symptoms of people with LGG are seizures. Although, there are no definitive guidelines on the management of LGGs, most people with LGGs are treated with a combination of surgery followed by radiotherapy. However, it is unclear whether to use radiotherapy in the early postoperative period, or to delay until the disease progresses.  
cochrane.org
over 4 years ago
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Propofol versus thiopental sodium for the treatment of refractory status epilepticus (RSE) | Cochrane

Persistent convulsions (lasting 30 minutes or more) are a major medical emergency associated with significant morbidity and mortality. At times, these convulsions fail to respond to first- and second-line drug therapy and may occur in up to 31% of patients suffering from persistent seizure or convulsive activities. Persistent seizure activity may become unresponsive to antiepileptic drugs. Anaesthetics such as thiopental sodium and propofol are frequently given for control of seizures in such situations. Both agents have their own side effects and complications. This review evaluates the evidence for the use of these anaesthetic drugs in controlling seizure activity in patients with RSE.  
cochrane.org
over 4 years ago
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Carbamazepine versus phenobarbitone monotherapy (single drug treatment) for epilepsy | Cochrane

Epilepsy is a common neurological disorder in which abnormal electrical discharges from the brain cause recurrent seizures. We studied two types of epileptic seizures in this review: generalised onset seizures in which electrical discharges begin in one part of the brain and move throughout the brain, and partial onset seizures in which the seizure is generated in and affects one part of the brain (the whole hemisphere of the brain or part of a lobe of the brain). For around 70% of people with epilepsy, a single antiepileptic drug can control generalised onset or partial onset seizures. Worldwide, phenobarbitone (PB) and carbamazepine (CBZ) are commonly used antiepileptic drugs; however, CBZ is used more commonly in the USA and Europe because of concerns over side-effects associated with PB, particularly concerns over behavioural changes in children treated with PB. Phenobarbitone is still commonly used in developing countries in Africa, Asia, and South America because of the low cost of the drug.  
cochrane.org
over 4 years ago
Www.bmj
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A pain in the neck type of headache

A 29 year old right hand dominant chef presented to the emergency department with a four day history of feeling “not normal.” He was sent home from work because of a gradual onset of dull pain on the left side of his neck radiating up into his head, which was getting progressively worse, as well as “seeing two of everything.” The pain was not influenced by changes in posture. In addition, his right side felt numb and he was dropping things at work. He felt unsteady on his feet, which prompted him to seek medical advice. He thought all his symptoms had come on suddenly and were gradually getting worse. He denied any recent alcohol consumption, illicit drug use, seizure activity, head injury, or loss of consciousness. He had no medical history of note, apart from hypothyroidism, for which he was taking thyroxine.  
feeds.bmj.com
over 4 years ago
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FDA approves first 3-D printed drug

WASHINGTON — The Food and Drug Administration has approved the first prescription drug made through 3-D printing: a dissolvable tablet that treats seizures. Aprecia Pharmaceuticals said Monday the FDA approved its drug Spritam for adults and children who suffer from certain types of seizures caused by epilepsy. The tablet is manufactured through a layered process via 3-D printing and dissolves when taken with liquid. The Ohio-based company says its printing system can package potent drug doses of up to 1,000 milligrams into individual tablets. It expects to launch Spritam in the first quarter of 2016. The FDA has previously approved medical devices — including prosthetics — made with 3-D printing. An agency spokeswoman confirmed the new drug is the first prescription tablet approved that uses the process. Aprecia said in a statement it plans to develop other medications using its 3-D platform in coming years, including more neurological drugs. The company is privately owned. Doctors are increasingly turning to 3-D printing to create customized implants for patients with rare conditions and injuries, including children who cannot be treated with adult-size devices. The FDA held a workshop last year for medical manufacturers interested in the technology.  
nypost.com
over 4 years ago
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Medicines for preventing epilepsy following traumatic head injury | Cochrane

Traumatic head injury is a frequent event and can injure the brain. This severe injury is often followed by seizures (fits), which may worsen the damage and can lead to chronic epilepsy, a neurologic disorder characterized by frequent recurrent seizures. Antiepileptic drugs are usually given to suppress already diagnosed seizures. Their role in curing the disease and preventing the development of epilepsy in people who are considered at risk for seizures after any brain injury, including head trauma, is not well understood.  
cochrane.org
over 4 years ago
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Calcium Channel Blockers in Pregnancy Don't Up Neonatal Seizure Risk

Contrary to prior research, a new study reports no increased risk of seizures in neonates born to mothers exposed to CCBs in late pregnancy.  
neurologyadvisor.com
over 4 years ago