Download Seizures in Critical Care: A Guide to Diagnosis and by Panayiotis Varelas PDF

By Panayiotis Varelas

A panel of foreign ICU and epilepsy physicians and researchers aspect the epileptic phenomena that happen within the advanced atmosphere of the ICU. concentrating on the imperative apprehensive process, the authors systematically research the main up to date evidenced-based info concerning ICU seizures, together with their so much common reasons, their pathophysiology, their medical presentation, and the diagnostic assessment had to make sure their presence. in addition they talk about the demanding situations and specifics of the administration of ICU seizures, reviewing the hot antiepileptics and their interplay with different ICU medicines, medicinal drugs with epileptogenic houses utilized in the ICU, and the position of the hot enterally to be had antiepileptics in treating seizures. quite a few tables summarize drug interactions, neuroimages demonstrate universal ICU seizure etiologies, and a number of electroencephalographic recordings display scientific or subclinical seizures in ICU sufferers.

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Additional resources for Seizures in Critical Care: A Guide to Diagnosis and Therapeutics

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Table 1 summarizes the aforementioned studies of stroke and seizures, as well as percentages of early, late, recurrent (epilepsy), or total seizures. Status Epilepticus SE is defined as a seizure or a series of repetitive seizures that lasts more than 30 min without recovery between episodes (43,44). SE may be an additional risk factor for increased mortality and morbidity after stroke through systemic metabolic changes, increased risk for herniation secondary to elevated intracranial pressure, cardiac arrhythmias leading to sudden death, or increased risk of aspiration pneumonia (41).

Early seizures were reported in 13 of 118 (11%) patients, with seizures and late seizures in 66 of 118 (66%). However, this study has several limitations, including 42 of 118 patients with unknown interval between seizure and stroke onset. 5%) with a first seizure had silent infarcts proven by CT of the head and no history of stroke. In patients with a single infarct (excluding lacunae and border zone infarcts), the frontal and the temporal lobes were the most commonly involved lobes, either solely or partially (58% each), followed by the parietal lobe (43%) and the occipital lobe (20%).

Early seizures (within 1 wk) occurred in 57% of those patients (39% within the first day). By the first year 88% of those 83 patients had seizures. Mortality during the first week was not different in patients with and without seizures. In a retrospective analysis of 90 patients with postischemic stroke seizures, immediate seizures (defined as occurring within 24 h) were observed in 30% and early seizures (within 2 wk) in 33% (32). Overall, 98% of the initial poststroke seizures were observed within 2 yr.

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