Acute Provoked Seizures—Work-Up and Management in Adults

Moosavi, Rana; Swisher, Christa B.

doi:10.1055/s-0040-1719075

Cited by 4 publications

(8 citation statements)

References 64 publications

(127 reference statements)

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“…No epileptiform discharges were observed on video electroencephalogram (VEEG) after admission for any of the patients. Magnetic resonance imaging indicated that only patient 2 exhibited a brain lesion in the left frontal lobe that was a probable epileptic focus 14 …”

Section: Case Reportmentioning

confidence: 99%

“…Magnetic resonance imaging indicated that only patient 2 exhibited a brain lesion in the left frontal lobe that was a probable epileptic focus. 14 We summarized the results from the laboratory tests for CK, myoglobin, electrolytes, and the estimated glomerular filtration rate (eGFR) because we focused on the seizure-induced elevation of CK and its complications. The interval between the first onset to admission (IT) ranged from 1 to 3 days.…”

Section: Case Reportmentioning

confidence: 99%

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Characteristics and treatments of patients with significantly elevated creatine kinase levels induced by seizures: Case report and literature review

Wang,

Yang,

et al. 2023

Clinical Case Reports

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Key Clinical MessageMotor signs accompanying seizures have been considered to result in overexertion of muscles and have the ability to cause elevated levels of serum creatine kinase (CK). There were no previous studies on the treatment of seizure‐induced elevated CK. We summarized the characteristics and treatments of six patients with significant elevation of CK after seizure onset. There were four males and two females, the age range was 16–68 years. The CK levels were greater than 5000 U/L in five of the six patients and the highest CK level was 39,300 U/L. All patients exhibited an estimated glomerular filtration rate (eGFR) < 90 mL/min/1.73m2. No patient developed renal failure or required continuous renal replacement therapy. We determined that serial assessment of CK, myoglobin, eGFR, and electrolytes should be performed in patients following seizures. Furthermore, fluid resuscitation, urine alkalization, and diuretic agents should be administrated when CK are significantly elevated after seizure onset. Serial assessment of CK levels after seizures should be performed, especially when the patient experiences electrolyte disorders. Fluid resuscitation, urine alkalization, and diuretic agents also should be administrated to patients when they exhibit a significantly elevated CK or myoglobin after seizures.

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Section: Case Reportmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

Characteristics and treatments of patients with significantly elevated creatine kinase levels induced by seizures: Case report and literature review

Wang,

Yang,

et al. 2023

Clinical Case Reports

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“…Acute provoked seizures, which are also called acute symptomatic seizures, are the first occurrence of a seizure in a given patient, usually caused by a neurological or systemic event triggering the seizure activity. 5 This type of seizure occurs due to a variety of conditions, most commonly including cerebrovascular disease, infections, trauma, drug toxicity, life-threatening metabolic derangements, autoimmune/inflammatory conditions, and neoplastic diseases. 6 Unprovoked seizures occur in the absence of any apparent trigger or acute cause and tend to be recurring in character.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of bedside optic nerve sheath diameter measurement in differentiating provoked seizure from unprovoked seizure in the emergency department

et al. 2023

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BACKGROUND: Emergency departments (EDs) are typically the first medical contact for seizure patients, and early diagnosis and treatment is primarily the responsibility of emergency physicians. OBJECTIVES: Demonstrate the efficacy of bedside ocular ultrasonography for optic nerve sheath diameter (ONSD) measurement in differentiating provoked seizure from unprovoked seizure in the ED. DESIGN: Prospective observational study SETTINGS: Tertiary care hospital PATIENTS AND METHODS: Patients presenting to the ED with seizure were divided into two groups according to medical history, physical examination, laboratory results, cranial computed tomography findings and electroencephalography results. Patients with seizures that did not have a specific cause (unprovoked) were compared with patients who had seizures caused by underlying pathology (provoked). The measurement of the ONSD was taken at the bedside within 30 minutes of arrival. The study compared the ONSD values, age, sex, type of seizure, and Glasgow Coma Score between the two groups. MAIN OUTCOME MEASURE: Efficacy of ONSD to distinguish between provoked and unprovoked seizures. SAMPLE SIZE: 210 patients RESULTS: One hundred and fourteen (54.3%) patients were in the provoked seizure group and 96 (45.7%) were in the unprovoked seizure group. The ONSD measurements were significantly higher in the provoked seizure group compared with the unprovoked seizure group (median 6.1 mm vs. 5.2 mm, P <.001). The cut-off value of ONSD higher than 5.61 was significantly associated with the prediction of the provoked seizure ( P <.001). The area under the curve value was 0.882 (95% CI: 0.830-0.922) with a sensitivity of 86.5 and specificity of 78.9%. CONCLUSIONS: Bedside ONSD measurement by means of ocular ultrasound is an effective method for differentiating provoked seizure from unprovoked seizure. LIMITATIONS: Statistical significance of age on ONSD and exclusion of pediatric patients. CONFLICT OF INTEREST: None.

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“…Acute provoked seizures are triggered by specific factors (such as head trauma, fever, metabolic imbalances, and infections, or an isolated event such as brain injury). [14,15] They occur in response to the imminent presence of the provocateur and are typically isolated occurrences of any age. Once the triggering factor is treated or eliminated, these seizures typically cease.…”

Section: Introductionmentioning

confidence: 99%

“…Once the triggering factor is treated or eliminated, these seizures typically cease. [15] EEG findings may be normal or may reveal abnormalities related to the underlying cause. [15] Early-onset epilepsies, on the other hand, are a group of epileptic disorders that typically manifest in infancy or early childhood.…”

Section: Introductionmentioning

confidence: 99%

Neonatal seizures: Etiologies, clinical characteristics, and radiological features: A cross-sectional study

Almuqbil,

Alrumayyan,

Alattas

et al. 2023

Medicine

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Seizures are a common clinical indication of central nervous system damage or abnormality in neonates. We aimed to identify the etiologies, clinical characteristics, and radiological features of neonatal seizures. This is a cross-sectional, retrospective, descriptive study using data obtained from the neonatal intensive care unit in King Abdulaziz Medical City (KAMC), a governmental, academic tertiary hospital in Riyadh, Saudi Arabia. The population of interest were neonates diagnosed with a neonatal seizure at KAMC between April 2015 and March 2019. A total of 61 patients with neonatal seizures were included in the study. The most common etiology was hypoxic-ischemic encephalopathy (43%). A total of 32 patients were full-term (52.5%). Around one-fifth of the study sample (21.3%) had a family history of neonatal seizures. Around 43.0% of the patients had epilepsy episodes. More than half of the patients (57.0%) were on one anti-seizure medication. Patients were followed up after 1 year, they had multiple comorbidities, including developmental delay, epilepsy, and cerebral palsy. Developmental delay was identified in 62.3% of the patients. A total of 19 patients have passed away (31%). Neonatal seizures are a common manifestation of neurologic disorders in neonates and are associated with high morbidity and mortality. Therefore, early identification of seizure etiology and proper management may help to improve the outcome.

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Acute Provoked Seizures—Work-Up and Management in Adults

Cited by 4 publications

References 64 publications

Characteristics and treatments of patients with significantly elevated creatine kinase levels induced by seizures: Case report and literature review

Characteristics and treatments of patients with significantly elevated creatine kinase levels induced by seizures: Case report and literature review

Efficacy of bedside optic nerve sheath diameter measurement in differentiating provoked seizure from unprovoked seizure in the emergency department

Neonatal seizures: Etiologies, clinical characteristics, and radiological features: A cross-sectional study

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