Electrographic status epilepticus and long-term outcome in critically ill children

Wagenman, Katherine L.; Blake, Taylor; Sánchez, Sarah; Schultheis, Maria T.; Radcliffe, Jerilynn; Berg, Robert A.; Dlugos, Dennis J.; Topjian, Alexis; Abend, Nicholas S.

doi:10.1212/wnl.0000000000000082

Cited by 131 publications

(150 citation statements)

References 38 publications

Supporting

Mentioning

143

Contrasting

Order By: Relevance

“…Both HPDs and HVSWs may occur at such high frequency in mice (Table 1) that they might be considered as electrographic SE (ESE), as, for instance, occurring in children with acute neurologic disorders and contributing to secondary brain injury and worse short‐term and long‐term outcomes 54. In patients, ESE is defined as either a single 30‐min electrographic seizure or a series of recurrent independent electrographic seizures totaling more than 30 min in any 1‐h period (50% seizure burden) 54.…”

Section: Discussionmentioning

confidence: 99%

The effects of carbamazepine in the intrahippocampal kainate model of temporal lobe epilepsy depend on seizure definition and mouse strain

Twele¹,

Töllner²,

Bankstahl³

et al. 2016

Epilepsia Open

View full text Add to dashboard Cite

SummaryObjectiveMesial temporal lobe epilepsy (TLE) with hippocampal sclerosis is a predominant form of acquired epilepsy, characterized by recurrent simple and complex partial seizures that are often resistant to treatment. Mice developing spontaneous recurrent nonconvulsive and convulsive seizures after intrahippocampal injection of the excitotoxic glutamate agonist kainate are thought to represent a valuable model of mesial TLE. Epileptic electroencephalogram (EEG) activity recorded in this model from the kainate focus in the ipsilateral hippocampus is resistant to antiseizure drugs such as carbamazepine (CBZ). We compared the efficacy of CBZ in this model in two different mouse strains (FVB/N and NMRI). Furthermore, we evaluated whether changes in the definition of electrographic seizures affect the antiseizure efficacy of CBZ.MethodsAs in previous studies, two types of epileptic EEG activity were defined: high‐voltage sharp waves (HVSWs) and hippocampal paroxysmal discharges (HPDs). The characteristics of these paroxysmal EEG events in epileptic mice were compared with EEG criteria for nonconvulsive seizures in patients. For HVSWs, different spike frequencies, interevent intervals, and amplitudes were used as inclusion and exclusion criteria. In addition to CBZ, some experiments were performed with diazepam (DZP) and phenobarbital (PB).ResultsFemale epileptic FVB/N mice predominantly exhibited frequent HVSWs, but only infrequent HPDs or secondarily generalized convulsive seizures. Slight changes in HVSW definition determined whether they were resistant or responsive to CBZ. Male NMRI mice exhibited both HVSWs and HPDs. HVSWs were more resistant than HPDs to suppression by CBZ. Both types of epileptic EEG activity were rapidly suppressed by DZP and PB.SignificanceThe data demonstrate that focal electrographic seizures in the intrahippocampal kainate mouse model are less resistant than previously thought. Both mouse strain and the criteria chosen for definition of EEG seizures determine whether such seizures are drug‐resistant or ‐responsive.

show abstract

Section: Discussionmentioning

confidence: 99%

The effects of carbamazepine in the intrahippocampal kainate model of temporal lobe epilepsy depend on seizure definition and mouse strain

Twele¹,

Töllner²,

Bankstahl³

et al. 2016

Epilepsia Open

View full text Add to dashboard Cite

show abstract

“…Compared to short seizures, convulsive or electrographic‐only SE45 has a negative impact on the long‐term QoL 5. However, population‐based studies comparing adults with childhood‐onset epilepsy with or without SE showed no association with educational attainment, employment status, and income 33.…”

Section: Long‐term Outcomes Of Sementioning

confidence: 99%

“…Long‐term mortality data after an episode of SE, including in‐hospital deaths, is 0%‐22% in children5, 6, 17, 26, 27, 28, 29, 33, 34, 35, 37, 38, 45, 53 and 0%‐57% in adults 10, 11, 12, 17, 19, 20, 43, 54…”

Section: Long‐term Outcomes Of Sementioning

confidence: 99%

“…In adults, etiologies associated with poor outcome include hypoxia,7, 8, 13 acute symptomatic,12, 20, 44, 45, 55 and progressive symptomatic causes 9, 12. In children, many studies have pointed out remote29, 35, 36 and acute6, 17, 24, 26, 71 symptomatic causes, progressive encephalopathies,17, 26, 35, 36 or more extensively “nonfebrile‐nonidiopathic SE”28 as predictors of poor outcome.…”

Section: Factors Affecting Outcomementioning

confidence: 99%

See 1 more Smart Citation

Long‐term outcomes of status epilepticus: A critical assessment

et al. 2018

View full text Add to dashboard Cite

SummaryWe reviewed 37 studies reporting long‐term outcomes after a status epilepticus (SE) episode in pediatric and adult populations. Study design, length of follow‐up, outcome measures, domains investigated (mortality, SE recurrence, subsequent epilepsy, cognitive outcome, functional outcome, or quality of life), and predictors of long‐term outcomes are summarized. Despite heterogeneity in the design of prior studies, overall risk of poor long‐term outcome after SE is high in both children and adults. Etiology is the main determinant of outcome, and the effect of age or SE duration is often difficult to distinguish from the underlying cause. The effect of the treatment on long‐term outcome after SE is still unknown.

show abstract

“…It is characterized by an enduring predisposition to generate spontaneous seizures often associated with cognitive and psychiatric comorbidities with negative social consequences. One major clinical need in epilepsy is to identify antiepileptogenesis treatments for preventing or arresting the development of the disease in patients who have been exposed to potentially epileptogenic brain insults, including status epilepticus (SE) (Holtkamp et al, 2005;Wagenman et al, 2014). The development of such treatments has been hampered by the lack of non-invasive biomarkers that could be used to identify the patients at-risk, thereby allowing to design affordable clinical studies (Engel et al, 2013;Pitkanen and Engel, 2014).…”

Section: Introductionmentioning

confidence: 99%

Cognitive deficits and brain myo-Inositol are early biomarkers of epileptogenesis in a rat model of epilepsy

Pascente

Frigerio

Rizzi

et al. 2016

Neurobiology of Disease

View full text Add to dashboard Cite

Cognitive deficits and brain myoInositol are early biomarkers of epileptogenesis in a rat model of epilepsy, Neurobiology of Disease (2016Disease ( ), doi: 10.1016Disease ( /j.nbd.2016 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. A C C E P T E DM A N U S C R I P T ACCEPTED MANUSCRIPT AbstractOne major unmet clinical need in epilepsy is the identification of therapies to prevent or arrest epilepsy development in patients exposed to a potential epileptogenic insult. The development of such treatments has been hampered by the lack of non-invasive biomarkers that could be used to identify the patients at-risk, thereby allowing to design affordable clinical studies. Our goal was to test the predictive value of cognitive deficits and brain astrocyte activation for the development of epilepsy following a potential epileptogenic injury. We used a model of epilepsy induced by pilocarpine-evoked status epilepticus (SE) in 21-day old rats where 60-70% of animals develop spontaneous seizures after around 70 days, although SE is similar in all rats. Learning was evaluated in the Morris water-maze at days 15 and 65 post-SE, each time followed by proton magnetic resonance spectroscopy for measuring hippocampal myo-Inositol levels, a marker of astrocyte activation. Rats were video-EEG monitored for two weeks at seven months post-SE to detect spontaneous seizures, then brain histology was done. Behavioral and imaging data were retrospectively analysed in epileptic rats and compared with non epileptic and control animals. Rats displayed spatial learning deficits within three weeks from SE. However, only epilepsy-prone rats showed accelerated forgetting and reduced learning rate compared to both rats not developing epilepsy and controls. These deficits were associated with reduced hippocampal neurogenesis. myoInositol levels increased transiently in the hippocampus of SE-rats not developing epilepsy while this increase persisted until spontaneous seizures onset in epilepsy-prone rats, being associated with a local increase in S100-positive astrocytes. Neuronal cell loss was similar in all SE-rats. Our data show that behavioral deficits, together with a non-invasive marker of astrocyte activation, predict which rats develop epilepsy after an acute injury. These measures have potential clinical relevance for identifying individuals at-risk for developing epilepsy following exposure to epileptogenic insults, and consequently, for designing adequately powered antiepileptogenesis trials.

show abstract

Electrographic status epilepticus and long-term outcome in critically ill children

Cited by 131 publications

References 38 publications

The effects of carbamazepine in the intrahippocampal kainate model of temporal lobe epilepsy depend on seizure definition and mouse strain

The effects of carbamazepine in the intrahippocampal kainate model of temporal lobe epilepsy depend on seizure definition and mouse strain

Long‐term outcomes of status epilepticus: A critical assessment

Cognitive deficits and brain myo-Inositol are early biomarkers of epileptogenesis in a rat model of epilepsy

Contact Info

Product

Resources

About