Pregabalin for Recurrent Seizures in Critical Illness: A Promising Adjunctive Therapy, Especially for cyclic Seizures

Busl, Katharina M.; Fong, Michael W.; Newcomer, Zachary; Patel, Mitesh; Cohen, Scott; Jadav, Rakesh; Smith, C.W.; Mitropanopoulos, Sotiris; Bruzzone, Maria; Hella, Maria; Eisenschenk, Stephan; Robinson, Carol; Roth, William; Ameli, Pouya; Babi, Marc-Alain; Pizzi, Michael; Gilmore, Emily J.; Hirsch, Lawrence J.; Maciel, Carolina B.

doi:10.1007/s12028-022-01459-6

Cited by 2 publications

(2 citation statements)

References 28 publications

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“…A second study by Dhakal et al 15 of gabapentin in post‐SAH patients noted that opioid use was decreasing as gabapentin dosing was increased in these patients, but the primary outcome of the study was safety and tolerability in which only minimal adverse effects were noted in these patients. Additionally, the actions of gabapentinoids confer the additional benefits of their anxiolytic, antiemetic, and antiseizure properties 9,67,68 . The antiseizure effects of gabapentinoids may be of particular interest as epilepsy is a known complication of SAH, with an incidence ranging from 0.9% to 25%, and despite a paucity of studies focusing on SAH, Alvarez‐Sabín et al 69 demonstrated 80% seizure remission in post‐stroke epilepsy with gabapentin monotherapy.…”

Section: Methodsmentioning

confidence: 99%

“…Additionally, the actions of gabapentinoids confer the additional benefits of their anxiolytic, antiemetic, and antiseizure properties. 9,67,68 The antiseizure effects of gabapentinoids may be of particular interest as epilepsy is a known complication of SAH, with an incidence ranging from 0.9% to 25%, and despite a paucity of studies focusing on SAH, Alvarez-Sabín et al 69 demonstrated 80% seizure remission in post-stroke epilepsy with gabapentin monotherapy. Although not extensively studied in post-SAH headache, there is some promising evidence that these medications could be effective analgesics while also decreasing seizure risk and potentially having a more benign side-effect profile than opioids or medications that could increase risk of re-bleed, such as non-steroidal anti-inflammatory drugs (NSAIDs).…”

Section: Gabapentinoids and Cortical Spreading Depressionmentioning

confidence: 99%

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Headache persisting after aneurysmal subarachnoid hemorrhage: A narrative review of pathophysiology and therapeutic strategies

et al. 2022

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Objective This narrative review of the literature concerns persistent headache attributed to past non‐traumatic subarachnoid hemorrhage (SAH), based off demographic and clinical features, what are pathophysiologic mechanisms by which these headaches occur, which medical and interventional treatments have the most evidence for pain alleviation, and what pre‐clinical evidence is there for emerging treatments for these patients. Background Following initial stabilization and treatment of spontaneous SAH, most commonly due to aneurysmal rupture, headache in the immediate inpatient setting and persisting after discharge are an important cause of morbidity. These headaches often receive heterogenous treatment of uncertain efficacy, and the risk factors and pathophysiology of their development has received little study. Methods A narrative review of current literature discussing post‐SAH headache was conducted using a literature search in PubMed with search term combinations including “post subarachnoid hemorrhage pain”, “subarachnoid hemorrhage headache”, and “post subarachnoid hemorrhage headache”. Clinical studies mentioning headache after SAH and/or treatment in the abstract/title were included through March, 2022. Results and Conclusion Post‐SAH headaches are shown to decrease quality of life, have a multi‐modal pathophysiology in their occurrence, and only a select few medications (reviewed herein) have been demonstrated to have efficacy in alleviation of these headaches, while also harboring possible risks including vasospasm and re‐bleeding. An effective treatment paradigm of these headaches will include trials of evidence‐based therapeutics, rapid reduction of opioid medications if not effective, and consideration of multi‐modal pain control strategies including nerve blocks.

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Section: Methodsmentioning

confidence: 99%

Section: Gabapentinoids and Cortical Spreading Depressionmentioning

confidence: 99%

Headache persisting after aneurysmal subarachnoid hemorrhage: A narrative review of pathophysiology and therapeutic strategies

et al. 2022

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Utility of Quantitative EEG in Neurological Emergencies and ICU Clinical Practice

Veciana de las Heras,

Sala-Padro,

Pedro-Perez

et al. 2024

Brain Sciences

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The electroencephalogram (EEG) is a cornerstone tool for the diagnosis, management, and prognosis of selected patient populations. EEGs offer significant advantages such as high temporal resolution, real-time cortical function assessment, and bedside usability. The quantitative EEG (qEEG) added the possibility of long recordings being processed in a compressive manner, making EEG revision more efficient for experienced users, and more friendly for new ones. Recent advancements in commercially available software, such as Persyst, have significantly expanded and facilitated the use of qEEGs, marking the beginning of a new era in its application. As a result, there has been a notable increase in the practical, real-world utilization of qEEGs in recent years. This paper aims to provide an overview of the current applications of qEEGs in daily neurological emergencies and ICU practice, and some elementary principles of qEEGs using Persyst software in clinical settings. This article illustrates basic qEEG patterns encountered in critical care and adopts the new terminology proposed for spectrogram reporting.

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Pregabalin for Recurrent Seizures in Critical Illness: A Promising Adjunctive Therapy, Especially for cyclic Seizures

Cited by 2 publications

References 28 publications

Headache persisting after aneurysmal subarachnoid hemorrhage: A narrative review of pathophysiology and therapeutic strategies

Headache persisting after aneurysmal subarachnoid hemorrhage: A narrative review of pathophysiology and therapeutic strategies

Utility of Quantitative EEG in Neurological Emergencies and ICU Clinical Practice

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