The Association Between Seizure Clustering and Convulsive Status Epilepticus in Patients with Intractable Complex Partial Seizures

Haut, Sheryl R.; Shinnar, Shlomo; Moshé, Solomon L.; O’Dell, Christine; Legatt, Alan D.

doi:10.1111/j.1528-1157.1999.tb01607.x

Cited by 85 publications

(66 citation statements)

References 6 publications

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“…Kellaway et al (1981) reported that absence seizures followed a clear ultradian rhythm in patients with high amount of these seizures, but were "essentially random" in patients with little paroxysmal activity. For convulsive epilepsies, Haut et al (1999Haut et al ( , 2002Haut et al ( , 2005 considered seizures as clustered if they occurred three or more times within 24 h. In another paper, these authors defined seizures as clustered, if the expected seizure rate on a given day depended on the number of seizures observed on the immediate prior days (Balish et al, 1991). These latter approaches are less adequate for the case of absence epilepsy, when a patient may have hundreds or even thousand of seizures per day and the seizure activity is easily modulated by external factors.…”

Section: Introductionmentioning

confidence: 99%

Measuring clusters of spontaneous spike-wave discharges in absence epileptic rats

Midzyanovskaya¹,

Strelkov²,

Rijn³

et al. 2006

Journal of Neuroscience Methods

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Section: Introductionmentioning

confidence: 99%

Measuring clusters of spontaneous spike-wave discharges in absence epileptic rats

Midzyanovskaya¹,

Strelkov²,

Rijn³

et al. 2006

Journal of Neuroscience Methods

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“…[3] monitorize edilen dirençli temporal lop epilepsili hastaların %48.3'ünde küme nöbet izlemişlerdir. Baş-ka bir çalışmada ise toplam 91 hastanın kayıtları incelenmiş ve %61.5'inde küme nöbet geliştiği bildirilmiştir.…”

Section: Discussionunclassified

“…Literatürdeki çalışmalarda ise bu süre 3.2-6 gün arasında değişmektedir. [3,4,8,9] Uzun süreli video-EEG monitorizasyonu süresince ortaya çıkan küme nöbetler sırasında izlenen nöbetler tamamen birbirinden bağımsız odaklardan kaynaklanabileceği gibi belirli bir odaktan da kaynaklanabilir. Bu nedenle yazarlara göre monitorizasyon süresince izlenen küme nöbetler predominan epileptik odağın tanımlanmasını zorlaştırır.…”

Section: Discussionunclassified

“…Önceden geçirilmiş status epileptikus/küme nöbet hikayesinin olması uzun süreli video-EEG monitorizasyonu sırasındaki küme nöbet görülme riskini artırdığı gösterilmiştir. [3,5] Bizim çalışmamızda küme nöbet izlenen 21 hastanın %28.6'sının özgeçmişlerinde status epileptikus/küme nöbet hikayesi vardı. Ancak, bu özellikler arasında istatistiksel ilişki kurulamaması hasta sayısının azlığına bağlandı.…”

Section: Discussionunclassified

“…Antiepileptik ilaçların kesilmesi hastanede kalış süresini kısaltarak ekonomik yükü azaltmasına rağmen status epileptikus, küme nöbetler, postiktal psikoz gibi bir takım komplikasyonları da beraberinde getirebilir. [1][2][3] Mevcut tedavilerin kesilmesi ile ortaya çıkan nöbetlerin nedeni, terapotik etkinliğin kaybıyla birlikte bazı ilaçlar için 'rebound: geri tepme' fenomeni ile de ilişkilidir. Antiepileptik ilaçların kesilmesini takiben akut dönemde ortaya çıkan jeneralize tonik klonik nöbet ya da nöbetlerin dirençli status epileptikusla sonlandığı bildirilmiştir.…”

Section: Introductionunclassified

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The Effects of Slow Withdrawal of Antiepileptic Drugs During Long-Term Video-EEG Monitoring on Seizure Clusters and Status Epilepticus

Barçın¹,

Gunal²,

Aktekin³

2013

Epilepsi

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SummaryObjectives: In this retrospective study, frequency of seizure clustering and occurrence of status epilepticus were investigated in patients with drug resistant focal epilepsy who were admitted in long term video-EEG monitoring unit (VEM) for presurgical evaluation. Methods: The VEM records of 49 patients (26 female, 23 male; mean age 26.35±10.2 years) between April 2004-April 2008 were reviewed. Results: Although there was no status epilepticus occured, seizure clustering was observed in 21 (%42.9) patients during VEM. Conclusion: Seizure clustering was common during presurgical VEM. The risk of seizure clustering might be reduced with a slow antiepileptic drugs tapering protocol and to avoid changing the presently used benzodiazepine dosage.Key words: Antiepileptic drugs; drug resistant epilepsy; seizure clustering; status epilepticus; video-EEG monitoring. ÖzetAmaç: Bu geriye dönük çalışmada dirençli epilepsi tanısı ile takip edilen ve cerrahi öncesi epileptik odağın tespiti amacıyla uzun süreli video-EEG monitorizasyonu (VEM) yapılan hastalarda küme nöbet ve status epileptikus gelişme sıklığı araştırıldı. Sonuç: Küme nöbet cerrahi öncesi video-EEG monitorizasyonu sırasında sık görülür. Bununla birlikte antiepileptik ilaçların yavaş kesilmesi ve kullanılmakta olan benzodiazepin dozunda değişiklikten kaçınılması durumunda küme nöbetlerin gelişme riski azalabilir. Gereç ve

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Outpatient management of prolonged seizures and seizure clusters to prevent progression to a higher‐level emergency: Consensus recommendations of an expert working group

Pina‐Garza,

Chez,

Cloyd

et al. 2024

Epileptic Disorders

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ObjectiveThe management of prolonged seizures (PS) and seizure clusters (SC) is impeded by the lack of international, evidence‐based guidance. We aimed to develop expert recommendations regarding consensus definitions of PS, SC, and treatment goals to prevent progression to higher‐level emergencies such as status epilepticus (SE).MethodsAn expert working group, comprising 12 epileptologists, neurologists, and pharmacologists from Europe and North America, used a modified Delphi consensus methodology to develop and anonymously vote on statements. Consensus was defined as ≥75% voting “Agree”/”Strongly agree.”ResultsAll group members strongly agreed that termination of an ongoing seizure in as short a time as possible is the primary goal of rapid and early seizure termination (REST) and that an ideal medication for REST would start to act within 2 min of administration to terminate ongoing seizure activity. Consensus was reached on the terminology defining PS (with proposed thresholds of 5 min for prolonged focal seizures and 2 min for prolonged absence seizures and the convulsive phase of bilateral tonic‐clonic seizures) and SC (an abnormal increase in seizure frequency compared with the individual patient's usual seizure pattern). All group members strongly agreed or agreed that patients who have experienced a PS should be offered a REST medication, and all patients who have experienced a SC should be offered an acute cluster treatment (ACT). Further, when prescribing a REST medication or ACT, a seizure action plan should be agreed upon in consultation with the patient and caregiver.SignificanceThe expert working group had a high level of agreement on the recommendations for defining and managing PS and SC. These recommendations will complement the existing guidance for the management of acute seizures, with the possibility of treating them earlier to potentially avoid progression to more severe seizures, including SE.

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The Association Between Seizure Clustering and Convulsive Status Epilepticus in Patients with Intractable Complex Partial Seizures

Cited by 85 publications

References 6 publications

Measuring clusters of spontaneous spike-wave discharges in absence epileptic rats

Measuring clusters of spontaneous spike-wave discharges in absence epileptic rats

The Effects of Slow Withdrawal of Antiepileptic Drugs During Long-Term Video-EEG Monitoring on Seizure Clusters and Status Epilepticus

Outpatient management of prolonged seizures and seizure clusters to prevent progression to a higher‐level emergency: Consensus recommendations of an expert working group

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