A5102990583- Epilepsy research and treatment
- Pharmacological Effects and Toxicity Studies
- Neuroscience and Neuropharmacology Research
- Neonatal and fetal brain pathology
- Metabolism and Genetic Disorders
- Diet and metabolism studies
- Cardiac Arrest and Resuscitation
- Anesthesia and Sedative Agents
- Mitochondrial Function and Pathology
- Neurological disorders and treatments
- Botulinum Toxin and Related Neurological Disorders
- Infectious Encephalopathies and Encephalitis
- EEG and Brain-Computer Interfaces
- Cerebrovascular and genetic disorders
- Neurology and Historical Studies
- Neurological and metabolic disorders
- Alcoholism and Thiamine Deficiency
- Nerve Injury and Rehabilitation
- Drug Transport and Resistance Mechanisms
- Coronary Interventions and Diagnostics
- Electroconvulsive Therapy Studies
- Dysphagia Assessment and Management
- ICT Impact and Policies
- Glycogen Storage Diseases and Myoclonus
- Genomics and Rare Diseases
University of California, San Francisco
2011-2024
Universidad Católica de Santa Fe
2020-2024
University of Michigan
2020-2021
Medical University of South Carolina
2021
Massachusetts General Hospital
2021
The Ohio State University Wexner Medical Center
2021
NewYork–Presbyterian Hospital
2021
Oxford University Press (United Kingdom)
2020
W. M. Keck Foundation
2020
Johns Hopkins Hospital
2018
The optimal pharmacologic treatment for early convulsive status epilepticus is unclear.
Early termination of prolonged seizures with intravenous administration benzodiazepines improves outcomes. For faster and more reliable administration, paramedics increasingly use an intramuscular route.This double-blind, randomized, noninferiority trial compared the efficacy midazolam that lorazepam for children adults in status epilepticus treated by paramedics. Subjects whose convulsions had persisted than 5 minutes who were still convulsing after arrived given study medication either...
The choice of drugs for patients with status epilepticus that is refractory to treatment benzodiazepines has not been thoroughly studied.In a randomized, blinded, adaptive trial, we compared the efficacy and safety three intravenous anticonvulsive agents - levetiracetam, fosphenytoin, valproate in children adults convulsive was unresponsive benzodiazepines. primary outcome absence clinically evident seizures improvement level consciousness by 60 minutes after start drug infusion, without...
We retrospectively reviewed the clinical course of adult patients treated for generalized status epilepticus (SE) at San Francisco General Hospital (SFGH) from 1980 to 1989. The review was designed determine whether etiologies SE our hospital have changed over last two decades, and investigate relationships between etiology, response anticonvulsant therapy, short-term outcome. Of 154 reviewed, four leading were drug withdrawal (39), alcohol-related toxicity (14), CNS infection (12). This...
<b>BACKGROUND AND PURPOSE:</b> Analysis of the prevertebral soft tissue (PVST) is helpful in detecting osseous and ligamentous injuries cervical spine. Because standard care has shifted from radiographs to multidetector CT (MDCT), a re-examination PVST on MDCT images needed establish normal values for thickness appropriate this imaging technique. <b>MATERIALS METHODS:</b> Thickness was measured 192 patients undergoing screening spine with multiplanar reconstructions as part trauma protocol....
We report our experience using barbiturate anesthesia for the treatment of refractory status epilepticus. Following a retrospective review eight patients treated with variety barbiturates and dosing regimens, we established specific protocol employing pentobarbital evaluated it prospectively in six patients. Among 14 patients, intravenous barbiturates, when administered loading dose followed by continuous infusion, were uniformly effective aborting seizures producing burst-suppression EEG...
Summary Early treatment of prolonged seizures with benzodiazepines given intravenously by paramedics in the prehospital setting has been shown to be associated improved outcomes. However, an increasing number Emergency Medical System (EMS) protocols use intramuscular (IM) route because it is faster and consistently achievable. RAMPART (Rapid Anticonvulsant Medication Prior Arrival Trial) a double‐blind randomized clinical trial determine if efficacy IM midazolam noninferior margin 10% that...
Status epilepticus is a common neurologic emergency with significant associated morbidity, mortality, and health care costs, yet limited data exist detailing trends in status epilepticus-related hospitalizations mortality.To examine mortality.We performed 2 retrospective serial cross-sectional studies including 408 304 hospital visits using generalizable national from January 1, 1999, to December 31, 2010, the Centers for Disease Control Prevention Nationwide Inpatient Sample. death...
Abstract Objective This study was undertaken to describe patterns of benzodiazepine use as first‐line treatment status epilepticus (SE) and test the association doses with response second‐line agents in patients enrolled Established Status Epilepticus Treatment Trial (ESETT). Methods Patients refractory an adequate dose benzodiazepines for SE were ESETT. Choice benzodiazepine, given prior administration agent, route administration, setting, patient weight characterized. These compared...
We retrospectively evaluated the clinical and EEG features of status epilepticus (SE) in 47 comatose adult patients whom SE was suspected clinically or because revealed repetitive electrographic seizures continuous spike-and-wave activity. Three groups were identified. Group-1 (n = 33) had both on EEG. They usually subtle, clonic movements restricted to eyes, face, upper extremities, most commonly showed Group-2 9) also subtle motor manifestations seizures, but not that SE, consisting either...
Pentobarbital coma (PBC) is a treatment for patients with refractory status epilepticus, but there are currently few guidelines choosing when to initiate or continue this therapy. To identify potential prognostic factors in setting, we reviewed the course of 17 adult treated standardized protocol PBC epilepticus over past 6 years. was extremely effective aborting seizures 16 patients, 11 developed severe hypotension that required therapy vasopressors. Six had full recoveries only minimal...
We assessed the severity and temporal profile of distant neuromuscular effects from a single dose (280 units) botulinum neurotoxin injected into neck muscles for torticollis. performed single-fiber EMG studies on biceps brachii six patients to measure jitter (20 pairs) fiber density initial treatment day then again, at least once more, after 2 12 weeks. No patient developed weakness beyond or decrement response repetitive 3-Hz nerve stimulation. Between baseline last follow-up study, average...
Twenty patients with torticollis had electromyographic studies of their neck muscles performed before and after a series local injections botulinum toxin. The pattern muscle activity changed the injections, this effect persisted even head position returned to baseline. Patients who did not experience any clinical benefit from also demonstrated change in activity. These results suggest that underlying abnormality usually involves general motor program for position, rather than individual muscles.
Summary Benzodiazepine‐refractory status epilepticus (established epilepticus, ESE) is a relatively common emergency condition with several widely used treatments. There are no controlled, randomized, blinded clinical trials to compare the efficacy and tolerability of currently available treatments for ESE. The ESE treatment trial designed determine most effective and/or least among patients older than 2 years by comparing three arms: fosphenytoin ( fPHT ) levetiracetam (LVT), valproic acid...
Summary Objective To examine the effectiveness of intramuscular ( IM ) midazolam versus intravenous IV lorazepam for treatment pediatric patients with status epilepticus SE in prehospital care setting. Methods This multicenter clinical trial randomized diagnosed to receive either or administered by paramedics Included this secondary analysis were only younger than 18 years age. Evaluated associations group vs. primary outcome, defined as seizure cessation prior emergency department ED...
The optimal therapeutic approach for the patient with refractory generalized status epilepticus remains to be defined. We describe four patients who were successfully treated intravenous midazolam. Each had prolonged convulsive unresponsive standard doses of benzodiazepines, phenytoin, and phenobarbital. subsequently received midazolam administered as an bolus (200 μg/Kg) followed by a continuous infusion (0.75 11 μg/kg/min) lasting 8 hours 10 days. Clinical examination scalp...
The field of epilepsy research has undergone a dramatic transformation in the past decade. However, substantial gaps exist our understanding epilepsy, from its causes and prevention to clinical impact treatment. In March 2000, prominent scientists, health care providers, leaders organizations came together for seminal conference discuss what it would take reach cure defined as people at risk, by effective safe therapy ("no seizures, no side effects") those with disorder. Cosponsored National...