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Psychiatric Disorders and Epilepsy
Published in Stanley R. Resor, Henn Kutt, The Medical Treatment of Epilepsy, 2020
Gregory L. Krauss, Ronald P. Lesser
Nonconvulsive status epilepticus is a rare ictal state in which stupor is due to prolonged or recurrent absence seizures or CPSs (11). Patients often appear confused, but many patients are able to answer simple questions and perform simple behaviors such as adjusting clothing or turning over. Some patients may develop a more severe encephalopathy and may exhibit subtle signs of clonic activity in the face and limbs or pupillary abnormalities. With absence status epilepticus, the EEG demonstrates frequent generalized 2- to 4-per-second spike-wave and polyspike discharges. During complex partial status epilepticus there are continuous or frequent, usually focal, epileptiform discharges with diffuse slowing in the EEG. Most patients have histories of absences or CPSs, although nonconvulsive status epilepticus can be the first manifestation of a seizure disorder. Common seizure precipitants are ischemic, toxic, and metabolic insults.
Unexplained Fever In Neurological Disorders
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
The simultaneous occurrence of seizures and unexplained fever in adults is extremely rare. There are only four reports entitled fever and epilepsy.84-87 However, in the first three, epilepsy was not confirmed. The claim for the coexistence of well documented febrile episodes and epileptic phenomena is based on the presence of rage attacks or the demonstration of spikes in the EEG during the febrile episodes and the favorable response of the fever to anticonvulsants.87-89 The only well-documented case had numerous febrile episodes lasting from 24 to 72 h during which complex partial status epilepticus was observed.90 Extensive fever and neurological work-up was negative and only one out of a number of EEGs was compatible with temporal lobe epileptic discharge.
The Psychiatric Interview
Published in Mohamed Ahmed Abd El-Hay, Essentials of Psychiatric Assessment, 2018
The use of electroencephalography in the differentiation of psychiatric disorders is fairly limited. However, an electroencephalogram can be very useful when a patient has altered mental status, such as delirium or encephalopathy. It can be useful for distinguishing between possible diagnoses, e.g.: It can diagnose complex partial status epilepticus, in cases of altered consciousness and abnormal behavior. However, normal EEG does not exclude seizure disorder from the differential diagnosis, because 20 percent of patients with epilepsy will have normal EEGs, and 2 percent of patients without epilepsy will have spike and wave formation.The EEG is also useful for distinguishing some specific etiologies of encephalopathy; it might show the di- and triphasic waves characteristic of renal failure, hepatic failure, or anoxia.In comatose patients, the EEG can be very valuable for identifying the level of nervous system impairment; it can show an alpha coma pattern or a theta coma pattern characteristic of brainstem lesions producing coma or it may show a delta coma pattern characteristic of bihemispheric disease. In catatonic patients, the EEG has a normal awake-look.The EEG may detect sleep abnormalities consistent with sleep apnea, rapid eye movement sleep behavior disorder, or narcolepsy.
Distinct effects of resveratrol on seizures and hyperexcitability induced by NMDA and 4-aminopyridine
Published in Nutritional Neuroscience, 2019
Ya-Jean Wang, Chung-Pin Hsieh, Ming-Huan Chan, Tzu-Yi Chan, Linyi Chen, Hwei-Hisen Chen
It is widely accepted that NMDA receptors may play a key role in the pathophysiology of epilepsy. NMDA receptor antagonists provide an anticonvulsant activity to suppress seizures in several epilepsy models.23–25 In fact, the compounds with NMDA receptor antagonistic property such as felbamate and MgSO4 are already in use for the treatment of epileptic seizures. Furthermore, NMDA receptor blocker ketamine has been clinically utilized for treating seizures and refractory status epilepticus, which is defined as either generalized or complex partial status epilepticus that fails to respond to first and second line therapies.26 In addition, NMDA receptors are believed to be responsible for the seizure-induced selective excitotoxic cell death.27 Taken together, NMDA receptors are thought to be a promising target for novel antiepileptic strategies.