Abstract:
INTRODUCTION:Status epilepticus remains a life-threatening condition that afflicts both adults and children which although occurs in patients with epilepsy, often presents as new-onset seizure activity also. Refractory status epilepticus poses a management challenge for neurological and neurosurgical teams. CASE REPORT AND METHODS:Subdural grid electrodes were used to record cortical discharges and guide tumor resection involving eloquent cortex and multiple subpial transections in a 48-year-old man with left hemiparesis in status epilepticus. He had been refractory to multiple medical therapies in persistent epilepsia partialis continua for a prolonged period. As an alternative to higher-dose suppressive medical therapy, the patient elected to proceed with subdural grid mapping after seizure semiology ("negative" scalp electroencephalogram) localized the seizure focus to the right hemisphere, motor cortex. Following tumor removal, multiple subpial transections were subsequently performed over large areas of the motor and sensory strips and successfully resolved the status epilepticus. RESULTS:The patient made an excellent recovery, became seizure free, had improved left-sided strength and was discharged home shortly after. CONCLUSION:This case illustrates a potentially life-saving technique for the treatment of refractory status epilepticus. Multiple subpial transections and other neurosurgical intervention should be considered for patients with status epilepticus. When localization with surface electrodes is poor, especially in eloquent cortex, subdural grid recording can be used to direct focal resection and/or multiple subpial transections to minimize neurological deficits. A review and summary of previously published neurosurgery cases for status epilepticus is discussed.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Ng YT,Bristol RE,Schrader DV,Smith KAdoi
10.1007/s12028-007-0038-4subject
Has Abstractpub_date
2007-01-01 00:00:00pages
86-91issue
1eissn
1541-6933issn
1556-0961journal_volume
7pub_type
杂志文章abstract::Neurocritical care relies on the continuous, real-time measurement of numerous physiologic parameters. While our capability to obtain such measurements from patients has grown markedly with multimodal monitoring in many neurologic or neurosurgical intensive care units (ICUs), our ability to transform the raw data into...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-013-9872-8
更新日期:2014-02-01 00:00:00
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journal_title:Neurocritical care
pub_type: 临床试验,杂志文章
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更新日期:2007-01-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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journal_title:Neurocritical care
pub_type: 杂志文章
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journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-010-9468-5
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pub_type: 杂志文章,评审
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journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-014-9981-z
更新日期:2014-10-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-012-9747-4
更新日期:2012-12-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-007-0040-x
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journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-008-9178-4
更新日期:2009-01-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s12028-012-9703-3
更新日期:2012-10-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-013-9886-2
更新日期:2013-12-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1385/NCC:3:3:195
更新日期:2005-01-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-017-0379-6
更新日期:2017-08-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s12028-018-0631-8
更新日期:2019-04-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-012-9760-7
更新日期:2012-09-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-011-9593-9
更新日期:2011-09-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
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更新日期:2017-12-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章
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更新日期:2011-12-01 00:00:00
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章
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更新日期:2020-02-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-010-9400-z
更新日期:2010-10-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1385/ncc:6:1:40
更新日期:2007-01-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-015-0236-4
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Cerebral edema, which is associated with increased intracranial fluid, is often a complication of many acute neurological conditions. There is currently no accepted method for real-time monitoring of intracranial fluid volume at the bedside. We evaluated a novel noninvasive technique called "Volumetric Integ...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-017-0409-4
更新日期:2018-02-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章,多中心研究
doi:10.1007/s12028-016-0343-x
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Neurogenic pulmonary edema (NPE) is an acute life-threatening complication associated with many forms of central nervous system injury. NPE usually appears within minutes to hours after injury and has a high mortality rate if not recognized and treated appropriately. Lung ultrasound quickly provides at the b...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-013-9828-z
更新日期:2013-06-01 00:00:00
abstract:INTRODUCTION:A case of cefepime-induced nonconvulsive status epilepticus in a 15-year-old child with end stage renal disease on hemodialysis is reported. Clinical symptoms and EEG dramatically improved 48 h after discontinuation of cefepime. METHODS:Twenty-five cases of nonconvulsive status epilepticus associated with...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-008-9166-8
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Status, refractory status and super refractory status epilepticus are common neurologic emergencies. The objective of this study is to investigate the feasibility, safety and effectiveness of a ketogenic diet (KD) for refractory status epilepticus (RSE) in adults in the intensive care unit (ICU). METHODS:We...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-018-0653-2
更新日期:2019-06-01 00:00:00