Acute and Critical Care

Case Report

Neurology
Myoclonic status epilepticus after severe hyperthermia in a patient with coronavirus disease 2019: Katherine A Hill, John J Peters, Sara M Schaefer; Received October 6, 2021 Accepted November 22, 2021 Published online March 24, 2022; DOI: https://doi.org/10.4266/acc.2021.01452 [Epub ahead of print]

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Abstract PDF: Myoclonic status epilepticus (MSE) is a sign of severe neurologic injury in cardiac arrest patients. To our knowledge, MSE has not been described as a result of prolonged hyperpyrexia. A 56-yearold man with coronavirus disease 2019 presented with acute respiratory distress syndrome, septic/hypovolemic shock, and presumed community-acquired pneumonia. Five days after presentation, he developed a sustained fever of 42.1°C that did not respond to acetaminophen or ice water gastric lavage. After several hours, he was placed on surface cooling. Three hours after fever resolution, new multifocal myoclonus was noted in the patient’s arms and trunk. Electroencephalography showed midline spikes consistent with MSE, which resolved with 40 mg/kg of levetiracetam. This case demonstrates that severe hyperthermia can cause cortical injury significant enough to trigger MSE and should be treated emergently using the most aggressive measures available. Providers should have a low threshold for electroencephalography in intubated patients with a recent history of hyperpyrexia.

Review

Status Epilepticus and Beyond: A Clinical Review of Status Epilepticus and an Update on Current Management Strategies in Super-refractory Status Epilepticus: Roy Poblete, Gene Sung; Korean J Crit Care Med. 2017;32(2):89-105. Published online May 31, 2017; DOI: https://doi.org/10.4266/kjccm.2017.00252

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Status epilepticus and refractory status epilepticus represent some of the most complex conditions encountered in the neurological intensive care unit. Challenges in management are common as treatment options become limited and prolonged hospital courses are accompanied by complications and worsening patient outcomes. Antiepileptic drug treatments have become increasingly complex. Rational polytherapy should consider the pharmacodynamics and kinetics of medications. When seizures cannot be controlled with medical therapy, alternative treatments, including early surgical evaluation can be considered; however, evidence is limited. This review provides a brief overview of status epilepticus, and a recent update on the management of refractory status epilepticus based on evidence from the literature, evidence-based guidelines, and experiences at our institution.

Citations

Citations to this article as recorded by

Proanthocyanidin from Vitis vinifera attenuates memory impairment due to convulsive status epilepticus
Opeyemi Samson Osuntokun, Gbola Olayiwola, Damilare Adedayo Adekomi, Ibukun Peter Oyeyipo, Abiodun Oladele Ayoka
Epilepsy & Behavior.2021; 124: 108333. CrossRef
Effect of Sodium Valproate Treatment on the Cardiac Index in New Cases with Status Epilepticus
Mohammad Radgoudarzi, Mohammad Vafaee-Shahi, Fatemeh Naderi
The Open Neurology Journal.2021; 15(1): 59. CrossRef
Electroconvulsive Therapy in Super Refractory Status Epilepticus: Case Series with a Defined Protocol
Beatriz García-López, Ana Isabel Gómez-Menéndez, Fernando Vázquez-Sánchez, Eva Pérez-Cabo, Francisco Isidro-Mesas, Arturo Zabalegui-Pérez, Ignacio Muñoz-Siscart, María Carmen Lloria-Gil, Raúl Soto-Cámara, Jerónimo J. González-Bernal, Josefa González-Santo
International Journal of Environmental Research and Public Health.2020; 17(11): 4023. CrossRef
Correlation of serum S100B levels with brain magnetic resonance imaging abnormalities in children with status epilepticus
Prastiya Indra Gunawan, Darto Saharso, Dian Purnama Sari
Korean Journal of Pediatrics.2019; 62(7): 281. CrossRef
Clinico-Etiological Profile of Pediatric Refractory Status Epilepticus at a Public Hospital in India
KC Sadik, Devendra Mishra, Monica Juneja, Urmila Jhamb
Journal of Epilepsy Research.2019; 9(1): 36. CrossRef

Case Report

Neurology/Liver
Non-Convulsive Status Epilepticus following Liver Transplantation: Bora Lee, Nar Hyun Min, Sung Yeon Ham, Sungwon Na, Jeongmin Kim; Korean J Crit Care Med. 2016;31(1):49-53. Published online February 29, 2016; DOI: https://doi.org/10.4266/kjccm.2016.31.1.49

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1 Citations

Abstract

Neurological complications following liver transplantation are more common than after other organ transplants. These complications include seizure in about 8% of cases, which is associated with morbidity and mortality. Seizure should be treated immediately, and the process of differential diagnosis has to be performed appropriately in order to avoid permanent neurologic deficit. We herein report a case of status epilepticus after liver transplantation. The status epilepticus was treated promptly and the cause of seizure was assessed. The patient was discharged without any complication.

Citations

Citations to this article as recorded by

Early postoperative seizures in liver and kidney recipients
O. M. Tsirulnikova, A. V. Syrkina, I. A. Miloserdov, I. E. Pashkova, S. Yu. Oleshkevich, I. B. Komarova
Russian Journal of Transplantology and Artificial Organs.2021; 23(2): 158. CrossRef

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