Online ISSN: 2515-8260

Keywords : seizures


Study of Comparing the Efficacy of Intravenous Levetiracetam Versus Intravenous Valproate inthe Management of Refractory Status Epilepticus in Children

U Ashok Kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1766-1777

Background: Primary: To compare the rates of clinical seizure cessation at 15 min after
intravenous bolus infusion in the two groups (valproate versus levetiracetam) of
children aged 1-12 years with refractory status epilepticus (uncontrolled with initial
BDZ and phenytoin bolus).
Materials and Methods: This study was conducted in Department of Pediatrics,
Mamata medical college and General hospital Khammam. Study Period: Oct 2017 to
Sept 2019. Study population: Children between 1 to 12 years with status epilepticus who
had received diazepam followed by phenytoin infusion of 20 mg/kg and repeat 10
mg/kg. If status was still not controlled, they were labelled as refractory status
epilepticus and enrolled in study. It was a Randomised controlled study.During the
study period(Oct 2017to Sept 2019) a total of 1835 children visited emergency room, at
our centre. Among them 259 children had seizures presenting feature. Fifty-seven
children met the criteria for enrolment. Seven of these children could not be
randomized. The remaining fifty children were randomized into two groups- group A
received valproate (n=25) and group B received levetiracetam (n=25).
Results: The mean age of the patients was 45± 34 months and there was male
preponderance (64%) seen in our study. The most common underlying etiology in both
groups was acute central nervous system infections including meningoencephalitis and
meningitis (40% in levetiracetam group and 64% in valproate group) Most children
came with first time seizures and only few(20%) were known cases of epilepsy and on
antiepileptics. Most of our children (56%) presented with generalised tonic clonic
seizures. Duration of status before admission was different in both groups with median
of 20 min and 30 min in levetiracetam and valproate group respectively and 40 % of
patients had received some treatment for seizure before reaching us.
Conclusion: In this study no significant differences were observed between intra venous
valproate and intra venous levetiracetam, in acute seizure control in children with SE
refractory to Benzodiazepam and Phenytoin. Both the drugs were effective in more than
2/3rd of the children. Perhaps this might justify the use of a new protocol for
management of refractory status epilepticus where in intravenous valproate or
levetiracetam could be included before use of benzodiazepine or thiopentol infusion

A study of 50 cases of seizures in adults and it’s clinical profile

Dr Bhavikkumar Prajapati, Dr Janak Chokshi, Dr Krunal Talsaniya .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 3039-3047

: Introduction: Seizure disorder is a one of major health problem in adults mostly in late adulthood in which chances of seizures are increased especially due to comorbidities like cerebrovascular stroke, CNS infection, degenerative disease of brain, and brain tumor. So we study 50 adult patients to identify various etiology of seizures.
Materials and methods: We check for various parameters like complete blood count, blood sugar level, renal function tests with electrolytes, liver function tests, brain imaging and Electroencephalogram. Result: With the help of this study, we identify that most common cause for seizure is idiopathic in less than 50 years of age and post stroke epilepsy in more than 50 years of age. Generalised tonic clonic seizure is most common type of seizure. With the help of newer neuro-imaging modalities and EEG it is possible to find out specific etiology of seizure, so EEG and imaging study should be integral part of investigation work of patient with seizure disorder.
Conclusion: The present study was an effort to find out the various etiology, type of seizures in adults, clinical profile and response to antiepileptic drugs. Every patient should be investigated thoroughly and diagnosed and best suitable drug given depending upon type of seizures to the patient for proper control of seizures and also improve morbidity and mortality due to seizures.
 

ELECTROENCEPHALOGRAPHY PATTERN IN CRITICAL ILL PATIENT WITH DECREASED LEVEL OF CONSCIOUSNESS AT HIGH CARE UNIT

Kenia Izzawa, PutriIrsalina, Abdulloh Machin KurniaKusumastuti2,3, WardahRahmatul Islamiyah 2,3,4, Ersifa Fatimah

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 4679-4684

Background: Brain dysfunction is associated with increased mortality in high care unit. Brain dysfunction due to convulsive seizures, nonconvulsive seizures or ischemia, may be difficult to identify by neurological examination. EEG examination can identify brain dysfunction.The aim of this study is to describe the most EEG pattern in critical ill patient with decreased level of consciousness at high care unit
Methods: This is a retrospective study. All patients who were treated in the high care unit and underwent an EEG examination in January-December 2019 was conducted in this study. The outcome of this study such as the sociodemographic patient characteristics (like age, sex and history of seizure during treatment in high care unit, past medical history of seizure), etiology diagnosis and EEG pattern. All data were analyzed using SPSS 25.
Conclusion:Continous Slow Activity (CSA) was most commonly abnormal EEG features in critical ill patient with decreased level of consciousness at high care unit.
 

TUNABLE-Q WAVELET TRANSFORM BASED ENTROPY MEASURES FOR IDENTIFICATION OF EPILEPTIC SEIZURES

Nazia Parveen; Syed Hasan Saeed

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 4702-4717

The accurate location of epileptic seizures by interpreting an EEG (Electroencephalogram) signal is highly demanding and involves skilled neurologists. In this study, the EEG is analyzed using the Tunable-Q Wavelet Transform (TQWT) method for identifying seizures by splitting an EEG signal into several sub-bands. The entropy computed for each sub-band signifies the nonlinearity in an EEG signal. The other novel parameters viz correntropy, centered correntropy (CCE) and correntropy coefficient assess the nonlinearity of EEG signal and forms the basis for classification. The study has been done on the freely accessible Bonn University EEG database and outperforms in terms of complexity. When contrasted to the existing state-of-the-art methods, 100% accuracy has been achieved in discriminating seizure, seizure-free signals, and non-seizure EEG signals using Random Forest Classifier. Moreover, the computation of the proposed features is fast, and the system is easy to implement.

Seizure Due To Electrolyte Imbalance In Pediatric

Nurul Hidayah; Huldani .; Fauziah .; M Naufal Risyad

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 4664-4668

Seizures are symptoms that are temporary and sudden as a result of abnormal electrical
activity in the brain. Seizures can be caused by various conditions, for example, epilepsy,
fever, hypoglycemia, hypoxia, hypotension, brain tumors, meningitis, electrolyte
imbalance, and drug overdose. Severe and acute electrolyte disturbances cause
neurological deficits such as seizures, which may be the sole presenting
symptom. Electrolytes are compounds in a solution that dissociate into particles with a
positive (cation) or negative (anion) charge. Most of the metabolic processes require and
are affected by electrolytes. Electrolyte imbalances are common in clinical practice and the
diagnosis is confirmed by laboratory tests. Seizures are common in patients with
hyponatremia, hypocalcemia, and hypomagnesia. Tonic-clonic seizures or other types can
be found due to these electrolyte disturbances. Hypo or hyperkalemia can also cause
seizures, but it is very rare. These electrolyte disturbances can trigger epileptic areas in the
brain. Central nervous system disorders due to electrolyte imbalance are reversible.
However, if this is not treated immediately it will cause permanent brain damage