This is the largest case series to date describing the use of lacosamide in patients with RSE. Despite the novel mechanism of action, we observed no evidence that lacosamide is effective in RSE; however, our sample size was small. Further study is needed to determine the role of lacosamide in SE, especially early in the treatment course.

Stroke patients are monitored hourly by physicians and nurses in an attempt to better understand their physical state. To quantify the patients’ level of mobility, hourly movement (i.e. motor) assessment scores are performed, which can be taxing and time-consuming for nurses and physicians. In this paper, we attempt to find a correlation between patient motor scores and continuous accelerometer data recorded in subjects who are unilaterally impaired due to stroke. The accelerometers were placed on both upper and lower extremities of four severely unilaterally impaired patients and their movements were recorded continuously for 7 to 14 days. Features that incorporate movement smoothness, strength, and characteristic movement patterns were extracted from the accelerometers using time-frequency analysis. Support vector classifiers were trained with the extracted features to test the ability of the long term accelerometer recordings in predicting dependent and antigravity sides, and significantly above baseline performance was obtained in most instances ( \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} }{}$P < 0.05$ \end{document} ). Finally, a leave-one-subject-out approach was carried out to assess the generalizability of the proposed methodology, and above baseline performance was obtained in two out of the three tested subjects. The methodology presented in this paper provides a simple, yet effective approach to perform long term motor assessment in neurocritical care patients.

Neurocritical care is a distinct subspecialty focusing on the optimal management of acutely ill patients with lifethreatening neurologic and neurosurgical disease or with life-threatening neurologic manifestations of systemic disease. Care by expert healthcare providers to optimize neurologic recovery is necessary. Given the lack of an organizational framework and criteria for the development and maintenance of neurological critical care units (NCCUs), this document is put forth by the Neurocritical Care Society (NCS). Recommended organizational structure, personnel and processes necessary to develop a successful neurocritical care program are outlined. Methods: Under the direction of NCS Executive Leadership, a multidisciplinary writing group of NCS members was formed. After an iterative process, a framework was proposed and approved by members of the writing group. A draft was then written, which was reviewed by the NCS Quality Committee and NCS Guidelines Committee, members at large, and posted for public comment. Feedback was formally collated, reviewed and incorporated into the final document which was subsequently approved by the NCS Board of Directors.

The extubation failure rate in our neurocritical care unit is low. In patients with encephalopathy and primary brain injury who were reintubated, respiratory distress caused by altered mental status was the most common cause of reintubation. These patients demonstrated signs disrupted ventilation usually with periods of prolonged hypoventilation. Increased work of breathing from lung injury due to pneumonia or aspiration was not the most common cause of reintubation in this population.

Successful management of an event where healthcare needs exceed regional healthcare capacity requires coordinated strategies for scarce resource allocation. Publications for rapid development, training, and coordination of regional hospital triage teams manage the allocation of scarce resources during COVID-19 are lacking. Over a period of 3 weeks, over 100 clinicians, ethicists, leaders, and public health authorities convened virtually to achieve consensus on how best to save the most lives possible and share resources. This is referred to as population-based crisis management. The rapid regionalization of 22 acute care hospitals across 4500 square miles in the midst of a pandemic with a shifting regulatory landscape was challenging, but overcome by mutual trust, transparency, and confidence in the public health authority. Because many cities are facing COVID-19 surges, we share a process for successful rapid formation of healthcare care coalitions, Crisis Standard of Care, and training of Triage Teams. Incorporation of continuous process improvement and methods for communication is essential for successful implementation. Utilization of our regional healthcare coalition communications, incident command system, and the crisis care committee helped mitigate crisis care in the San Diego and Imperial County region as COVID-19 cases surged and scarce resource collaborative decisions were required.