Multimodality Monitoring Correlates of Seizures

Witsch, Jens; Morris, Nicholas; Roh, David; Frey, Hans‐Peter; Claassen, Jan

doi:10.1007/978-3-319-49557-6_6

Cited by 1 publication

(1 citation statement)

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“…According to this concept, the state of hyperperfusion demonstrated in vascular and perfusion studies in cases of NCSE and IIC can be understood [8,[11][12][13]. However, with prolonged and persistent epileptic activity, the increase of CBF becomes insufficient to meet the metabolic needs of the exhausted tissue, with progressive mitochondrial and energy failure and uncoupling state or homeostatic failure ensues, which participates in secondary neuronal injury, perpetuating the epileptic activity.…”

Section: Ncse: Cerebral Hemodynamics Changesmentioning

confidence: 99%

Non-Convulsive Status Epilepticus (NCSE) in ICU: Bedside Usefulness of TCD in Comatose Patient Diagnosis. When the EEG Is Too Far

Othman

Abd‐Allah

2021

Neurosonology in Critical Care

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Points 1. Nonconvulsive status epilepticus (NCSE) is an important cause for unexplained impairment of consciousness, particularly in the intensive care unit (ICU). 2. Generation of abnormally prolonged or repeatedly recurrent brain electrical activity represents a metabolic burden not only on the neurons but also on the glial cells. This should be coupled by increase in cerebral blood flow (CBF). 3. The merits of the TCCS (transcranial color-coded duplex sonography) are being available, fast, bedside, safe, repeatable, and not interfering with continuous monitoring in the ICU. 4. TCCS assessment can help not only in diagnosis and follow-up of NCSE/IIC, but also in identifying the underlying etiology: arterial stenosis as a cause of acute ischemic stroke (AIS), dural venous sinus thrombosis, hydrocephalus, increased of ICP (by MLS, ONSD, and papilledema measurements) as in cases caused of space-occupying lesions (SOLs) (neoplasms, intra-and extra-axial hematoma, etc.). 5. Indirect assessment of cerebral blood flow (CBF) through cerebral blood flow velocities (CBFVs) measurement using TCD/TCCS was the most studied application of neurosonology in epileptic seizures, due to its ability to provide realtime evaluation at bedside. 6. EEG is the gold standard for diagnosis of NCSE/IIC; however, it can be unavailable or not conclusive enough. In these cases, vascular imaging can help to establish the diagnosis.

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Section: Ncse: Cerebral Hemodynamics Changesmentioning

confidence: 99%