When the Electric Circuit Is Not Working, It Is Time to Check All Outlets: How Status Epilepticus May Impact Cardiac Electric Activity*

Maciel, Carolina B.; Barlow, Brooke; Busl, Katharina M.

doi:10.1097/ccm.0000000000005771

Cited by 1 publication

(2 citation statements)

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“…In particular, insula and limbic system regions are important components of the brain–heart axis, stimulation of which can induce changes in cardiac rhythms [27 ▪ ,35,36]. Finally, arrhythmia can also result from ASMs, in particular those that target voltage-gated Na + channels [36].…”

Section: Acute Complications and Long-term Prognosismentioning

confidence: 99%

“…These cardiorespiratory effects may be related to seizure invasion of brain regions implicated in autonomic nervous system regulation [33,34]. In particular, insula and limbic system regions are important components of the brain-heart axis, stimulation of which can induce changes in cardiac rhythms [27 & , 35,36]. Finally, arrhythmia can also result from ASMs, in particular those that target voltage-gated Na þ channels [36].…”

Section: Acute Complications and Long-term Prognosismentioning

confidence: 99%

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Status epilepticus: what's new for the intensivist

Benghanem,

Pruvost-Robieux,

Neligan

et al. 2024

Current Opinion in Critical Care

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Purpose of review Status epilepticus (SE) is a common neurologic emergency affecting about 36.1/100 000 person-years that frequently requires intensive care unit (ICU) admission. There have been advances in our understanding of epidemiology, pathophysiology, and EEG monitoring of SE, and there have been large-scale treatment trials, discussed in this review. Recent findings Recent changes in the definitions of SE have helped guide management protocols and we have much better predictors of outcome. Observational studies have confirmed the efficacy of benzodiazepines and large treatment trials indicate that all routinely used second line treatments (i.e., levetiracetam, valproate and fosphenytoin) are equally effective. Better understanding of the pathophysiology has indicated that nonanti-seizure medications aimed at underlying pathological processes should perhaps be considered in the treatment of SE; already immunosuppressant treatments are being more widely used in particular for new onset refractory status epilepticus (NORSE) and Febrile infection-related epilepsy syndrome (FIRES) that sometimes revealed autoimmune or paraneoplastic encephalitis. Growing evidence for ICU EEG monitoring and major advances in automated analysis of the EEG could help intensivist to assess the control of electrographic seizures. Summary Research into the morbi-mortality of SE has highlighted the potential devastating effects of this condition, emphasizing the need for rapid and aggressive treatment, with particular attention to cardiorespiratory and neurological complications. Although we now have a good evidence-base for the initial status epilepticus management, the best treatments for the later stages are still unclear and clinical trials of potentially disease-modifying therapies are long overdue.

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Section: Acute Complications and Long-term Prognosismentioning

confidence: 99%