Seizures in Critical Care: A Guide to Diagnosis and by Marek A. Mirski (auth.), Panayiotis Varelas (eds.)

By Marek A. Mirski (auth.), Panayiotis Varelas (eds.)

This totally revised moment variation of Seizures in severe Care: A consultant to analysis and Therapeutics is a necessary advisor for ICU pros and neurologists. Incorporating the final 5 years of advances within the box, this necessary name retains an analogous constitution because the earlier version, with sections on epidemiology, pathophysiology, diagnostic assessment and healing procedures, yet comprises an additional bankruptcy on seizure tracking within the ICU. This variation additionally provides a couple of new sections devoted to new remedies, akin to neurostimulation, hypothermia or resection of the refractory epileptic concentration and antiepileptic medicines. furthermore, readers will locate additional circulation charts and remedy algorithms with extra particular drug doses. extra, extra EEGs with greater rationalization and labeling for the non-expert intensivist were further to every section.

Chapter authors contain an identical overseas crew of well known specialists as within the first variation, in addition to numerous new professional individuals. Chapters disguise very important themes equivalent to seizures in organ transplant recipients, these caused by renal and hepatic failure, seizures regarding alcohol misuse, and seizures caused by mind damage and tumors. In all, this new and improved variation of Seizures in serious Care: A advisor to prognosis and Therapeutics fills evolving wishes and entices new curiosity within the care of sufferers that suffer epileptic occasions. accomplished and imperative for ICU pros and neurologists, this new version will back meet – and surpass—the want for extra in-depth and really expert wisdom approximately seizures in severe care.

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Extra info for Seizures in Critical Care: A Guide to Diagnosis and Therapeutics

Sample text

Fig. 2-7. Benzodiazepine trial in a 51-year-old man with multiple medical problems including chronic liver disease and HIV who was admitted to the medical ICU with sepsis. Despite treatment, he continued to have poor mental status. (a) Initial cEEG monitoring showed GPEDs at 1–2 Hz. (b) Following the administration of lorezapam 1 mg IV, the GPEDs became less frequent and the patient became responsive and followed commands, strongly suggesting that the initial pattern was ictal Chapter 2 Diagnosing and Monitoring Seizures in the ICU 35 focal motor seizures consistently elicited by alerting stimuli (18).

These include acute structural lesions, infections, metabolic derangements, toxins, withdrawal, and epilepsy, all common diagnoses in the critically ill patient (31). However, NCSz are the more common ictal manifestation (or lack thereof) in ICU patients (1–5). NCSz are even more common in the pediatric population, especially in infants (1, 20, 32, 33). Recent prospective studies using cEEG have indentified the incidence of NCSz and NCSE in various patient populations. These studies are summarized in Table 2-1.

Reducing the raw cEEG to a few displayed variables using qEEG tools will make it a practical tool that can be interpreted by nurses and intensivists or by neurotelemetry technicians. In addition, trend and critical value alarms can be used to alert staff to changes in neurological status (23). Computer algorithms have been successfully used to detect ongoing seizures in patients in epilepsy monitoring units (95). Because seizure patterns in the critically ill are different from ambulatory patients, new algorithms must be designed to detect seizures in this patient population (23).

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