PMID- 25462146
OWN - NLM
STAT- MEDLINE
DCOM- 20150722
LR  - 20171116
IS  - 1537-1603 (Electronic)
IS  - 0736-0258 (Linking)
VI  - 31
IP  - 6
DP  - 2014 Dec
TI  - Stimulus-induced generalized epileptiform discharges: an unrecognized EEG pattern 
      in refractory nonconvulsive status epilepticus.
PG  - 580-5
LID - 10.1097/WNP.0000000000000092 [doi]
AB  - PURPOSE: To report an unrecognized EEG pattern occurring in patients with coma 
      with nonconvulsive status epilepticus (NCSE) treated with thiopental and 
      characterized by a high amplitude generalized sharp wave that was induced by 
      isolated or repetitive low frequency photic or tactile stimulation 
      (stimulus-induced generalized epileptiform discharges). METHODS: Review of 
      clinical and EEG records of 4 patients with stimulus-induced generalized 
      epileptiform discharges identified among patients admitted to an intensive care 
      unit (ICU) of our institution who underwent EEG monitoring between July 2011 and 
      January 2013. RESULTS: Four patients had refractory NCSE secondary to hepatic 
      encephalopathy, brain tumor, immunomediated encephalopathy, or anti-NMDA 
      encephalitis. All of them were treated with several antiepileptic drugs and 
      anesthetics, but stimulus-induced generalized epileptiform discharges were only 
      recorded after control of NCSE with thiopental. The discharges occurred without 
      associated clinical manifestations. Two patients died in the ICU, and two had a 
      favorable outcome. Stimulus-induced generalized epileptiform discharges were not 
      recorded in 240 critically ill patients admitted to the ICU who had an EEG 
      recorded during this period. Twenty-two of them were in NCSE, and only one was 
      treated with thiopental. CONCLUSIONS: Stimulus-induced generalized epileptiform 
      discharges is an EEG pattern occurring in patients with NCSE treated with 
      thiopental. The clinical relevance and pathophysiology of stimulus-induced 
      generalized epileptiform discharges remain to be clarified.
FAU - Gaig, Carles
AU  - Gaig C
AD  - *Neurology Service, Hospital Clinic de Barcelona, Institut d'Investigacions 
      Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; and daggerDepartment of 
      Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, 
      Massachusetts, U.S.A.
FAU - Iranzo, Alex
AU  - Iranzo A
FAU - Tercero, Ana
AU  - Tercero A
FAU - Herman, Susan T
AU  - Herman ST
FAU - Santamaria, Joan
AU  - Santamaria J
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - J Clin Neurophysiol
JT  - Journal of clinical neurophysiology : official publication of the American 
      Electroencephalographic Society
JID - 8506708
RN  - 0 (Anticonvulsants)
RN  - JI8Z5M7NA3 (Thiopental)
SB  - IM
MH  - Adult
MH  - Aged, 80 and over
MH  - Anticonvulsants/therapeutic use
MH  - Brain/drug effects/*physiopathology
MH  - *Brain Waves/drug effects
MH  - *Electroencephalography
MH  - Epilepsy, Generalized/*diagnosis/drug therapy/etiology/physiopathology
MH  - Fatal Outcome
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Pain Threshold
MH  - Physical Stimulation
MH  - Predictive Value of Tests
MH  - Thiopental/therapeutic use
MH  - *Touch
MH  - Treatment Outcome
EDAT- 2014/12/03 06:00
MHDA- 2015/07/23 06:00
CRDT- 2014/12/03 06:00
PHST- 2014/12/03 06:00 [entrez]
PHST- 2014/12/03 06:00 [pubmed]
PHST- 2015/07/23 06:00 [medline]
AID - 00004691-201412000-00013 [pii]
AID - 10.1097/WNP.0000000000000092 [doi]
PST - ppublish
SO  - J Clin Neurophysiol. 2014 Dec;31(6):580-5. doi: 10.1097/WNP.0000000000000092.