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Cannabidiol in refractory status epilepticus

Don't Forget the Bubbles

A UK-based study found that 4% of admissions to a tertiary paediatric intensive care unit (PICU) over a 10-year period were due to refractory status epilepticus (RSE) – seizures which fail to terminate despite appropriate first and second-line treatments. Despite this, the CFAM still showed ongoing electrical seizure activity.

Seizures 122
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Super Refractory Status Epilepticus

Don't Forget the Bubbles

Four-year-old Fern is a previously healthy girl who presents with a febrile illness and seizures. Seizure activity did not respond to either first or second-line treatments, so she needed rapid sequence induction and transfer to PICU for ongoing anaesthesia and management. What causes Super Refractory Status Epilepticus?

Seizures 111
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ACMT Toxicology Visual Pearl: The Bark with Some Bite

ALiEM

Cases of toxicity have been reported following ingestion of supplements as well as ingestion of willow bark tea [4,5]. With severe toxicity, patients can have altered mental status, seizures, hyperthermia, and pulmonary edema. Phytotherapy Research. Tinnitus, nausea, vomiting, and abdominal pain are common. 2001;57(5):387-391.

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Targeted Temperature Management in Paediatric Traumatic Brain Injury

Don't Forget the Bubbles

Therapeutic hypothermia is thought to decrease the brain’s metabolic demand, reduce inflammation and cell death, and reduce the risk of seizures. In contrast, Kochanek reviewed each meta-analysis, as well as the RCT and secondary analyses, separately to assess overall results and potential moderators of effect.

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Soft Robotic Electrode Enables Minimally Invasive Placement

Medagadget

Researchers at Ecole Polytechnique Fédérale de Lausanne (EPFL) in Switzerland have developed a soft robotic electrode, that can be advanced through a small hole in the skull and then opened into a series of spiral arms, to provide electrocorticography measurements from a relatively large area of the brain surface.

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ToxCard: Second Generation Antipsychotic Overdose

EMDocs

1 Seizures may occur due to lowered seizure threshold. 1,2 Neuroleptic malignant syndrome (NMS) (hyperthermia, autonomic instability, rigidity, altered mental status [AMS]) can occur as well and is most often seen with clozapine but has been observed with other atypicals. 6 Seizures have been observed and are dose-dependent.

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SGEM#195: Some Like It Hot – ED Temperature and ICU Survival

The Skeptics' Guide to EM

In contrast, fever may actually be of benefit; thus, the real goal of antipyretic therapy is not simply to normalize body temperature but to improve the overall comfort and well-being of the child.” Alternating therapy may be beneficial for comfort, but more research is required to address this specific question. Probably not.

Sepsis 52