Dataset Information

['Wait and see' in paediatric epilepsy. Our experience].

ABSTRACT:

Introduction

Pharmacological treatment of epilepsy is not healing; it tries to avoid seizures, as far as possible, in children who probably would still have them.

Patients and methods

Our purpose is to analyse our experience with epileptic children and those who have a first non-symptomatic seizure without pharmacological treatment. Patients seen in a paediatric neurology consultation, from 2017 to 2021, who had suffered one or more acute non-symptomatic crises and who had not been treated pharmacologically, were analysed.

Results

Sixty-five patients meet the selection criteria. Twenty-four patients had had a single crisis with a mean duration of 12 minutes (1-60). In 66.7% it was nocturnal. 41.7% presented pathological electroencephalogram, and 21% pathological findings in neuroimaging. The mean control time was 2.7 years (0.003-13.6 years). Forty-one presented more than one crisis, with a mean duration of nine minutes (1-60). Five patients presented more than 20 seizures, the rest between two and 17. Twenty-four (58.5%) presented only nocturnal seizures. An electroencephalogram was performed in all: epileptiform graphoelements in 63.4%; and neuroimaging in all: pathological in 4.9%. Mean control time was 3.8 years (0.01-9.1 years).

Conclusions

Seizure frequency, underlying pathology or test results should not be the only variables to take into consideration when starting antiepileptic drug treatment. The repercussion on their quality of life and neurodevelopment should prevail, agreeing on this decision with the parents.

SUBMITTER: Salinas-Salvador B

PROVIDER: S-EPMC10364043 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature

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Publications

['Wait and see' in paediatric epilepsy. Our experience].

Salinas-Salvador B B Moreno-Sánchez A A Carmen-Marcén G G Molina-Herranz D D Lafuente-Hidalgo M M López-Pisón J J

Revista de neurologia 20230201 3

<h4>Introduction</h4>Pharmacological treatment of epilepsy is not healing; it tries to avoid seizures, as far as possible, in children who probably would still have them.<h4>Patients and methods</h4>Our purpose is to analyse our experience with epileptic children and those who have a first non-symptomatic seizure without pharmacological treatment. Patients seen in a paediatric neurology consultation, from 2017 to 2021, who had suffered one or more acute non-symptomatic crises and who had not bee ...[more]

PMID: 36703501

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Project description:BackgroundHeart transplantation is limited by a severe donor organ shortage. Potential donors with brain death (BD) and left ventricular dysfunction due to neurogenic stunning are currently excluded from donation--although such abnormalities can be reversible with aggressive treatment including Hormonal Treatment (HT) and deferred organ retrieval.AimTo assess the recovery of left ventricular dysfunction in potential brain-dead donors with hemodynamic instability treated by aggressive treatment and HT.MethodsIn a single-center, observational study design, we evaluated 15 consecutive brain-dead potential donors (DBD) (8 males, age?=?48?±?15?years) with hemodynamic instability. All underwent standard hemodynamic monitoring and transthoracic 2-dimensional echo (2-DE) with assessment of Ejection Fraction (EF). Measurements were obtained before BD and after BD within 6?h, at 24?h and within 48?h. HT (with insulin, methylprednisolone, vasopressin and T3) was started as soon as possible to treat hemodynamic instability and avoid administration of norepinephrine (NE). Eligible potential heart donors underwent coronary angiography.ResultsAfter HT, we observed a normalization of hemodynamic conditions with improvement of mean arterial pressure (pre?=?68?±?8?mmHg vs post?=?83?±?13?mmHg, p?<?.01), cardiac index (pre?=?2.4?±?0.6?L/min/m2 vs post 3.7?±?1.2?L/min/m2, p?<?.05), EF (pre?=?48?±?15 vs post?=?59?±?3%, p?<?.01) without administration of norepinephrine (NE) in 67% of cases. Five potential donors were excluded from donation (opposition, n?=?3, tubercolosis n?=?1, malignancy n?=?1). At pre-harvesting angiography, coronary artery stenosis was present in 2 of the 10 consented donors. Eight hearts were uneventfully transplanted. No early graft failure occurred and all eight recipients were alive at 6-month follow-up.ConclusionIn BD donors, intensive treatment including HT is associated with improvement of regional and global LV function and reverse remodeling detectable by transthoracic 2DE. Donor hearts with recovered LV function may be eligible for uneventful heart transplant. The wait (in brain death), treat (with HT) and see (with 2D echo) strategy can help rescue organs suitable for heart donation.

Dataset Information

['Wait and see' in paediatric epilepsy. Our experience].

Introduction

Patients and methods

Results

Conclusions

Publications

['Wait and see' in paediatric epilepsy. Our experience].

Similar Datasets

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