Index Note: Page numbers of article titles are in boldface type. A Absence seizures, 6 in childhood, 95 Adults, seizures and status epilepticus in, management of, 34 35 with first-time seizures. See Seizure(s), first-time, adult with. Alcohol-related seizures, 117 124 alcohol withdrawal syndrome and, 117 118 management of, 121 121 differential diagnosis of, 118 future directions in, 122 in abnormal neurologic presentation, 120 in alert patient, with seizure, 120 with seizure history, 119 in normal neurologic examination, 119 120 management of, 120 121 new-onset, 119 partial seizure, 120 obtundation in, 120 phenytoin/anticonvulsant conundrum in, 121 122 prevalence of, 117 progressing to status epilepticus, 121 Alcohol withdrawal syndrome, 117 118 management of, 120 121 Anesthesia, general, in toxin-related seizures, 134 Anticonvulsants, in afebrile seizures, 102 103 in toxin-related seizures, 134 Antiepileptic drugs, in afebrile seizures, 101 in first-time seizures in adult, 45, 47 old and new, 141 150 teratogenic effects of, 109 B Bacteremia, risk for, in simple febrile seizures, 85 86 Bacterial enteritis, risk for, in simple febrile seizures, 86 Barbiturates, anesthetic, in refractory status epilepticus, 58 59 in toxin-related seizures, 133 134 Benzodiazepines, in alcohol-related seizures, progressing to status epilepticus, 121 in alcohol withdrawal syndrome, 119, 121 in generalized convulsive status epilepticus, 56 in seizure management in adults, 34 35 in toxin-related seizures, 132 133 Blood pressure control, in eclampsia, 112 113 Emerg Med Clin N Am 29 (2011) 151 158 doi:10.1016/s0733-8627(10)00114-8 0733-8627/11/$ see front matter ª 2011 Elsevier Inc. All rights reserved. emed.theclinics.com
152 Index C Carbamazepine, in seizures in pregnancy, 109 in treatment of seizures, 141 Cerebyx. See Fosphenytoin. Children, absence seizures in, 95 afebrile seizures in, 95 108 febrile seizures in, 18, 83 93 seizure and status epilepticus management in, 32 34 seizures in. See also Seizure(s), pediatric. differential diagnosis of, 98 prehospital evaluation and management of, 30 31, 32 Clonazepam, in treatment of seizures, 141 142 Computed tomography, in toxin-related seizures, 130 Concussion, convulsive, 4 Convulsion, definition of, 3 Convulsive concussion, 4 D Delirium tremens, 118 Depakate, in treatment of seizures, 144, 145 Diazepam, in alcohol-related seizures, progressing to status epilepticus, 121 in alcohol withdrawal syndrome, 119, 120 in generalized status epilepticus in children, 32 33 in seizure management in adults, 34 35 Dilantin, in seizures in pregnancy, 109 in treatment of seizures, 143 144 Diuretics, in eclampsia, 113 Drug of abuse screening, in toxin-related seizures, 130 131 Drugs, used in management of seizures, 99 E Eclampsia, and pregnancy, seizures in, 109 116 blood pressure control in, 112 113 definition of, 111 delivery in, indications for, 113, 114 diuretics in, 113 management of, 111 112 pathophysiology of, 111 plasma volume expansion in, 113 seizure control in, 111 112 Electroencephalography, in afebrile pediatric seizures, 100 101 in generalized convulsive status epilepticus, 55 in psychogenic seizures, 75 in toxin-related seizures, 131 Emergency Medical Services, in prehospital seizure care, 30 32 Epilepsy, and seizures, 1 autosomal dominant nocturnal frontal lobe, 2 benign Rolandic, 96 definition of, 3 idiopathic generalized, 2
Index 153 juvenile myoclonic, of Janz, 96 localization-related, 7 risk of, in simple pediatric febrile seizures, 90 Epileptic syndromes, classification of, 7 Ethanol withdrawal, 18 Ethosuximide, in treatment of seizures, 142 F Felamate, in treatment of seizures, 144 145 Felbatol, in treatment of seizures, 144 145 Fosphenytoin, in alcohol-related seizures, progressing to status epilepticus, 121 in generalized convulsive status epilepticus, 56 57 in prehospital seizure management, 35, 36 in treatment of seizures, 143 144 G Gabapentin, in treatment of seizures, 145 146 Gabitril, in treatment of seizures, 146 147 Gamma-aminobutyric acid, as site of seizure aborting drug action, 2 3 inadequate production of, seizures and, 128 Gamma-aminobutyric acid receptors, toxin-related seizures and, 126 128 Glutamate, 2 H Hypertension, pregnancy-induced, 110 future directions in, 113 114 I Infantile spasms, 96 J Janz, juvenile myoclonic epilepsy of, 96 Juvenile myoclonic epilepsy, 8 of Janz, 96 K Keppra, in treatment of seizures, 146 Klonopin, in treatment of seizures, 141 142 L Lamictal, in treatment of seizures, 147 148 Lamotrigine, in treatment of seizures, 147 148 Lennox-Gastaut syndrome, 8, 96 Levetiracetam, in treatment of seizures, 146
154 Index Lorazepam, in alcohol-related seizures, progressing to status epilepticus, 121 in alcohol withdrawal syndrome, 119 in seizure management in adults, 34 35 Lumbar puncture, in first-time seizures in adult, 45 in generalized convulsive status epilepticus, 55 M Magnesium sulfate, in eclampsia, 111 112 Meningitis, bacterial, risk for, in simple febrile seizures, 85 Midazolam, in generalized status epilepticus in children, 33 34 in refractory status epilepticus, 58 N Neurocysticercosis, 17 Neuroimaging, in afebrile pediatric seizures, 99 100 in first-time seizures in adult, 44 45 in generalized convulsive status epilepticus, 55 Neuronal injury, in status epilepticus, excitotoxic mechanisms and, 11 Neurontin, in treatment of seizures, 145 146 Neurotransmission receptors, excitatory, toxin-related seizures and, 126 128 O Oxcarbazepine, in treatment of seizures, 148 P Petit mal, 6, 95 Phenobarbital, in generalized convulsive status epilepticus, 57 in treatment of seizures, 142 Phenobarbitone. See Phenobarbital. Phenytoin, in generalized convulsive status epilepticus, 56 57 in seizures in pregnancy, 109 in treatment of seizures, 143 144 Phenytoin/anticonvulsant conundrum, in alcohol-related seizures, 121 122 Plasma volume expansion, in eclampsia, 113 Preeclampsia, 110 future directions in, 113 114 Pregnancy, and eclampsia, seizures in, 109 116 Propofol, in refractory status epilepticus, 58 in toxin-related seizures, 133 Pyridoxine, in seizures in hydrazine poisoning, 128 in toxin-related seizures, 133 R Rolandic epilepsy, benign, 96 S Seizure-terminating process, 8 Seizure(s), absence, 6 in childhood, 95 alcohol-related. See Alcohol-related seizures.
and epilepsy, 1 and status epilepticus, diagnosis and management of, future directions in, 36 37 in prehospital setting, 29 39 management in adults, 34 35 management in children, 32 34 pathophysiology and definitions of, 1 13 treatment of, future directions in, 11 12 as common problem in emergency medicine, 15 classification of, 3 6 complex, 5 6 complex partial, 6 control of, in eclampsia, 112 113 definition of, 3, 4 differential diagnosis of, 4 disease attributable to, in emergency department setting, cost and burden of, 21 22 drugs used to manage, 99 epidemiology of, in emergency medicine, 15 27 in prehospital setting, 20 etiology of, 3 6 failure to stop, 8 first-time, adult with, algorithmic approach to, 46 antiepileptic drug therapy in, 45, 47 emergency department evaluation of, 41 49 hospital admission in, 45 46 laboratory testing in, 41 44 lumbar puncture in, 45 neuroimaging in, 44 45 following trauma, 19 generalized, 6 generalized tonic-clonic, 2, 6 hospital admission in, 21 in adults, prehospital evaluation and management of, 34 35 in children, differential diagnosis of, 98 in emergency department, age and, 16 etiology of, 16 20 gender and, 16 race and, 16 in pregnancy/eclampsia, 109 116 in known seizure disorder, 109 110 neonatal, 101 105 etiology of, 104 neuroimaging in, 17 pathophysiology of, 1 3 pediatric, prehospital evaluation and management of, 30 31, 32 pediatric afebrile, 95 108 electroencephalography in, 100 101 emergency department evaluation of, 97 emergency department management of, 97 future directions in, 105 history and physical examination in, 97 laboratory testing in, 98 99 Index 155
156 Index Seizure(s) (continued) neuroimaging in, 99 100 pediatric febrile, complex, 83 emergent imaging in, 87 88 laboratory testing in, 86 87 evaluation and management of, in emergency department, 83 93 simple, 83 clinical assessment of, 84 clinical elelments of, 83 84 discharge instructions in, 88 90 laboratory testing in, 84 86 recurrent, prevention of, 89 90 risk for, 88, 89 risk of epilepsy in, 90 prehospital evaluation and management of, 30 32 propensity for, factors affecting, 2 psychogenic, 21 diagnosis of, 75 inappropriate, 77 epidemiology of, 74 etiology of, 74 failure to adequately follow-up, 78 future directions in, 78 pitfalls in acute diagnosis and management of, in emergency department, 73 81 prognosis in, 76 psychopathologic condition in, neglecting of, 77 78 signs of, failure to recognize, 77 therapeutic maneuvers and provocative testing in, 75 76 treatment of, 76 psychomotor, 6 recurrence of, and prognosis in, 20 21 simple partial, 6 toxin-related. See Toxin-related seizures. types of, classification of, 5 various presentations of, 19 20 Status epilepticus, absence, 65 alcohol-related seizures progressing to, 121 and neuronal injury, excitotoxic mechanisms and, 11 causes of, 52 classification of, 6, 7 complex partial, 65 definitions of, 6, 21, 52 generalized convulsive, algorithm for treating, 59, 60 as medical emergency, 51 complications of, 36 consequences of, 10 11 electroencephalographic monitoring in, 55 in adults and children, treatment guidelines and protocols for, 51 64 incidence, morbidity, and mortality in, 52 54 initial stabilization in, 54 lumbar puncture in, 55
Index 157 neuroimaging in, 55 physiologic changes in, 9, 10 treatment of, 55 57 nonconvulsive, 21, 65 72 clinical manifestations of, 65 66 clinical presentations of, 67, 68 diagnostic evaluation of, 67, 68 epidemiology and etiology of, 66 67 future directions in, 69 treatment of, 69 refractory, therapy for, 58 59 choice for, 59 60 seizures and, diagnosis and management of, future directions in, 36 37 in prehospital setting, 29 39 management in adults, 32 34 management in children, 32 34 pathophysiology and definitions of, 1 13 treatment of, future directions in, 11 12 Syncope, 4 T Tegretol. See Carbamazepine. Tiagabine, in treatment of seizures, 146 147 Todd paralysis, 4 Topamax, in treatment of seizures, 146 Topiramate, in treatment of seizures, 146 Toxin-related seizures, adenosine activity in, 129 complications in, 130 epidemiology of, 125 126 excitatory neurotransmission receptors and, 126 128 gamma-aminobutyric acid receptors and, 126 128 in disruption of normal ionic-fluxtoxins inducing, 128 investigations in, 130 131 management of, 131 134 pathophysiology of, 126 130 toxins inducing, 126, 127, 128 Triage considerations, in seizures, 35 36 Trileptal, in treatment of seizures, 148 U Urinary tract infection, risk for, in simple febrile seizures, 86 V Valproate, in generalized convulsive status epilepticus, 57 parenteral, in prehospital seizure management, 35 Valproic acid, in treatment of seizures, 144, 145 Vitamin B6, in seizures in hydrazine poisoning, 128 in toxin-related seizures, 133
158 Index W West syndrome, 8, 96 Z Zarontin, in treatment of seizures, 142 Zonegran, in treatment of seizures, 147 Zonisamide, in treatment of seizures, 147