Claustrum damage and refractory status epilepticus following febrile illness.

Autor:	Meletti S; From the Department of Biomedical, Metabolic, and Neural Science (S.M., G.M., G.G.), University of Modena and Reggio Emilia, Modena; NOCSAE Hospital (S.M., G.M., G.G., A.C.), ASL Modena, Italy; Clinic of Neurology (J.S., P.H., V.M., D.B., M.B.) and Radiodiagnostic Institute (P.K.), University Hospital Ostrava; the Neurological Department of Na Homolce Hospital (I.M.), Prague, Czech Republic; and the Division of Neurology (N.S., N.P.), Bambino Gesù Children's Hospital, IRCCS, Rome Italy. stefano.meletti@unimore.it., Slonkova J; From the Department of Biomedical, Metabolic, and Neural Science (S.M., G.M., G.G.), University of Modena and Reggio Emilia, Modena; NOCSAE Hospital (S.M., G.M., G.G., A.C.), ASL Modena, Italy; Clinic of Neurology (J.S., P.H., V.M., D.B., M.B.) and Radiodiagnostic Institute (P.K.), University Hospital Ostrava; the Neurological Department of Na Homolce Hospital (I.M.), Prague, Czech Republic; and the Division of Neurology (N.S., N.P.), Bambino Gesù Children's Hospital, IRCCS, Rome Italy., Mareckova I; From the Department of Biomedical, Metabolic, and Neural Science (S.M., G.M., G.G.), University of Modena and Reggio Emilia, Modena; NOCSAE Hospital (S.M., G.M., G.G., A.C.), ASL Modena, Italy; Clinic of Neurology (J.S., P.H., V.M., D.B., M.B.) and Radiodiagnostic Institute (P.K.), University Hospital Ostrava; the Neurological Department of Na Homolce Hospital (I.M.), Prague, Czech Republic; and the Division of Neurology (N.S., N.P.), Bambino Gesù Children's Hospital, IRCCS, Rome Italy., Monti G; From the Department of Biomedical, Metabolic, and Neural Science (S.M., G.M., G.G.), University of Modena and Reggio Emilia, Modena; NOCSAE Hospital (S.M., G.M., G.G., A.C.), ASL Modena, Italy; Clinic of Neurology (J.S., P.H., V.M., D.B., M.B.) and Radiodiagnostic Institute (P.K.), University Hospital Ostrava; the Neurological Department of Na Homolce Hospital (I.M.), Prague, Czech Republic; and the Division of Neurology (N.S., N.P.), Bambino Gesù Children's Hospital, IRCCS, Rome Italy., Specchio N; From the Department of Biomedical, Metabolic, and Neural Science (S.M., G.M., G.G.), University of Modena and Reggio Emilia, Modena; NOCSAE Hospital (S.M., G.M., G.G., A.C.), ASL Modena, Italy; Clinic of Neurology (J.S., P.H., V.M., D.B., M.B.) and Radiodiagnostic Institute (P.K.), University Hospital Ostrava; the Neurological Department of Na Homolce Hospital (I.M.), Prague, Czech Republic; and the Division of Neurology (N.S., N.P.), Bambino Gesù Children's Hospital, IRCCS, Rome Italy., Hon P; From the Department of Biomedical, Metabolic, and Neural Science (S.M., G.M., G.G.), University of Modena and Reggio Emilia, Modena; NOCSAE Hospital (S.M., G.M., G.G., A.C.), ASL Modena, Italy; Clinic of Neurology (J.S., P.H., V.M., D.B., M.B.) and Radiodiagnostic Institute (P.K.), University Hospital Ostrava; the Neurological Department of Na Homolce Hospital (I.M.), Prague, Czech Republic; and the Division of Neurology (N.S., N.P.), Bambino Gesù Children's Hospital, IRCCS, Rome Italy., Giovannini G; From the Department of Biomedical, Metabolic, and Neural Science (S.M., G.M., G.G.), University of Modena and Reggio Emilia, Modena; NOCSAE Hospital (S.M., G.M., G.G., A.C.), ASL Modena, Italy; Clinic of Neurology (J.S., P.H., V.M., D.B., M.B.) and Radiodiagnostic Institute (P.K.), University Hospital Ostrava; the Neurological Department of Na Homolce Hospital (I.M.), Prague, Czech Republic; and the Division of Neurology (N.S., N.P.), Bambino Gesù Children's Hospital, IRCCS, Rome Italy., Marcian V; From the Department of Biomedical, Metabolic, and Neural Science (S.M., G.M., G.G.), University of Modena and Reggio Emilia, Modena; NOCSAE Hospital (S.M., G.M., G.G., A.C.), ASL Modena, Italy; Clinic of Neurology (J.S., P.H., V.M., D.B., M.B.) and Radiodiagnostic Institute (P.K.), University Hospital Ostrava; the Neurological Department of Na Homolce Hospital (I.M.), Prague, Czech Republic; and the Division of Neurology (N.S., N.P.), Bambino Gesù Children's Hospital, IRCCS, Rome Italy., Chiari A; From the Department of Biomedical, Metabolic, and Neural Science (S.M., G.M., G.G.), University of Modena and Reggio Emilia, Modena; NOCSAE Hospital (S.M., G.M., G.G., A.C.), ASL Modena, Italy; Clinic of Neurology (J.S., P.H., V.M., D.B., M.B.) and Radiodiagnostic Institute (P.K.), University Hospital Ostrava; the Neurological Department of Na Homolce Hospital (I.M.), Prague, Czech Republic; and the Division of Neurology (N.S., N.P.), Bambino Gesù Children's Hospital, IRCCS, Rome Italy., Krupa P; From the Department of Biomedical, Metabolic, and Neural Science (S.M., G.M., G.G.), University of Modena and Reggio Emilia, Modena; NOCSAE Hospital (S.M., G.M., G.G., A.C.), ASL Modena, Italy; Clinic of Neurology (J.S., P.H., V.M., D.B., M.B.) and Radiodiagnostic Institute (P.K.), University Hospital Ostrava; the Neurological Department of Na Homolce Hospital (I.M.), Prague, Czech Republic; and the Division of Neurology (N.S., N.P.), Bambino Gesù Children's Hospital, IRCCS, Rome Italy., Pietrafusa N; From the Department of Biomedical, Metabolic, and Neural Science (S.M., G.M., G.G.), University of Modena and Reggio Emilia, Modena; NOCSAE Hospital (S.M., G.M., G.G., A.C.), ASL Modena, Italy; Clinic of Neurology (J.S., P.H., V.M., D.B., M.B.) and Radiodiagnostic Institute (P.K.), University Hospital Ostrava; the Neurological Department of Na Homolce Hospital (I.M.), Prague, Czech Republic; and the Division of Neurology (N.S., N.P.), Bambino Gesù Children's Hospital, IRCCS, Rome Italy., Berankova D; From the Department of Biomedical, Metabolic, and Neural Science (S.M., G.M., G.G.), University of Modena and Reggio Emilia, Modena; NOCSAE Hospital (S.M., G.M., G.G., A.C.), ASL Modena, Italy; Clinic of Neurology (J.S., P.H., V.M., D.B., M.B.) and Radiodiagnostic Institute (P.K.), University Hospital Ostrava; the Neurological Department of Na Homolce Hospital (I.M.), Prague, Czech Republic; and the Division of Neurology (N.S., N.P.), Bambino Gesù Children's Hospital, IRCCS, Rome Italy., Bar M; From the Department of Biomedical, Metabolic, and Neural Science (S.M., G.M., G.G.), University of Modena and Reggio Emilia, Modena; NOCSAE Hospital (S.M., G.M., G.G., A.C.), ASL Modena, Italy; Clinic of Neurology (J.S., P.H., V.M., D.B., M.B.) and Radiodiagnostic Institute (P.K.), University Hospital Ostrava; the Neurological Department of Na Homolce Hospital (I.M.), Prague, Czech Republic; and the Division of Neurology (N.S., N.P.), Bambino Gesù Children's Hospital, IRCCS, Rome Italy.
Jazyk:	angličtina
Zdroj:	Neurology [Neurology] 2015 Oct 06; Vol. 85 (14), pp. 1224-32. Date of Electronic Publication: 2015 Sep 04.
DOI:	10.1212/WNL.0000000000001996
Abstrakt:	Objective: To characterize the clinical, EEG, and brain imaging findings in an adult case series of patients with de novo refractory status epilepticus (SE) occurring after a febrile illness. Methods: A retrospective study (2010-2013) was undertaken with the following inclusion criteria: (1) previously healthy adults with refractory SE; (2) seizure onset 0-21 days after a febrile illness; (3) lacking evidence of infectious agents in CSF; (4) no history of seizures (febrile or afebrile) or previous or concomitant neurologic disorder. Results: Among 155 refractory SE cases observed in the study period, 6 patients (17-35 years old) fulfilled the inclusion criteria. Confusion and stupor were the most common symptoms at disease onset, followed after a few days by acute repeated seizures that were uncountable in all but one. Seizures consisted of focal motor/myoclonic phenomena with subsequent generalization. Antiepileptic drugs failed in every patient to control seizures, with all participants requiring intensive care unit admission. Barbiturate coma with burst-suppression pattern was applied in 4 out of 6 patients for 5-14 days. One participant died in the acute phase. In each patient, we observed a reversible bilateral claustrum MRI hyperintensity on T2-weighted sequences, without restricted diffusion, time-related with SE. All patients had negative multiple neural antibodies testing. Four out of 5 surviving patients developed chronic epilepsy. Conclusions: This is a hypothesis-generating study of a preliminary nature supporting the role of the claustrum in postfebrile de novo SE; future prospective studies are needed to delineate the specificity of this condition, its pathogenesis, and the etiology. (© 2015 American Academy of Neurology.)
Databáze:	MEDLINE
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