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RISS 인기검색어
- 검색키워드
- 저자 : Lothar Burghaus (검색결과 2 건)
- 무료
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Prehospital Levetiracetam Use in Adults With Status Epilepticus: Results of a Multicenter Registry
Lothar Burghaus,Marie Madlener,Felix Kohle,Emanuel F. Bruno,Volker Limmroth,Gereon R. Fink,Michael P. Malter 대한신경과학회 2023 Journal of Clinical Neurology Vol.19 No.4
Background and Purpose Status epilepticus (SE) is a neurological emergency due to prolonged seizure activity or multiple seizures without full recovery in between them. Prehospital SE management is crucial since its duration is correlated with higher morbidity and mortality rates. We examined the impact of different therapeutic strategies in the prehospital setting with a focus on levetiracetam. Methods We initiated the Project for SE in Cologne, a scientific association of all neurological departments of Cologne, the fourth-largest city in Germany with around 1,000,000 inhabitants. All patients with an SE diagnosis were evaluated over 2 years (from March 2019 to February 2021) to determine whether prehospital levetiracetam use had a significant effect on SE parameters. Results We identified 145 patients who received initial drug therapy in the prehospital setting by professional medical staff. Various benzodiazepine (BZD) derivatives were used as first-line treatments, which were mostly used in line with the recommended guidelines. Levetiracetam was regularly used (n=42) and mostly in combination with BZDs, but no significant additional effect was observed for intravenous levetiracetam. However, it appeared that the administered doses tended to be low. Conclusions Levetiracetam can be applied to adults with SE in prehospital settings with little effort. Nevertheless, the prehospital treatment regimen described here for the first time did not significantly improve the preclinical cessation rate of SE. Future therapy concepts should be based on this, and the effects of higher doses should in particular be reexamined.
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Dysautonomia in Narcolepsy: Evidence by Questionnaire Assessment
Gilles Klein,Lothar Burghaus,Michel Vaillant,Vannina Pieri,Gereon R. Fink,Nico Diederich 대한신경과학회 2014 Journal of Clinical Neurology Vol.10 No.4
Background and Purpose Excessive daytime sleepiness and sudden sleep attacks are themain features of narcolepsy, but rapid-eye-movement sleep behavior disorder (RBD), hyposmia,and depression can also occur. The latter symptoms are nonmotor features in idiopathic Parkinson’s disease (IPD). In the present study, IPD-proven diagnostic tools were tested to determine whether they are also applicable in the assessment of narcolepsy. Methods This was a case-control study comparing 15 patients with narcolepsy (PN) and 15control subjects (CS) using the Scales for Outcomes in Parkinson’s Autonomic Test (SCOPA-AUT), Parkinson’s Disease Nonmotor Symptoms (PDNMS), University of Pennsylvania SmellTest, Farnsworth-Munsell 100 Hue test, Beck Depression Inventory, and the RBD screeningquestionnaire. Results Both the PN and CS exhibited mild hyposmia and no deficits in visual tests. Frequentdysautonomia in all domains except sexuality was found for the PN. The total SCOPA-AUTscore was higher for the PN (18.47±10.08, mean±SD) than for the CS (4.40±3.09), as was thePDNMS score (10.53±4.78 and 1.80±2.31, respectively). RBD was present in 87% of the PNand 0% of the CS. The PN were more depressed than the CS. The differences between the PNand CS for all of these variables were statistically significant (all p<0.05). Conclusions The results of this study provide evidence for the presence of dysautonomia andconfirm the comorbidities of depression and RBD in narcolepsy patients. The spectrum, whichis comparable to the nonmotor complex in IPD, suggests wide-ranging, clinically detectabledysfunction beyond the narcoleptic core syndrome.
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