Withdrawal Seizures Seen In the Setting of Synthetic Cannabinoid Abuse Christopher S. Sampson, Starr-Mar’ee Bedy, Terry Carlisle
DOI: http://dx.doi.org/10.1016/j.ajem.2015.03.025
The American Journal of Emergency Medicine , Vol. 33 , Issue 11 ,
Published online: March 15 2015
x The recent rise in the abuse of synthetic cannabinoid receptor agonists (Spice, K2) has led to an increase of patients presenting to emergency departments (EDs) with complications stemming from their abuse. We present a case of withdrawal seizures seen in a chronic abuser of these herbal mixtures who stopped using them abruptly. Seizures have been reported in the literature in the setting of abuse, but not during withdrawal [1].
When a seizure is not a real seizure! Soheila Talebi, Farzaneh Ghobadi, Sameer Chaudhari, Ely Gracia, Ola Olatunde, Gerald Pekler, Ferdinand Visco, Getaw Worku Hassen
DOI: http://dx.doi.org/10.1016/j.ajem.2015.07.077
The American Journal of Emergency Medicine , Vol. 34 , Issue 4 ,
Published online: August 7 2015
x We report here 2 cases of methadone induced Torsades de Pointes with a clinical presentation mimicking convulsive seizures in a substance abuser These cases highlight the importance of being aware of methadone-induced Torsades de Pointes and the occasional atypical clinical presentations of this condition.
Electroencephalography findings in patients presenting to the ED for evaluation of seizures Pooja Kadambi, Kimberly W. Hart, Opeolu M. Adeoye, Christopher J. Lindsell, William A. Knight IV
DOI: http://dx.doi.org/10.1016/j.ajem.2014.10.041
The American Journal of Emergency Medicine , Vol. 33 , Issue 1 ,
Published online: October 29 2014
x Status epilepticus is a life-threatening, time-sensitive emergency. Acquiring an electroencephalogram (EEG) in the emergency department (ED) could impact therapeutic and disposition decisions for patients with suspected status epilepticus.
Ranolazine overdose–induced seizures Nour Akil, Edward Bottei, Sameer Kamath
DOI: http://dx.doi.org/10.1016/j.ajem.2015.04.062
The American Journal of Emergency Medicine , Vol. 33 , Issue 12 ,
Published online: April 30 2015
x Ranolazine is a new anti-anginal medication that was approved by the US Food and Drug Administration (FDA) in 2006 for patients with symptomatic chronic angina despite optimized therapy. This paper presents a case report of a fifteen year old male patient admitted to the pediatric intensive care unit after ranolazine overdose ingestion. He had recurrent new onset seizures that are most likely due to ranolazine overdose. Seizures have never been reported with ranolazine use or abuse.
Emergent diagnostic testing for pediatric nonfebrile seizures Ashley M. Strobel, Vikramjit S. Gill, Michael D. Witting, Getachew Teshome
DOI: http://dx.doi.org/10.1016/j.ajem.2015.06.004
The American Journal of Emergency Medicine , Vol. 33 , Issue 9 ,
Published online: June 6 2015
x Guidelines from the American Academy of Neurology recommend laboratory studies or computed tomography (CT) for children who experience a nonfebrile seizure if anything in their history suggests a clinically significant abnormality.
A patient with altered mental status and possible seizure reveals an atypical aortic dissection upon workup Olufolahan J. Lawal, Harinder S. Dhindsa, Joshua W. Loyd
DOI: http://dx.doi.org/10.1016/j.ajem.2013.11.010
The American Journal of Emergency Medicine , Vol. 32 , Issue 5 ,
Published online: November 18 2013
x Aortic dissection occurs when a tear occurs in the inner muscle wall lining of the aorta, allowing blood to split the muscle layers of the aortic wall apart. It is classically characterized by pain that starts in the upper chest, which then radiates to the upper back and is tearing or ripping in quality. Our objective is to present a case followed by a brief literature review of aortic dissection and uncommon but important features that may be demonstrated. In this report, we present the case of a 57-year-old woman who was transported to the emergency department with an acute episode of altered mental status, presenting as a possible stroke with possible seizures.
Clinical assessment of children with first-attack seizures admitted to the ED Chun-Yu Chen, Wen-Chieh Yang, Kang-Hsi Wu, Han-Ping Wu
DOI: http://dx.doi.org/10.1016/j.ajem.2011.07.008
The American Journal of Emergency Medicine , Vol. 30 , Issue 7 ,
Published online: October 26 2011
x This study aims to evaluate clinical values and determine the function of a pediatric observation unit (POU) as an alternative to inpatient unit admission for children with newly onset seizures.
The Denver Seizure Score: anion gap metabolic acidosis predicts generalized seizure Katherine M. Bakes, Jeff Faragher, Vince J. Markovchick, Kevin Donahoe, Jason S. Haukoos
DOI: http://dx.doi.org/10.1016/j.ajem.2010.07.014
The American Journal of Emergency Medicine , Vol. 29 , Issue 9 ,
Published online: October 18 2010
x Anion gap (AG) and serum bicarbonate concentration (BICARB) may help confirm a diagnosis of seizure in an unwitnessed collapse; however, little data exist to support this practice. Our objective was to assess the association between AG metabolic acidosis and generalized seizure and to derive a simple score to predict seizure.
Ischemia-modified albumin in patients with seizure Sevket Balta, Mustafa Aparci, Mustafa Demir, Cengiz Ozturk, Turgay Celik
DOI: http://dx.doi.org/10.1016/j.ajem.2014.06.028
The American Journal of Emergency Medicine , Vol. 32 , Issue 10 ,
Published online: July 1 2014
x We read the article “Novel biochemical marker for differential diagnosis of seizure: Ischemia modified albumin� by Uzel et al [1]. They aimed to evaluate and investigate the diagnostic value of ischemia-modified albumin (IMA) in adult patients presented to emergency department with seizures. They demonstrated that blood IMA level and IMA/albumin ratio significantly increase in adult patients who experienced seizures. Ischemia-modified albumin may be considered as a useful biomarker in the differential diagnosis of seizure.
Electrocardiographic manifestations of tramadol toxicity with special reference to their ability for prediction of seizures Mohammadali Emamhadi, Hossein Sanaei-Zadeh, Masoumeh Nikniya, Nasim Zamani, Richard C. Dart
DOI: http://dx.doi.org/10.1016/j.ajem.2011.12.009
The American Journal of Emergency Medicine , Vol. 30 , Issue 8 ,
Published online: February 10 2012
x The aims of this study are to determine the electrocardiographic (ECG) manifestations of the symptomatic patients with isolated tramadol toxicity and to predict seizures based on ECG parameters.
Clinical predictors for delirium tremens in patients with alcohol withdrawal seizures Dong Wook Kim, Hyun Kyung Kim, Eun-Kee Bae, So-Hee Park, Kwang Ki Kim
DOI: http://dx.doi.org/10.1016/j.ajem.2015.02.030
The American Journal of Emergency Medicine , Vol. 33 , Issue 5 ,
Published online: February 23 2015
x Delirium tremens (DT) is the severest form of alcohol withdrawal syndrome, frequently after alcohol withdrawal seizures. Delirium tremens occurs in a small proportion of patients with alcohol withdrawal seizures; nevertheless, early identification of high-risk patients is important for intensive preventive management of unexpected episodes due to agitation and its associated increased mortality. However, there are limited studies on clinical predictors of the development of DT in patients with alcohol withdrawal seizures.
Cerebral oximetry with cerebral blood volume index in detecting pediatric stroke in a pediatric ED Thomas J. Abramo, Z. Leah Harris, Mark Meredith, Kristen Crossman, Rawle Seupaul, Abby Williams, Sheila McMorrow, Jennifer Dindo, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2015.07.037
The American Journal of Emergency Medicine , Vol. 33 , Issue 11 ,
Published online: July 22 2015
x Despite pediatric stroke awareness and pediatric stroke activation systems, recognition and imaging delays along with activation inconsistency still occur. Reliable objective pediatric stroke detection tools are needed to improve detection and activations. Regional cerebral oxygen saturation (rc so 2 ) with cerebral blood volume index (CBVI) can detect abnormal cerebral physiology.
Subject Index
DOI: http://dx.doi.org/10.1016/S0735-6757(15)00997-3
The American Journal of Emergency Medicine , Vol. 33 , Issue 12 ,
Published in issue: December 2015
Prevalence of non-convulsive seizure and other electroencephalographic abnormalities in ED patients with altered mental status Shahriar Zehtabchi, Samah G. Abdel Baki, Ahmet Omurtag, Richard Sinert, Geetha Chari, Shweta Malhotra, Jeremy Weedon, André A. Fenton, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.002
The American Journal of Emergency Medicine , Vol. 31 , Issue 11 ,
Published online: September 25 2013
x Four to ten percent of patients evaluated in emergency departments (ED) present with altered mental status (AMS). The prevalence of non-convulsive seizure (NCS) and other electroencephalographic (EEG) abnormalities in this population is unknown.
Synthetic cannabinoid hyperemesis resulting in rhabdomyolysis and acute renal failure Jacqueline R. Argamany, Kelly R. Reveles, Bryson Duhon
DOI: http://dx.doi.org/10.1016/j.ajem.2015.08.051
The American Journal of Emergency Medicine , Vol. 34 , Issue 4 ,
Published online: September 7 2015
x Synthetic cannabinoid usage has increased in the past decade. Concurrently, emergency management of associated adverse effects due to synthetic cannabinoid usage has also risen. Reported toxicities include psychosis, seizures, cardiotoxicity, acute kidney injury, and death. While cannabis was first described as a cause of acute hyperemesis in 2004, a more recent case series also describes the association between cannabinoid hyperemesis and risk of acute renal failure. Synthetic cannabinoids have also been reported to cause acute hyperemesis and acute renal failure; however, the risk of rhabdomyolysis-induced renal failure has yet to be elucidated.
Small subdural hemorrhages: is routine intensive care unit admission necessary? Paul Albertine, Samuel Borofsky, Derek Brown, Smita Patel, Woojin Lee, Anthony Caputy, M. Reza Taheri
DOI: http://dx.doi.org/10.1016/j.ajem.2015.12.035
The American Journal of Emergency Medicine , Vol. 34 , Issue 3 ,
Published online: December 18 2015
x With advancing technology, the sensitivity of computed tomography (CT) for the detection of subdural hematoma (SDH) continues to improve. In some cases, the finding is limited to one or 2 images of the CT examination. At our institution, all patients with an SDH require intensive care unit (ICU) admission, regardless of size. In this report, we tested the hypothesis that patients with a small traumatic SDH on their presenting CT examination do not require the intensive monitoring offered in the ICU and can instead be managed on a hospital unit with a lower level of monitoring.
Comparison of quantitative EEG to current clinical decision rules for head CT use in acute mild traumatic brain injury in the ED Syed Imran Ayaz, Craig Thomas, Andrew Kulek, Rosa Tolomello, Valerie Mika, Duane Robinson, Patrick Medado, Claire Pearson, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2014.11.015
The American Journal of Emergency Medicine , Vol. 33 , Issue 4 ,
Published online: November 19 2014
x We compared the performance of a handheld quantitative electroencephalogram (QEEG) acquisition device to New Orleans Criteria (NOC), Canadian CT Head Rule (CCHR), and National Emergency X-Radiography Utilization Study II (NEXUS II) Rule in predicting intracranial lesions on head computed tomography (CT) in acute mild traumatic brain injury in the emergency department (ED).
Cerebral oximetry with blood volume index in asystolic pediatric cerebrospinal fluid malfunctioning shunt patients Thomas J. Abramo, Mark Meredith, Mathew Jaeger, Bradford Schneider, Holli Bagwell, Eleym Ocal, Gregory Albert
DOI: http://dx.doi.org/10.1016/j.ajem.2014.04.007
The American Journal of Emergency Medicine , Vol. 32 , Issue 11 ,
Published online: April 17 2014
x Pediatric cerebrospinal fluid shunt malfunctions can present with varying complaints. The primary cause is elevated intracranial pressure (ICP). Malfunctioning sites are the proximal or distal sites [1-4]. A rare presenting complaint is cardiac arrest. Immediate ICP reduction is the only reversible option for this type of cardiac arrest.
Clinical factors in predicting acute renal failure caused by rhabdomyolysis in the ED Chun-Yu Chen, Yan-Ren Lin, Lu-Lu Zhao, Wen-Chieh Yang, Yu-Jun Chang, Han-Ping Wu
DOI: http://dx.doi.org/10.1016/j.ajem.2013.03.047
The American Journal of Emergency Medicine , Vol. 31 , Issue 7 ,
Published online: May 22 2013
x This study aimed to determine the clinical factors in predicting acute renal failure (ARF) in rhabdomyolysis and investigate the potential risk of renal replacement therapy (RRT).
Lack of efficacy of phenytoin in children presenting with febrile status epilepticus Salima Ismail, Arielle Lévy, Helena Tikkanen, Marcel Sévère, Franciscus Johannes Wolters, Lionel Carmant
DOI: http://dx.doi.org/10.1016/j.ajem.2011.11.007
The American Journal of Emergency Medicine , Vol. 30 , Issue 9 ,
Published online: March 2 2012
x Fever is the most common precipitant of status epilepticus in children. Animal models suggest that only γ -aminobutyric acidic drugs are effective in the treatment of febrile seizures, but there is limited clinical evidence to support this.
