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Related Concept Videos

Electroconvulsive Therapy01:30

Electroconvulsive Therapy

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Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early...
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Epilepsy and Seizures: Overview01:24

Epilepsy and Seizures: Overview

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Epilepsy is a chronic neurological disease marked by recurrent, unpredictable seizures. These seizures are caused by abnormal electrical discharges in the brain, leading to behavior, sensation, or consciousness alterations. They can also cause transient impairment of awareness, interfering with daily activities.
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
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Seizures: Classification01:13

Seizures: Classification

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Epilepsy is primarily characterized by unpredictable seizures, either provoked by an identifiable factor, such as injury or illness, or unprovoked, occurring spontaneously without apparent cause.
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
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Antiepileptic Drugs: Potassium Channel Activators01:20

Antiepileptic Drugs: Potassium Channel Activators

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Ezocgabine or retigabine, an antiepileptic drug of remarkable efficacy, has revolutionized the management of seizures. It is a potassium channel activator, explicitly targeting the family of Q subtype potassium channels. It enhances the transmembrane potassium currents, regulating neuronal excitability. This action stabilizes the resting membrane potential, a pivotal factor in mitigating the hyperexcitability that characterizes epilepsy.
Ezogabine has gained approval as an adjunctive treatment...
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Instrumental Activities of Daily Living in Older Adults with Epilepsy: A Cross-Sectional and Longitudinal Multicenter Study.

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Related Experiment Video

Updated: Aug 24, 2025

Non-restraining EEG Radiotelemetry: Epidural and Deep Intracerebral Stereotaxic EEG Electrode Placement
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Electrographic Seizures in the Critically Ill.

Smitha K Holla1, Parimala Velpula Krishnamurthy1, Thanujaa Subramaniam2

  • 1Department of Neurology, UW Medical Foundation Centennial building, 1685 Highland Avenue, Madison, WI 53705, USA.

Neurologic Clinics
|October 21, 2022
PubMed
Summary

Identifying and treating seizures in critically ill patients is difficult. This review covers at-risk populations, prognostication tools like 2HELPS2B, and management strategies for electrographic seizures.

Keywords:
2HELPS2B scoreContinuous EEGCritical illnessElectrographic seizuresIIC pattern

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Area of Science:

  • Critical Care Medicine
  • Neuroscience
  • Neurology

Background:

  • Seizures in critically ill patients present diagnostic and therapeutic challenges.
  • Accurate identification and management are crucial for improving patient outcomes.
  • Existing guidelines require updates based on recent data.

Purpose of the Study:

  • To review current knowledge on risk factors, prognostication, and diagnostic tools for seizures in the critically ill.
  • To discuss the ictal-interictal continuum and its clinical implications.
  • To propose evidence-based recommendations for the targeted treatment of electrographic seizures.

Main Methods:

  • Comprehensive literature review of studies on critically ill patients with seizures.
  • Analysis of data on risk stratification and prognostication tools (e.g., 2HELPS2B).
  • Evaluation of ancillary testing, including imaging, biomarkers, and invasive monitoring.

Main Results:

  • Detailed review of patient populations at risk for seizures.
  • Explanation of electrographic seizures and ictal-interictal continuum patterns with updated definitions and risks.
  • Illustrative case studies of 5 patient scenarios, including treatment and outcomes.

Conclusions:

  • Targeted treatment of electrographic seizures in critically ill patients requires a multidisciplinary approach.
  • Prognostication tools and advanced monitoring aid in decision-making.
  • Further research is needed to refine treatment strategies and improve patient outcomes.