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Rainer Dziewas

Publications and source records attributed to Rainer Dziewas.

22 records · Page 2Linked to original sources

Tiagabine-related non-convulsive status epilepticus in partial epilepsy: three case reports and a review of the literature.

There have been several recent reports of non-convulsive status epilepticus during tiagabine therapy in patients with partial epilepsy. We report three cases where elevation of tiagabine dosage was followed by electroclinical features, or electroencephalographic features without clinical signs, of non-convulsive status epilepticus. Administration of clonazepam and/or discontinuation to tiagabine lead to complete remission. In one case after re-exhibition of tiagabine the EEG again showed rhythmic delta waves. We review the other cases reported so far and discuss the different pathophysiological hypotheses about the association in the light of new experimental data.

Adult↗

Nonconvulsion status epilepticus in patients with juvenile myoclonic epilepsy: types and frequencies.

Juvenile myoclonic epilepsy (JME) is an idiopathic, age-related generalized epileptic syndrome, featuring generalizedtonic-clonic and absence seizures as well as myoclonic jerks. Except for some case reports, little is known about type and frequency of nonconvulsive status epilepticus (NCSE) in adult patients with JME. In a retrospective study we therefore reviewed all patients with JME, who had been referred to our hospital between 1994 and 1999 for the occurrence of NCSE. Of the 69 patients with JME seen within these 6 years three women had typical absence status-one of them two times-and one woman had impulsive-petit-mal status. All four patients had a history of myoclonic, absence and generalized tonic-clonic seizures. Because of the extreme rarity of impulsive-petit-mal status the corresponding case history is presented in detail. According to our findings the prevalence of NCSE in JME can be estimated at 5.8%, the incidence at 1.2% per year with a clear preponderance of female gender.

Adult↗

Hypoglossal nerve palsy as complication of oral intubation, bronchoscopy and use of the laryngeal mask airway.

Hypoglossal nerve injury is a recognized but rare complication of oropharyngeal manipulation during intubation, bronchoscopy and use of a laryngeal mask airway. We present 2 new cases of temporary hypoglossal nerve palsy after orotracheal intubation for general anesthesia. The relevant literature is reviewed and different hypotheses concerning the pathophysiological mechanisms of nerve damage are discussed.

Adult↗

Follow-up examinations by transcranial Doppler ultrasound in primary angiitis of the central nervous system.

BACKGROUND: Primary angiitis of the central nervous system (PACNS) is a rare disease. The definite diagnosis is made upon proof of mononuclear inflammation of the vessel wall on brain biopsy. The diagnosis can also be established on clinical grounds, typical findings on intra-arterial angiography and other investigatory grounds excluding other diseases. Therapy comprises an aggressive immunosuppressive approach. Close monitoring of the patients is mandatory. Transcranial Doppler ultrasound (TCD) has not yet been used to follow up the vasculitic lesions in PACNS. CASE: We report on a 32-year-old female with massive cerebral infarctions secondary to multiple large-vessel stenoses because of probable PACNS. The patient was followed closely by means of TCD. During therapy the cerebral blood flow velocities normalized as displayed by TCD. Clinical improvement followed several days after normalization of cerebral blood flow. CONCLUSIONS: TCD is a valuable noninvasive bedside tool to monitor cerebral blood flow velocities and therapy response in patients with cerebral vasculitis, if large arteries are involved.

Adult↗