Electrocardiographic Changes at the Early Stage of Status Epilepticus: First Insights From the ICTAL Registry

Electrocardiographic Changes at the Early Stage of Status Epilepticus: First Insights From the ICTAL Registry. Crit Care Med. 2022 Dec 19

In this cohort study, early ECG abnormalities in the acute phase of SE were frequent, often unrecognized, mostly categorized as major, mainly concerned the ST segment and the T wave, and were associated with clinical and biological stigma of hypoxemia. They were not independently associated with 90-day functional outcome.

Multicentre observational status-epilepticus registry: protocol for ICTAL

Multicentre observational status-epilepticus registry: protocol for ICTAL. Jacq G, Chelly G, Quenot JP, Soulier P, Lesieur O, Beuret P, Holleville M, Bruel C, Bailly P, Sauneuf B, Sejourne C, Rigaud JP, Galbois A, Arrayago M, Plantefeve G, Stoclin A, Schnell D, Fontaine C, Perier F, Bougouin W, Pichon N, Mongardon M, Ledoux D, Lascarrou JB, Legriel S. BMJ Open 2022

Abstract

Introduction Status epilepticus (SE) is a common life-threatening neurological emergency that can cause long-term impairments. Overall outcomes remain poor. Major efforts are required to clarify the epidemiology of SE and the determinants of outcomes, thereby identifying targets for improved management.

Methods and analysis ICTAL Registry is a multicentre open cohort of critically ill patients with convulsive, non-convulsive or psychogenic non-epileptic SE. Observational methods are applied to collect uniform data. The goal of the ICTAL Registry is to collect high-quality information on a large number of patients, thereby allowing elucidation of the pathophysiological mechanisms involved in mortality and morbidity. The registry structure is modular, with a large core data set and the opportunity for research teams to create satellite data sets for observational or interventional studies (eg, cohort multiple randomised controlled trials, cross-sectional studies and short-term and long-term longitudinal outcome studies). The availability of core data will hasten patient recruitment to studies, while also decreasing costs. Importantly, the vast amount of data from a large number of patients will allow valid subgroup analyses, which are expected to identify patient populations requiring specific treatment strategies. The results of the studies will have a broad spectrum of application, particularly given the multidisciplinary approach used by the IctalGroup research network.

Ethics and dissemination The ICTAL Registry protocol was approved by the ethics committee of the French Intensive Care Society (#CE_SRLF 19-68 and 19-68a). Patients or their relatives/proxies received written information to the use of the retrospectively collected and pseudonymised data, in compliance with French law. Prospectively included patients receive written consent form as soon as they recover decision-making competency; if they refuse consent, they are excluded from the registry. Data from the registry will be disseminated via conference presentations and peer-reviewed publications.

Trial registration number NCT03457831.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

http://dx.doi.org/10.1136/bmjopen-2021-059675

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L’association IctalGroup est une association loi 1901 à but non lucratif de professionnels soignants, médecins et paramédicaux, qui se consacre à l’enseignement et à la recherche dans le domaine des soins critiques chez les patients avec une atteinte neurologique. Nous avons un intérêt particulier pour l’état de mal épileptique et ses complications à long terme.

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Spectrum of neurological manifestations associated with SARS-CoV-2 infection

All neurological manifestations

Acute Encephalopathy :

Anti-NMDA receptor encephalitis

Anti-NMDA receptor encephalitis in a psychiatric Covid-19 patient: A case report. Brain, Behavior, and Immunity 2020

Seizures / Status Epilepticus / Myoclonus / EEG findings

Acute Hemorrhagic Necrotizing Encephalopathy :

Ischemic Stroke / Intra Cerebral Hemorrhage / Cerebral Venous Sinus Thrombosis :

Encephalitis

Demyelinating lesions

ADEM

Myelitis

Guillain-Barré Syndrome / Miller Fisher Syndrome

Posterior Reversible Encephalopathy Syndrome

Subjective neurological symptoms

Postmortem positive or negative findings

Imaging findings

Biomarkers of CNS injury

Management complications