The Experts below are selected from a list of 240 Experts worldwide ranked by ideXlab platform
Shunzo Chiba - One of the best experts on this subject based on the ideXlab platform.
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Obtundation status dravet caused by complex partial status epilepticus in a patient with severe myoclonic epilepsy in infancy
Epilepsia, 1996Co-Authors: Shuji Wakai, Masami Ikehata, Hiroshi Nihira, Hirofumi Sueoka, Yoshitaka Kawamoto, Hiroyuki Hayasaka, Shunzo ChibaAbstract:Summary: Purpose: We report a 1-year 7-month-old boy with severe myoclonic epilepsy in infancy (SME) who exhibited complex partial status epilepticus (CPSE), which was confirmed by ictal video-EEG analysis. This boy first had a hemi-convulsion in a hot bath at age 3 months. Thereafter, he exhibited both partial and generalized seizures that were extremely intractable. At age 9 months, he had a prolonged episode of impaired consciousness that fit the “Obtundation status in SME” defined by Dravet et al. Methods and Results: Ictal EEG revealed persisting irregular spike-and-wave complexes over the left hemisphere, predominantly in the occipitotemporal area, and confirmed CPSE. The EEG abnormalities with decreased level of the consciousness continued -6 h after onset of the symptoms even with AED administration. Conclusions: Because SME features both generalized and focal seizures, both types of nonconvulsive status may be seen in SME. Although Dravet et al. already reported long-lasting atypical absences in patients with SME as “Obtundation status,” we demonstrated CPSE in an infant with SME who exhibited a prolonged stuporous state.
Jeremy C Weiss - One of the best experts on this subject based on the ideXlab platform.
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harmonic mean point processes proportional rate error minimization for Obtundation prediction
arXiv: Machine Learning, 2019Co-Authors: Jeremy C WeissAbstract:In healthcare, the highest risk individuals for morbidity and mortality are rarely those with the greatest modifiable risk. By contrast, many machine learning formulations implicitly attend to the highest risk individuals. We focus on this problem in point processes, a popular modeling technique for the analysis of the temporal event sequences in electronic health records (EHR) data with applications in risk stratification and risk score systems. We show that optimization of the log-likelihood function also gives disproportionate attention to high risk individuals and leads to poor prediction results for low risk individuals compared to ones at high risk. We characterize the problem and propose an adjusted log-likelihood formulation as a new objective for point processes. We demonstrate the benefits of our method in simulations and in EHR data of patients admitted to the critical care unit for intracerebral hemorrhage.
Shuji Wakai - One of the best experts on this subject based on the ideXlab platform.
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Obtundation status dravet caused by complex partial status epilepticus in a patient with severe myoclonic epilepsy in infancy
Epilepsia, 1996Co-Authors: Shuji Wakai, Masami Ikehata, Hiroshi Nihira, Hirofumi Sueoka, Yoshitaka Kawamoto, Hiroyuki Hayasaka, Shunzo ChibaAbstract:Summary: Purpose: We report a 1-year 7-month-old boy with severe myoclonic epilepsy in infancy (SME) who exhibited complex partial status epilepticus (CPSE), which was confirmed by ictal video-EEG analysis. This boy first had a hemi-convulsion in a hot bath at age 3 months. Thereafter, he exhibited both partial and generalized seizures that were extremely intractable. At age 9 months, he had a prolonged episode of impaired consciousness that fit the “Obtundation status in SME” defined by Dravet et al. Methods and Results: Ictal EEG revealed persisting irregular spike-and-wave complexes over the left hemisphere, predominantly in the occipitotemporal area, and confirmed CPSE. The EEG abnormalities with decreased level of the consciousness continued -6 h after onset of the symptoms even with AED administration. Conclusions: Because SME features both generalized and focal seizures, both types of nonconvulsive status may be seen in SME. Although Dravet et al. already reported long-lasting atypical absences in patients with SME as “Obtundation status,” we demonstrated CPSE in an infant with SME who exhibited a prolonged stuporous state.
Robert R Hammond - One of the best experts on this subject based on the ideXlab platform.
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june 2001 61 year old woman with confusion and Obtundation
Brain Pathology, 2001Co-Authors: J Barron, S P Lownie, Robert R HammondAbstract:Cases of the Month, April–June, 2001 The April Case of the Month (COM). The contributors report a case of a 70 year-old woman with recurrent meningiomas, one of which showed rhabdoid and lipomatous differentiation. Histopathological study of the first and second previous resections showed only typical meningothelial meningioma. On the third craniotomy, a new tumor specimen showed an admixture of classic meningothelial meningioma with lipomatous and rhabdoid foci. Immunohisto-chemical studies showed diffuse reactivity for epithelial membrane antigen and vimentin, as well as focal positivity for desmin and smooth muscle actin in the areas with rhabdoid features and S100 protein in the lipomatous foci. The presence of these three different and concomitant histological patterns only in the third surgical resection might support a meta-plastic origin and, also, corroborates the concept that rhabdoid features are suggestive of an aggressive behavior. The May COM. A 32-year-old woman with a history of previous mastoid surgery presented with bilateral extremity weakness and ambulatory instability. MRI revealed a dural-based mass completely encircling the upper cervical spinal cord. Workup was significant for an abnormally elevated c-ANCA, positive at a dilution Of 1:128. A portion of the lesion was removed by a posterior surgical approach to decompress the cervical cord. Histologic examination of the dura showed a dense granulomatous infiltrate with vasculitis and giant cells; coupled with the positive c-ANCA, the Process was felt to be most consistent with Wegener's granulomatosis. Wegener's granulomatosis infrequently involves the dura or meninges and has not previously been reported to affect dura of the cervical cord. Symptomatic improvement followed surgical decompression and high-dose corticosteroid therapy, with resultant resolution of an elevated c-ANCA titer. The June COM. A 61 year old female presents with a three week history of increasing confusion, lethargy and headache. A neurological exam revealed dis-orientation, mild expressive aphasia, bilateral papilledema, and a right pronator drift. She had a craniotomy and resection of tumor. The tumor histologically was consistent with a solitary fibrous tumor displaying malignant features of hypercellularity, marked nuclear atypia, high mitotic activity, and a high proliferation index. This case is unique as the first malignant variant of solitary fibrous tumor to be reported intracranially.
Michael Shannon - One of the best experts on this subject based on the ideXlab platform.
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Obtundation and seizure following ondansetron overdose in an infant
Clinical Toxicology, 2008Co-Authors: Mathew George, Nadeem Alduaij, Katherine Odonnell, Michael ShannonAbstract:Introduction. Ondansetron, an increasingly prescribed 5-HT3 antagonist used in the management of nausea and vomiting of various etiologies, has a well-established safety profile in therapeutic use. However, little is known about its effects in the setting of an overdose. We describe the first case of severe toxicity in an infant who unintentionally ingested a large quantity of ondansetron. Case report. A 12-month-old infant who ingested seven to eight tablets of his mother's Zofran (ondansetron) ODT 8 mg rapidly developed Obtundation and myoclonic movements. While treated by health care providers, he developed seizures, hepatotoxicity, QTc prolongation, and a serotonin syndrome that required endotracheal intubation and intensive care unit management. His clinical status improved over the course of 24 h with supportive care, and he was discharged to home with no sequelae. Discussion. With the increasing popularity of ondansetron among health care providers, particularly for the control of nausea in pregnan...
