Today at Parkland Morning Report, Dr. David Hellmann (Chairman of Internal Medicine at Johns Hopkins Bayview Medical Center) talked about the origins of the word, eureka, and how it applies to the practice of medicine. Eureka is derived from Ancient Greek and means “I have found it!” and is thought to have been exclaimed by the great Greek scholar Archimedes when he discovered how to determine the volume of an irregular shape. As physicians, we can be recognizing our “eureka” moments when we are talking to patients, obtaining a history, examining them, interpreting their tests, and so forth. What eureka moments have we had as physicians taking care of our patients and doing research? Maybe these discoveries can lay the foundation of a caring, thoughtful physician.
- NCSE was originally described in patients with chronic epilepsy, but is now recognized with increased frequency in populations such as the critically ill
- Similar to traditional classification of seizures, NCSE can be absence (as in this case), simple partial or complex partial
- Some NCSE occur after a seizure where a patient remains confused and is confused for a prolonged post-ictal state
- Up to 8 to 20% of comatose patients without seizure history will have EEG findings c/w NCSE when monitored
- Risk factors for NCSE in critically ill: severe alteration of consciousness, hx of seizure, younger age, hx of brain injury, neurosurgical procedure, sepsis
- Other risk factors for NCSE include medication non-adherence/discontinuation, drug withdrawal, structural brain injury or infection and metabolic derangements
- Treatment: Unknown if treatment should be as aggressive as convulsive status, no RCT. Overall goal is to treat as well as sedate as minimally as possible to avoid inducing or prolonging coma and intubation
- Treat with IV benzo and IV AED while monitoring with continuous EEG
Andy Laccetti (PGY-03) recently presented his research at the Eastern Cooperative Oncology Group (ECOG) – American College of Radiology Imaging Network (ACRIN) conference and won the “ECOG-ACRIN Young Investigator Symposium Award of Distinction for Clinical Research” for his work. Below is a recent article from Science Daily about the research that Andy is involved in working with Dr. David Gerber, Dr. Ethan Halm, Dr. Sandi Pruitt, and Dr. Lei Xuan from UT Southwestern. Great job Andy!