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Infection or Inflammation and Critical Care Seizures

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Seizures in Critical Care

Part of the book series: Current Clinical Neurology ((CCNEU))

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Abstract

Central nervous system (CNS) infections and inflammatory disease are frequent causes of seizures in the intensive care unit (ICU). Given the high incidence of seizures in these disease states, early recognition and treatment can improve patient outcomes, and should be suspected early in the course of evaluation and treatment. Specific infectious causes of encephalitis such as Herpes Simplex Virus (HSV) and Japanese Encephalitis (JE) can present with seizures in up to 34% and 28% of patients, respectively. An infectious etiology is identified in at least 18% of cases of new onset refractory status epilepticus (NORSE). Additionally, there are frequent electroencephalogram (EEG) findings that are characteristic of certain infections, such as lateralized periodic discharges in HSV infections. In some diseases, such as JE, the EEG can also be used as an additional tool to aid in prognosis. Given that many viral and inflammatory illnesses that affect the CNS have no specific treatment, the management of comorbid seizures may be one of the few targets that can effectively improve outcomes.

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Authors and Affiliations

  1. Division of Neurocritical Care, Department of Neurology, University of Virginia, 800394, Charlottesville, VA, 22908, USA

    Andrew C. Schomer

  2. Neurosciences Critical Care Division, Departments of Neurology, Neurosurgery, and Anesthesiology – Critical Care Medicine, Johns Hopkins Hospital, Baltimore, MD, USA

    Wendy Ziai

  3. Departments of Neurology and Neurosurgery, K-11 Henry Ford Hospital, 2799 West Grand Blvd, Detroit, MI, USA

    Mohammed Rehman

  4. Division of Neurocritical Care, Department of Neurology, University of Virginia, Charlottesville, VA, USA

    Barnett R. Nathan

Authors
  1. Andrew C. Schomer
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  2. Wendy Ziai
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  3. Mohammed Rehman
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  4. Barnett R. Nathan
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Correspondence to Andrew C. Schomer .

Editor information

Editors and Affiliations

  1. Departments of Neurology and Neurosurgery, Henry Ford Hospital, Detroit, Michigan, USA

    Panayiotis N. Varelas

  2. Neurocritical Care, Columbia University College of Physicians & Surgeons, New York, New York, USA

    Jan Claassen

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Schomer, A.C., Ziai, W., Rehman, M., Nathan, B.R. (2017). Infection or Inflammation and Critical Care Seizures. In: Varelas, P., Claassen, J. (eds) Seizures in Critical Care. Current Clinical Neurology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-49557-6_17

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