Filzah Faheem MD
Aspiring Neurologist. Research Fellow at AINeuroCare Academy. Epilepsy Sub-section Coordinator.
mHealth also known as the Internet of Things has advanced over the years. Policy for Device Software Functions and Mobile Medical Applications was first issued by FDA in 2013, later on, mHealth Task Force and HIPAA set goals in order to provide care using wireless technology. Many applications approved by FDA and Epilepsy foundation have been introduced to monitor patient symptom diaries and aid clinical trials. Effective delivery of mHealth (telehealth) services will decrease accident & emergency admissions by 15%.
Digital health is an intersection between technology and healthcare that uses computing platforms, connectivity, software, and sensors. With the increased amount of data being produced Artificial Intelligence as a Service and Ecosystem as a service for cAI open doors for the global coalition of AI clinicians, individual hospitals, networking, and training opportunities. WHO, FDA, and NHS have been continuously releasing guidelines to cope with digital health transformation.
Sudden, unexpected, non-traumatic, non-drowning, witnessed or unwitnessed death, in any individual who has history of epilepsy, excludes documented status epilepticus and post-mortem examination does not reveal any cause (anatomical or toxicological) of death.
Classifying the type of status epilepticus is important in determining morbidity and aggressiveness of treatment required. Clinical manifestations vary according to the type of seizure the patient experiences and yet diagnosis is made clinically based on those clinical manifestations. This chapter will help you understand the classification and how to diagnose patient based on clinical features.
When patients fail first-line therapy which is a sufficient dose of benzodiazepines and at least one AED as second-line therapy, irrespective of time this is termed refractory status epilepticus. Primary drugs being used for refractory status epilepticus are Midazolam, Propofol, and Ketamine while other interventions include DBS, surgery, VNS, etc. This chapter focuses on the treatment strategies being involved to treat patients with refractory status epilepticus
Continuous EEG monitoring device with a video camera for at least 24 hours in a conscious patient reflecting cortical synaptic activity. CEEG is most commonly performed in ICU settings in order to monitor critically ill patients. Neuronal activity depends on the blood supply hence it makes EEG monitoring reliable to check for brain ischemia. Automated displays help to interpret raw EEG effectively. Commonly used techniques for these displays are Color density spectral array and Amplitude-integrated EEG. This chapter will help you understand the concepts of continuous EEG, it’s indications, and utilization in different settings along with the emphasis on the advantages to use this technique.
Status epilepticus (SE) is defined as ≥5 minutes of continuous clinical and/or electrographic seizure activity or recurrent seizure activity without recovery (returning to baseline) between seizures