levetiracetam and Hypertension

Posterior Reversible Encephalopathy Syndrome (PRES) is characterized by acute neurological symptoms with typical imaging features, primarily in the territories of the brain supplied by the posterior circulation, probably due to vasogenic edema. Both clinical and imaging features are generally reversible. We report a 13-year-old girl affected by Nodular Sclerosis Classical Hodgkin Lymphoma stage IIIB into complete remission, with a recurrence and autologous bone-marrow transplantation, who has been treated with an anti-CD30 monoclonal antibody, brentuximab-vedotin. The girl has suddenly presented a convulsive status epilepticus, that needed intubation and sedation. Therefore, an IV therapy with levetiracetam was started. Furthermore, the girl has presented high blood pressure and reduced kidney function. Brain MRI demonstrated a diffuse PRES-like disease, that went into regression after the first week. After another week, the girl presented a new prolonged generalized tonic clonic convulsive episode, that needed intubation and sedation and an association of clobazam and levetiracetam: a new brain MRI showed a recurrence of PRES-like lesions in addition to some signs of leukoencephalopathy with brain lactate accumulation on 1H-MRS, due to cerebral energetic failure. The girl also presented a refractory arterial hypertension. After 45 days of ICU hospitalization the patient has been discharged and followed up with neurological examinations. Brain MRI and brain 1H-MRS, 5 months after patient's discharge, showed incomplete regression of cerebral white matter signal abnormalities with MRS normalization.

Topics: Adolescent; Brentuximab Vedotin; Female; Humans; Hypertension; Levetiracetam; Magnetic Resonance Imaging; Posterior Leukoencephalopathy Syndrome; Status Epilepticus

Posterior reversible encephalopathy syndrome (PRES) is a neurological disorder characterised by parieto-occipital vasogenic oedema seen on MRI. Infection and sepsis has been reported as a possible cause for this disorder.We present a 19-year-old immunocompetent Caucasian man with known type 1 diabetes mellitus who presented to the emergency department with acute onset of bilateral visual loss, headaches and hypertension; he had been discharged 2 weeks ago for severe diabetic ketoacidosis and

Topics: Anticonvulsants; Antihypertensive Agents; Brain; Diabetic Ketoacidosis; Humans; Hypertension; Levetiracetam; Magnetic Resonance Imaging; Male; Nicardipine; Piracetam; Posterior Leukoencephalopathy Syndrome; Sepsis; Tomography, X-Ray Computed; Young Adult

Cardiac dysfunction occurring secondary to neurologic disease, termed neurogenic stunned myocardium, is an incompletely understood phenomenon that has been described after several distinct neurologic processes. We present a case of neurogenic stunned myocardium, discovered intraoperatively after anesthetic induction, in a patient who presented to our operating room with a recent intraparenchymal hemorrhage. We discuss the longitudinal cardiac functional course after neurogenic stunned myocardium. Finally, we discuss the pathophysiology of neurogenic stunned myocardium, as well as its implications for anesthesiologists caring for neurosurgical patients.

Topics: Adult; Anesthesia, General; Cerebral Hemorrhage; Emergency Service, Hospital; Heart; Hemangioma, Cavernous, Central Nervous System; Humans; Hypertension; Hypotension; Levetiracetam; Male; Methamphetamine; Myocardial Stunning; Nicardipine; Perioperative Period; Phenylephrine; Piracetam; Seizures; Substance-Related Disorders; Takotsubo Cardiomyopathy

Topics: Aged, 80 and over; Alzheimer Disease; Anticonvulsants; Electroencephalography; Epilepsy, Frontal Lobe; Humans; Hypertension; Levetiracetam; Male; Night Terrors; Piracetam

Cerebral venous thrombosis is a rare entity in pregnancy and the postpartum period, with an incidence of 1:10,000 to 1:25,000.. A 19-year-old woman, gravida 1, para 1, presented to the emergency department on postpartum day 7, having experienced seizures. Severe preeclampsia had been diagnosed during the antepartum period. The patient initially was diagnosed with postpartum eclampsia and started on magnesium sulfate for seizure prophylaxis. Magnetic resonance imaging later showed cerebral venous thrombosis of the left transverse sinus and right frontal and left frontoparietal cortical veins.. Cerebral venous thrombosis and eclampsia may manifest in a similar manner. Physicians can optimize the care of patients presenting with seizures by considering etiologies rarer than eclampsia and pursuing tests that may distinguish them.

Topics: Anticoagulants; Anticonvulsants; Brain; Female; Heparin; Humans; Hypertension; Levetiracetam; Magnesium Sulfate; Magnetic Resonance Imaging; Piracetam; Postpartum Period; Pregnancy; Pregnancy Complications, Hematologic; Seizures; Sinus Thrombosis, Intracranial; Stroke; Tomography, X-Ray Computed; Treatment Outcome; Venous Thrombosis; Young Adult

Topics: Aged; Anti-Dyskinesia Agents; Anticonvulsants; Antihypertensive Agents; Ataxia; Cerebellum; Dose-Response Relationship, Drug; Drug Administration Schedule; Dyskinesias; Haloperidol; Hemangioma, Cavernous, Central Nervous System; Humans; Hypertension; Intracranial Hemorrhage, Hypertensive; Levetiracetam; Lorazepam; Magnetic Resonance Imaging; Male; Piracetam; Recurrence; Subthalamic Nucleus; Treatment Outcome; Vomiting