vitamin-k-semiquinone-radical and Seizures

Seizures and intracranial hemorrhage are possible medical diseases that any obstetrician may encounter. This article reviews the cause, treatment, and medical management in pregnancy for seizures and intracranial hemorrhage, and how the two can overlap into preeclampsia or eclampsia. This article also highlights some challenging management issues from the obstetrician's perspective.

Topics: Anticonvulsants; Carbamazepine; Congenital Abnormalities; Eclampsia; Epilepsy; Female; Folic Acid; Heparin; Humans; Infant, Newborn; Intracranial Hemorrhages; Lamotrigine; Monitoring, Physiologic; North America; Phenobarbital; Phenytoin; Pregnancy; Risk Factors; Seizures; Subarachnoid Hemorrhage; Triazines; Valproic Acid; Vitamin K

Topics: Bacterial Vaccines; Bicarbonates; Brain Edema; Diagnosis, Differential; Diazepam; Digoxin; Fever; Gastrointestinal Hemorrhage; Heparin; Humans; Hydrocortisone; Infant; Infant, Newborn; Isoproterenol; Mannitol; Meningitis; Meningitis, Meningococcal; Meningitis, Viral; Phenytoin; Seizures; Shock, Septic; Vitamin K

The American Academy of Pediatrics recommends vitamin K prophylaxis at birth for all newborns to prevent vitamin K deficiency bleeding (VKDB). Despite a lack of evidence for serious harms, barriers to prophylaxis, including parental refusal, are rising, as are cases of VKDB.. This simulation involved an infant presenting to the emergency department who decompensated due to a cerebral hemorrhage caused by VKDB and was treated by pediatric and emergency providers. The case was incorporated into the fellow and division monthly curricula, and participants completed postsimulation surveys. The patient required a secure airway, seizure management, vitamin K, and a fresh frozen plasma infusion upon suspicion of the diagnosis, plus a coordinated transfer to definitive care. The case included a description of the simulated case, learning objectives, instructor notes, an example of the ideal flow of the scenario, anticipated management mistakes, and educational materials.. The simulations were carried out with 48 total participants, including 40 fellows and eight attendings, from five different training institutions over 1 year. In surveys, respondents gave overall positive feedback. Ninety-four percent of participants gave the highest score on a Likert scale indicating that the simulation was relevant, and over 80% gave the highest score indicating that the experience helped them with medical management.. This simulation trained physicians how to recognize and treat a distressed infant with VKDB. The case was perceived to be an effective learning tool for both fellow and attending physicians.

Topics: Child; Curriculum; Humans; Infant; Infant, Newborn; Pediatric Emergency Medicine; Seizures; Vitamin K; Vitamin K Deficiency Bleeding

Factor VII deficiency is characterized by epistaxis, bruising, hemarthrosis, menorrhagia, gastrointestinal bleeding, hematuria, and intracranial hemorrhage during infancy. Causes of acquired factor VII deficiency include liver disease, Vitamin K deficiency, and warfarin administration. Congenital factor VII deficiency is an autosomal recessive disorder, with the homozygotes having a severe deficiency and the heterozygotes a moderate deficiency of factor VII. Orthopedic, gynecological, cardiothoracic, and abdominal surgical procedures have been successfully performed in patients with factor VII deficiency both with and without factor VII replacement. We present two patients with moderate and moderately severe factor VII deficiency who successfully underwent intracranial procedures using plasma during the perioperative period for factor VII replacement. One patient successfully underwent stereotactic placement of mesial temporal lobe depth electrodes and subdural strip electrodes followed by anterior temporal lobectomy for medically refractory seizures. The second patient successfully underwent craniotomy for an olfactory groove meningioma. No bleeding complications were encountered with any of the three intracranial procedures performed. These cases represent the first reported cases of successful intracranial procedures in patients with factor VII deficiency, other than shunting procedures performed for intraventricular hemorrhage during infancy.

Topics: Adult; Aged; Blood Transfusion; Brain; Brain Neoplasms; Craniotomy; Electrodes, Implanted; Factor VII Deficiency; Female; Humans; Male; Meningioma; Neurosurgery; Psychosurgery; Seizures; Stereotaxic Techniques; Temporal Lobe; Vitamin K

The alcohol withdrawal syndromes are generally self-limited processes from which spontaneous recovery can be anticipated. To achieve this outcome, the various types of withdrawal must be managed in such a way as to prevent the occurrence of life-threatening situations. This begins with a good initial evaluation, followed by the appropriate pharmacologic and behavioral steps to control the severity of withdrawal symptoms and to manage complications. Once the withdrawal process is completed, the patient can then be entered into a long-term treatment program.

Topics: Acute Disease; Alcohol Withdrawal Delirium; Alcoholism; Benzodiazepines; Chloral Hydrate; Ethanol; Folic Acid; Gastrointestinal Hemorrhage; Hallucinations; Humans; Nutrition Disorders; Seizures; Social Support; Substance Withdrawal Syndrome; Thiamine; Vitamin K; Water-Electrolyte Imbalance

Certain anticonvulsant drugs, especially phenytoin and phenobarbital, interfere with vitamin K metabolism as indicated by a raised serum osteocalcin level. This finding may be of importance in the pathogenesis of side effects of these medications.

Topics: Adolescent; Adult; Aging; Anticonvulsants; Calcium-Binding Proteins; Child; Child, Preschool; Drug Interactions; Female; Humans; Infant; Male; Middle Aged; Osteocalcin; Phenobarbital; Phenytoin; Seizures; Vitamin K

Topics: Adult; Female; Hemorrhage; Humans; Infant, Newborn; Male; Partial Thromboplastin Time; Persistent Fetal Circulation Syndrome; Phenytoin; Pregnancy; Pregnancy Complications; Prothrombin Time; Seizures; Syndrome; Vitamin K

Topics: Alanine Transaminase; Anemia; Aspartate Aminotransferases; Blood Coagulation Disorders; Blood Coagulation Tests; Blood Platelets; Blood Transfusion; Cerebral Hemorrhage; Ecchymosis; Female; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Male; Prognosis; Prothrombin; Prothrombin Time; Seizures; Spinal Puncture; Subarachnoid Hemorrhage; Thrombin; Thromboplastin; Vitamin K

Topics: Adipose Tissue; Adolescent; Ammonia; Anti-Bacterial Agents; Anticonvulsants; Aspartate Aminotransferases; Blood Glucose; Brain Diseases; Child; Child, Preschool; Consciousness; Electroencephalography; Fatty Liver; Female; Glucocorticoids; Glucose; Hepatitis; Humans; Insulin; Intracranial Pressure; Kidney Diseases; Male; Prognosis; Seizures; Vitamin K

Topics: Blood Transfusion; Emergencies; Exchange Transfusion, Whole Blood; Hemorrhage; Humans; Hypothermia; Infant, Newborn; Infant, Newborn, Diseases; Jaundice, Neonatal; Poisoning; Seizures; Vitamin K; Vitamin K Deficiency Bleeding

Topics: Anticonvulsants; Female; Humans; Infant, Newborn; Pregnancy; Pregnancy Complications; Seizures; Vitamin K; Vitamin K Deficiency Bleeding

Topics: Abortion, Spontaneous; Anemia, Hemolytic, Congenital; Animals; Ascorbic Acid; Ergocalciferols; Female; Humans; Hydrocephalus; Infant, Newborn; Infant, Newborn, Diseases; Jaundice, Neonatal; Maternal-Fetal Exchange; Osteomalacia; Pregnancy; Pregnancy, Prolonged; Pyridoxine; Rats; Scurvy; Seizures; Skull; Vitamin A; Vitamin B 12; Vitamin E; Vitamin K; Vitamins

Topics: Athetosis; Audiometry; Blindness; Brain; Brain Damage, Chronic; Cerebral Palsy; Child; Congenital Abnormalities; Deafness; Dwarfism; Exchange Transfusion, Whole Blood; Follow-Up Studies; Hemiplegia; Humans; Hyperbilirubinemia; Hyperopia; Infant; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Intellectual Disability; Myopia; Neurology; Paraplegia; Seizures; Speech Disorders; Vitamin K

Topics: Humans; Hypertrophy; Male; Muscle, Smooth; Prostatic Hyperplasia; Seizures; Vitamin A; Vitamin K; Vitamins

Topics: Seizures; Tetanus; Tetanus Toxoid; Thiamine; Vitamin A; Vitamin K; Vitamins