title: Not everything that shakes is a seizure… Role of continuous EEG in the intensive care unit.
abstract: Treatment of status epilepticus often requires highly sedative drugs with risk of side effects. Correct diagnosis is mandatory in order to prevent introduction of usefulness treatments. We report a case of suspected myoclonic status epilepticus. A thalamic lesion secondary to an osmotic demyelination syndrome was found to be the likely etiology of the myoclonus. Electrophysiological data (electroencephalography and electromyography) provided evidence for a subcortical origin of myoclonus and use of continuous EEG allowed monitoring of drug withdrawal.
authors.affiliation: Service de réanimation neurologique, hôpital neurologique, hospices civils de Lyon, 59, boulevard Pinel, 69677 Bron cedex, France; Université de Lyon CREATIS, CNRS UMR5220, Inserm U1044, INSA-Lyon, université Lyon-I, hospices civils de Lyon, 69677 Bron cedex, France. Electronic address: thomas.ritzenthaler@chu-lyon.fr.
authors.forename: Thomas
authors.initials: T
authors.lastname: Ritzenthaler
authors.affiliation: Service de neurologie C, hôpital neurologique, hospices civils de Lyon, 59, boulevard Pinel, 69677 Bron cedex, France.
authors.forename: Chloé
authors.initials: C
authors.lastname: Laurencin
authors.affiliation: Service de neurologie fonctionnelle et d'épileptologie, hôpital neurologique, hospices civils de Lyon, 59, boulevard Pinel, 69677 Bron cedex, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: André Obadia
authors.affiliation: Service de réanimation neurologique, hôpital neurologique, hospices civils de Lyon, 59, boulevard Pinel, 69677 Bron cedex, France.
authors.forename: Carole
authors.initials: C
authors.lastname: Bodonian
authors.affiliation: Service de réanimation neurologique, hôpital neurologique, hospices civils de Lyon, 59, boulevard Pinel, 69677 Bron cedex, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Dailler
mesh_terms: D001932:Brain Neoplasms / Q000150:complications; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D003711:Demyelinating Diseases / Q000150:complications; D004569:Electroencephalography / Q000379:methods*; D004576:Electromyography; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008875:Middle Aged; D009207:Myoclonus / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D064926:Neurophysiological Monitoring / Q000379:methods; D013226:Status Epilepticus / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology
keywords: Central pontine myelinolysis; EEG; Electroencephalography; Intensive care units; Myoclonus; Myélinolyse centro-pontique; Osmotic demyelination syndrome; Réanimation; Status epilepticus; Syndrome de démyélinisation osmotique; État de mal épileptique