@article{ref1,
title="Metabolic crisis occurs with seizures and periodic discharges after brain trauma",
journal="Annals of neurology",
year="2016",
author="Vespa, Paul M. and Tubi, Meral and Claassen, Jan and Blanco, Manuel and McArthur, David L. and Velazquez, Angela G. and Tu, Bin and Prins, Mayumi and Nuwer, Marc",
volume="79",
number="4",
pages="579-590",
abstract="OBJECTIVE Traumatic brain injury (TBI) results in persistent disruption of brain metabolism that has yet to be mechanistically defined. Early post-traumatic seizures are one potential mechanism for metabolic crisis and hence could be a therapeutic target. We hypothesized that seizures and pseudoperiodic discharges (PDs) may be mechanistically linked to metabolic crisis as measured by cerebral microdialysis. <br><br>METHODS A prospective multicenter study of surface and intracortical depth EEG were performed in conjunction with cerebral microdialysis in a cohort of severe TBI patients with time-locked analysis of the neurochemical response to seizures and pseudoperiodic discharges. <br><br>RESULTS Seizures or PDs occurred in 61% of 34 subjects, with 42.9% of these seizures noted only on intracortical depth EEG and in some cases lasted for many hours. Metabolic crisis as measured by elevated cerebral microdialysis lactate/pyruvate ratio occurred during seizures or PDs but not during electrically nonepileptic epochs. Interpretation In TBI patients, seizures and periodic discharges are one mechanism for metabolic crisis, and hence represent a therapeutic target for future study. This article is protected by copyright. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0364-5134",
doi="10.1002/ana.24606",
url="http://dx.doi.org/10.1002/ana.24606"
}