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A female infant born at 40+3 weeks gestation with a birth weight of 3450 grams. The mother was G2P1 with known hypothyroidism, antibody negative. The pregnancy was uncomplicated and there was spontaneous onset of labour. The amniotic fluid was initially clear when membranes were artificially ruptured, but soon after there was loss of blood. Simultaneously, a deceleration was seen on the CTG. A fetal scalp blood sample showed a pH of 6.84 and an emergency caesarean section was performed. There was no heartbeat, no tone and no spontaneous breathing at
birth. After aspiration of blood from her throat, resuscitation was commenced, initially with mask and bag ventilation, followed by intubation after 7 minutes. Chest compressions were started and two doses of adrenalin were given. The first gasp was seen at 15 minutes. Apgar scores were 0, 3 and 5 at 1, 5 and 10 minutes respectively. At the referring hospital 10 ml/kg saline was given and because of hypotension dopamine was commenced (5 microgram/kg/min). Because of the blood loss an erythrocyte transfusion was also given.
The infant was transported to our NICU because of the severe asphyxia and the need for ventilation and hypothermia treatment.
Please download following .PDF to view the full clinical case study.
Dr. Linda van Rooij
Department of Neonatology,
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Upcoming LIVE eSeminars
December
18dec11:00 am12:00 pmHow to Interpret SEEG RecordingsLive eSeminar
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SEEG interpretation relies on the compartmentalization of the epileptogenic region into ‘lesional’, ‘irritative’, and ‘epileptogenic’ zones to differentiate interictal and ictal abnormalities. This approach avoids any bias in localization, i.e.
Event Details
SEEG interpretation relies on the compartmentalization of the epileptogenic region into ‘lesional’, ‘irritative’, and ‘epileptogenic’ zones to differentiate interictal and ictal abnormalities. This approach avoids any bias in localization, i.e. causing confusion between lesion and epilepsy, or between spikes and seizures. We will review what these different terms mean, which are the relevant biomarkers that help to differentiate these 3 zones, what are their causal relationship, and how their identification then allows, through their 3D representation, a careful individualized planning of the surgical resection.
Learning Objectives:
- Understand that SEEG interpretation starts with electrode implantation
- Identify relevant paroxysmal activities
- Identify relevant seizure onset patterns
- Understand how to use stimulation
1.0 CEU is available through ASET
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Prof. Philippe Kahane
Prof. Philippe Kahane
Philippe Kahane, MD, PhD, is a neurologist and neurophysiologist, Hospital Practitioner and University Professor at Grenoble-Alpes Hospital & University, France. He is heading the Clinical Neurosciences Axis of Grenoble Hospital. He is acknowledged as an international expert on presurgical assessment of drug-resistant epilepsies in adults and children, including SEEG recordings. The area of research covers various fields in epileptology and physiology in humans, including the characterization of epileptogenic networks using SEEG recordings and stimulation, the assessment of physiological networks by analysing SEEG oscillatory responses to different cognitive tasks, and the implementation of novel surgical therapies such as deep brain stimulation. He is Associate Editor of the international journal Epileptic Disorders, and is co-director of the annual Asian, European and North-American SEEG Training Courses. He is author or co-author of over 280 articles in international journals indexed in Medline, and has been invited to give presentations in over 320 international seminars and meetings.
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