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Article: [No title information]

Rosenow, Felix

2023 Volume 54, Issue 03, Page(s) 140–145

Abstract: Die Klassifikation von Epilepsien und epileptischen Syndromen und -eng verbunden- von epileptischen Anfällen unterliegt stetem Wandel. Ziel dieser Anpassungen ist es den aktuellen Erkenntnisstand und die ... ...

Abstract	Die Klassifikation von Epilepsien und epileptischen Syndromen und -eng verbunden- von epileptischen Anfällen unterliegt stetem Wandel. Ziel dieser Anpassungen ist es den aktuellen Erkenntnisstand und die Fortschritte in Diagnostik und im Krankheitsverständnis von Epilepsien abzubilden. In der aktuellen „Klassifikation der Epilepsien der International League Against Epilepsy (ILAE)“ von 2017 wird die Bedeutung von Ätiologie und Komorbidität hervorgehoben. Epilepsien werden vor allem in solche mit fokalen Anfällen, generalisierten Anfällen, fokalen und generalisierten Anfällen und unbekanntem Anfallstyp eingeteilt. Andere Befunde (z. B. aus EEG und MRT) gehen auf jeder Ebne ein. Auf der anderen Seite wurde von Lüders und Mitarbeitern eine „4-dimensionale Epilepsie Klassifikation“ vorgeschlagen, die diese Aspekte getrennt betrachtet und eine rein semiologische Anfallsklassifikation verwendet. In 2020 wurde mit der „Integrierten Epilepsie Klassifikation“ ein Vorschlag unterbreitet, der versucht die Vorteile dieser verschiedenen Systeme zu nutzen. In den hier vorliegenden Review werden diese Klassifikationssysteme vorgestellt und die jeweiligen Vor- und Nachteile diskutiert.
Keywords	Internationale Klassifikation ; Vier-dimensinonale Epilepsieklassifikation ; semiologische Anfallsklassifikation ; Integrierte Epilepsieklassifikation (IEC) ; Klassifikationsvergleich ; International classification ; four-dimensinonal epilepsy classification ; semiological seizure classification ; integrated epilepsy classification (IEC) ; classification comparison.
Language	German
Publishing date	2023-09-01
Publisher	Georg Thieme Verlag
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	80107-0
ISSN	1439-4081 ; 1434-0275 ; 0012-7590
ISSN (online)	1439-4081
ISSN	1434-0275 ; 0012-7590
DOI	10.1055/a-2142-4463
Database	Thieme publisher's database

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Article: In reference to Jack F. Fowler's alpha, beta, alpha/beta and s.

Rosenow, U F

International journal of radiation oncology, biology, physics

1993 Volume 27, Issue 1, Page(s) 177–178

MeSH term(s)	Cell Survival/radiation effects ; Radiation Dosage ; Terminology as Topic
Language	English
Publishing date	1993-09-01
Publishing country	United States
Document type	Comment ; Letter
ZDB-ID	197614-x
ISSN	1879-355X ; 0360-3016
ISSN (online)	1879-355X
ISSN	0360-3016
DOI	10.1016/0360-3016(93)90438-2
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Article ; Online: Status epilepticus in pregnancy.

Rosenow, Felix / Mann, Catrin

Epilepsy & behavior : E&B

2022 Volume 138, Page(s) 109034

Abstract: Status epilepticus is a frequent neurological emergency associated with a case fatality of about 10-15% depending on age, cause, and other factors, and a high burden for patients, caregivers, and society. In pregnancy, it can occur in two different ... ...

Abstract	Status epilepticus is a frequent neurological emergency associated with a case fatality of about 10-15% depending on age, cause, and other factors, and a high burden for patients, caregivers, and society. In pregnancy, it can occur in two different clinical constellations: (1) In women with a history of epilepsy and (2) as new onset status epilepticus in pregnancy (NOSEP). Both entities are relatively rare but differ in terms of etiology. Here we describe the epidemiology, etiologies, diagnosis, clinical course with the maternal and fetal outcome, and the suggested management strategies for either manifestation. This paper was presented at the 8th London-Innsbruck Colloquium on Status Epilepticus and Acute Seizures held in September 2022.
MeSH term(s)	Pregnancy ; Humans ; Female ; Status Epilepticus/diagnosis ; Status Epilepticus/epidemiology ; Status Epilepticus/therapy ; Seizures/diagnosis ; Family ; Prenatal Care ; London
Language	English
Publishing date	2022-12-14
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2010587-3
ISSN	1525-5069 ; 1525-5050
ISSN (online)	1525-5069
ISSN	1525-5050
DOI	10.1016/j.yebeh.2022.109034
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Article ; Online: S2k-Leitlinie: Status Epilepticus im Erwachsenenalter : Leitlinie der Deutschen Gesellschaft für Neurologie.

Rosenow, F / Weber, J

Der Nervenarzt

2021 Volume 92, Issue 10, Page(s) 1002–1030

Abstract: This S2k guideline on diagnosis and treatment of status epilepticus (SE) in adults is based on the last published version from 2021. New definitions and evidence were included in the guideline and the clinical pathway. A seizures lasting longer than 5 ... ...

Title translation	S2k guidelines: status epilepticus in adulthood : Guidelines of the German Society for Neurology.
Abstract	This S2k guideline on diagnosis and treatment of status epilepticus (SE) in adults is based on the last published version from 2021. New definitions and evidence were included in the guideline and the clinical pathway. A seizures lasting longer than 5 minutes (or ≥ 2 seizures over more than 5 mins without intermittend recovery to the preictal neurological state. Initial diagnosis should include a cCT or, if possible, an MRI. The EEG is highly relevant for diagnosis and treatment-monitoring of non-convulsive SE and for the exclusion or diagnosis of psychogenic non-epileptic seizures. As the increasing evidence supports the relevance of inflammatory comorbidities (e.g. pneumonia) related clinical chemistry should be obtained and repeated over the course of a SE treatment, and antibiotic therapy initiated if indicated.Treatment is applied on four levels: 1. Initial SE: An adequate dose of benzodiazepine is given i.v., i.m., or i.n.; 2. Benzodiazepine-refractory SE: I.v. drugs of 1st choice are levetiracetam or valproate; 3. Refractory SE (RSE) or 4. Super-refractory SE (SRSE): I.v. propofol or midazolam alone or in combination or thiopental in anaesthetic doses are given. In focal non-convulsive RSE the induction of a therapeutic coma depends on the circumstances and is not mandatory. In SRSE the ketogenic diet should be given. I.v. ketamine or inhalative isoflorane can be considered. In selected cased electroconvulsive therapy or, if a resectable epileptogenic zone can be defined epilepsy surgery can be applied. I.v. allopregnanolone or systemic hypothermia should not be used.
MeSH term(s)	Adult ; Anticonvulsants/therapeutic use ; Benzodiazepines ; Coma ; Humans ; Neurology ; Seizures/drug therapy ; Status Epilepticus/drug therapy ; Status Epilepticus/therapy
Chemical Substances	Anticonvulsants ; Benzodiazepines (12794-10-4)
Language	German
Publishing date	2021-03-22
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	123291-5
ISSN	1433-0407 ; 0028-2804
ISSN (online)	1433-0407
ISSN	0028-2804
DOI	10.1007/s00115-020-01036-2
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Article: Stufenadaptierte Therapie des Status epilepticus

Willems, Laurent M. / Rosenow, Felix / Strzelczyk, Adam

Intensivmedizin up2date

2024 Volume 20, Issue 01, Page(s) 85–101

Keywords	Neurologie ; Intensivmedizin ; Krampfanfall ; Benzodiazepin ; Epilepsie
Language	German
Publishing date	2024-03-01
Publisher	Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	2180698-6
ISSN	1614-6697 ; 1614-4856
ISSN (online)	1614-6697
ISSN	1614-4856
DOI	10.1055/a-2115-0674
Database	Thieme publisher's database

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Article ; Online: Is it time to look for frontal lobe seizures onset zone after they are over?--Defining the value of the postical irritative zone (PIZ) and postictal functional deficit zone (PFDZ) in localizing the epileptogenic zone.

Rosenow, Felix

Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology

2016 Volume 127, Issue 3, Page(s) 1757–1758

MeSH term(s)	Brain Mapping/methods ; Electroencephalography/methods ; Epilepsy, Frontal Lobe/diagnosis ; Epilepsy, Frontal Lobe/physiopathology ; Female ; Humans ; Male
Language	English
Publishing date	2016-03
Publishing country	Netherlands
Document type	Comment ; Editorial
ZDB-ID	1463630-x
ISSN	1872-8952 ; 0921-884X ; 1388-2457
ISSN (online)	1872-8952
ISSN	0921-884X ; 1388-2457
DOI	10.1016/j.clinph.2015.12.001
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Article ; Online: Management of status epilepticus in pregnancy: a clinician survey.

Swor, Dionne / Juneja, Pallavi / Constantine, Charlotte / Mann, Catrin / Rosenow, Felix / LaRoche, Suzette

Neurological research and practice

2024 Volume 6, Issue 1, Page(s) 3

Abstract: Background: Status epilepticus in pregnancy (SEP) is rare and life-threatening for both mother and fetus. There are well-established guidelines for the management of women with epilepsy during pregnancy; however, there is little evidence guiding the ... ...

Abstract	Background: Status epilepticus in pregnancy (SEP) is rare and life-threatening for both mother and fetus. There are well-established guidelines for the management of women with epilepsy during pregnancy; however, there is little evidence guiding the management of SEP, leading to uncertainty among treating physicians. Therefore, this survey aims to investigate the real-world practices of physicians treating SEP to explore management approaches for improvements in care. Methods: An anonymous, electronic survey was created and distributed to neurointensivists and neurologists between September and December 2021. Results: One hundred physicians initiated the survey and 95 completed it in full: 87 (87%, 87/100) identified neurology as their primary specialty, 31 had subspecialty training in neurocritical care, and 48 had subspecialty training in epilepsy and/or clinical neurophysiology. Over half of the survey respondents (67%, 67/100) reported having participated in the management of SEP, with 48.9% (49/98) having done so in the past year. Most survey respondents (73%, 73/100) reported that their management approach to SEP is different than that of non-pregnant patients. Survey respondents were more likely to involve epilepsy consultants when treating SEP (58.5%, 58/99) and the vast majority involved Obstetrics/Maternal Fetal Medicine consultants (90.8%, 89/98). Survey respondents showed a clear preference for levetiracetam (89.7%, 87/97) in the treatment of benzodiazepine refractory status epilepticus followed by lacosamide (61%, 60/98) if an additional second line agent was needed. Valproate and phenobarbital were unlikely to be used. There was less agreement for the management of refractory and super-refractory SEP. Conclusions: Levetiracetam is the most frequently used anti-seizure medication (ASM) for benzodiazepine-refractory SEP. Survey participants tended to manage SEP differently than in non-pregnant patients including greater involvement of interdisciplinary teams as well as avoidance of ASMs associated with known teratogenicity.
Language	English
Publishing date	2024-01-18
Publishing country	England
Document type	Journal Article
ISSN	2524-3489
ISSN (online)	2524-3489
DOI	10.1186/s42466-023-00295-z
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Article ; Online: Fenfluramine for the treatment of status epilepticus: use in an adult with Lennox-Gastaut syndrome and literature review.

Strzelczyk, Adam / Becker, Hendrik / Tako, Lisa / Hock, Susanna / Hattingen, Elke / Rosenow, Felix / Mann, Catrin

Neurological research and practice

2024 Volume 6, Issue 1, Page(s) 10

Abstract: Background: Novel treatments are needed to control refractory status epilepticus (SE). This study aimed to assess the potential effectiveness of fenfluramine (FFA) as an acute treatment option for SE. We present a summary of clinical cases where oral ... ...

Abstract	Background: Novel treatments are needed to control refractory status epilepticus (SE). This study aimed to assess the potential effectiveness of fenfluramine (FFA) as an acute treatment option for SE. We present a summary of clinical cases where oral FFA was used in SE. Methods: A case of an adult patient with Lennox-Gastaut syndrome (LGS) who was treated with FFA due to refractory SE is presented in detail. To identify studies that evaluated the use of FFA in SE, we performed a systematic literature search. Results: Four case reports on the acute treatment with FFA of SE in children and adults with Dravet syndrome (DS) and LGS were available. We report in detail a 30-year-old woman with LGS of structural etiology, who presented with generalized tonic and dialeptic seizures manifesting at high frequencies without a return to clinical baseline constituting the diagnosis of SE. Treatment with anti-seizure medications up to lacosamide 600 mg/d, brivaracetam 300 mg/d, valproate 1,600 mg/d, and various benzodiazepines did not resolve the SE. Due to ongoing refractory SE and following an unremarkable echocardiography, treatment was initiated with FFA, with an initial dose of 10 mg/d (0.22 mg/kg body weight [bw]) and fast up-titration to 26 mg/d (0.58 mg/kg bw) within 10 days. Subsequently, the patient experienced a resolution of SE within 4 days, accompanied by a notable improvement in clinical presentation and regaining her mobility, walking with the assistance of physiotherapists. In the three cases reported in the literature, DS patients with SE were treated with FFA, and a cessation of SE was observed within a few days. No treatment-emergent adverse events were observed during FFA treatment in any of the four cases. Conclusions: Based on the reported cases, FFA might be a promising option for the acute treatment of SE in patients with DS and LGS. Observational data show a decreased SE frequency while on FFA, suggesting a potentially preventive role of FFA in these populations. Key points: We summarize four cases of refractory status epilepticus (SE) successfully treated with fenfluramine. Refractory SE resolved after 4-7 days on fenfluramine. Swift fenfluramine up-titration was well-tolerated during SE treatment. Treatment-emergent adverse events on fenfluramine were not observed. Fenfluramine might be a valuable acute treatment option for SE in Dravet and Lennox-Gastaut syndromes.
Language	English
Publishing date	2024-02-22
Publishing country	England
Document type	Journal Article
ISSN	2524-3489
ISSN (online)	2524-3489
DOI	10.1186/s42466-023-00306-z
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Article ; Online: Transient postictal dysphagia in older adults with focal structural epilepsy.

Lapa, Sriramya / Schwingshackl, Anna / Frank, Ulrike / Rosenow, Felix / Mann, Catrin / Strzelczyk, Adam

Epilepsia

2024

Abstract: Objective: Seizures can cause transient neurological symptoms, such as hemiparesis and aphasia. However, temporary swallowing changes leading to postictal dysphagia have not been previously described. Therefore, this study evaluated the presence of ... ...

Abstract	Objective: Seizures can cause transient neurological symptoms, such as hemiparesis and aphasia. However, temporary swallowing changes leading to postictal dysphagia have not been previously described. Therefore, this study evaluated the presence of swallowing disorders following seizure. In addition, dysphagia severity and duration of any recovery from dysphagic symptoms were investigated. Methods: The local clinical database of all fiberoptic endoscopic evaluation of swallowing (FEES) examinations performed from 2008 to 2019 was screened for patients diagnosed with seizures, but excluding patients with intensive care unit admission or intubation >24 h. Patient charts were evaluated to identify preexisting dysphagia or potential concurrent medical causes for dysphagia, including hyponatremia, increased intracranial pressure, sepsis, or other encephalopathies associated with infections, or other possible causes at the time of admission. Patients receiving >.5 defined daily doses of benzodiazepines or neuroleptics were also excluded. Age, sex, seizure semiology and etiology, comorbidities, concurrent pneumonia, and dysphagia course during hospitalization were evaluated as predictors of the occurrence of dysphagia or its potential duration. Results: We identified 41 patients with dysphagia following a seizure, without evidence of any concurrent cause of swallowing dysfunction. These patients all presented with focal structural epilepsy, they had a mean age of 79 ± 11.3 years (range = 44-95 years), and 21 were women. The mean Elixhauser Comorbidity Score was 4.8. Hospital-acquired pneumonia was detected in 21 patients (51.2%). FEES diagnosed mild and severe dysphagia in 21 (51.2%) and 20 (48.8%) patients, respectively. Dysphagia improved significantly (p = .001) during hospitalization, persisting for an average of 3.9 days (median = 3 days, SD = 2.07 days, range = 1-8 days). Significance: Dysphagia is a potential transient neurological deficit following seizure. Our findings suggest that older patients, with focal structural epilepsy, are at risk for postictal dysphagia. Further studies are needed to ascertain the prevalence, complications, and predictors of postictal dysphagia. Dysphagia screening may improve early detection in patients with relevant risk factors, as well as reduce the occurrence of aspiration pneumonia.
Language	English
Publishing date	2024-03-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	216382-2
ISSN	1528-1167 ; 0013-9580
ISSN (online)	1528-1167
ISSN	0013-9580
DOI	10.1111/epi.17914
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Article ; Online: The FDA Reclassification of Cervical Pedicle and Lateral Mass Screws: A Case Study in Regulatory History.

Sussman, Jonathan H / Albayar, Ahmed / Saylany, Anissa / Budihal, Bhargavi R / Romeo, Dominic / Xu, Jason / Rosenow, Joshua / Heary, Robert F / Welch, William C

Therapeutic innovation & regulatory science

2024

Abstract: The classification of medical devices by the Food and Drug Administration (FDA) involves rigorous scrutiny from specialized panels that designate devices as Class I, II, or III depending on their levels of relative risk to patient health. Posterior rigid ...

Abstract	The classification of medical devices by the Food and Drug Administration (FDA) involves rigorous scrutiny from specialized panels that designate devices as Class I, II, or III depending on their levels of relative risk to patient health. Posterior rigid pedicle screw systems were first classified by the FDA in 1984 and have since revolutionized the treatment of many spine pathologies. Despite this early classification by the FDA, posterior cervical pedicle and lateral mass screws were not reclassified from unclassified to Class III and then to Class II until 2019, nearly 35 years after their initial classification. This reclassification process involved a decades-long interplay between the FDA, formal panels, manufacturers, academic leaders, practicing physicians, and patients. It was delayed by lawsuits and a paucity of data demonstrating the ability to improve outcomes for cervical spinal pathologies. The off-label use of thoracolumbar pedicle screw rigid fixation systems by early adopters assisted manufacturers and professional organizations in providing the necessary data for the reclassification process. This case study highlights the collaboration between physicians and professional organizations in facilitating FDA reclassification and underscores changes to the current classification process that could avoid the prolonged dichotomy between common medical practice and FDA guidelines.
Language	English
Publishing date	2024-04-15
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2708397-4
ISSN	2168-4804 ; 2168-4790
ISSN (online)	2168-4804
ISSN	2168-4790
DOI	10.1007/s43441-024-00654-1
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