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N K Rathlev

Publications and source records attributed to N K Rathlev.

5 recordsLinked to original sources
PubMed2000

Clinical characteristics as predictors of recurrent alcohol-related seizures.

OBJECTIVE: To determine whether clinical data available in the emergency department can accurately predict a subset of patients at low risk of developing recurrent seizures following one or more initial alcohol-related seizures in the out-of-hospital arena. METHODS: This was a retrospective secondary analysis of data obtained from the placebo arms of two prospective, randomized trials of drug treatments for the prevention of recurrent alcohol-related seizures. Subjects with and without one or more recurrent alcohol-related seizures during the study period were compared according to the following characteristics: 1) age, 2) gender, 3) daily ethanol consumption, 4) years of ethanol abuse, 5) previous alcohol-related seizure, 6) previous seizure of other etiology, 7) temperature, 8) heart rate, 9) systolic blood pressure, 10) diastolic blood pressure, 11) respiratory rate, and 12) ethanol level. Data were analyzed with t-tests and chi-square where appropriate. RESULTS: One hundred five placebo-treated patients were analyzed and 31 (30%) developed recurrent alcohol-related seizures. None of the listed characteristics were statistically different between the two groups except for the initial ethanol level. Subjects with an ethanol level higher than 100 mg/dL were less likely (0%) to develop recurrent seizures than patients with a level equal to or below 100 mg/dL (36%) (p < 0.01). CONCLUSIONS: An initial ethanol level higher than 100 mg/dL was significantly associated with a low risk for recurrent alcohol-related seizures during the observation period. No other low-risk clinical characteristics could be identified.

Adult↗
PubMed1999

Lorazepam for the prevention of recurrent seizures related to alcohol.

BACKGROUND AND METHODS: Alcohol abuse is one of the most common causes of seizures in adults. In a randomized, double-blind study, we compared lorazepam with placebo for the prevention of recurrent seizures related to alcohol. Over a 21-month period, we studied consecutive patients with chronic alcohol abuse who were at least 21 years of age and who presented to the emergency departments of two hospitals in Boston after a witnessed, generalized seizure. The patients were randomly assigned to receive either 2 mg of lorazepam in 2 ml of normal saline or 4 ml of normal saline intravenously and then observed for six hours. The primary end point was the occurrence of a second seizure during the observation period. RESULTS: Of the 229 patients who were initially evaluated, 186 met the entry criteria. In the lorazepam group, 3 of 100 patients (3 percent) had a second seizure, as compared with 21 of 86 patients (24 percent) in the placebo group (odds ratio for seizure with the use of placebo, 10.4; 95 percent confidence interval, 3.6 to 30.2; P<0.001). Forty-two percent of the placebo group were admitted to the hospital, as compared with 29 percent of the lorazepam group (odds ratio for admission, 2.1; 95 percent confidence interval, 1.1 to 4.0; P=0.02). Seven patients in the placebo group and one in the lorazepam group were transported to an emergency department in Boston with a second seizure within 48 hours after hospital discharge. CONCLUSIONS: Treatment with intravenous lorazepam is associated with a significant reduction in the risk of recurrent seizures related to alcohol.

Adult↗
PubMed1994

The lack of efficacy of phenytoin in the prevention of recurrent alcohol-related seizures.

STUDY OBJECTIVE: To determine the effectiveness of IV phenytoin in the prevention of recurrent alcohol-related seizures during a six-hour observation period. DESIGN: Prospective, randomized, double-blind trial comparing IV phenytoin with normal saline placebo, conducted from January 1990 through December 1991. SETTING: Emergency department of an inner-city, university-affiliated, teaching hospital. PARTICIPANTS: One hundred forty-seven consecutive adults more than 25 years of age who presented with a witnessed generalized seizure in the setting of chronic alcohol abuse. INTERVENTIONS: Eligible subjects received 15 mg/kg of phenytoin or normal saline at an equivalent volume over 20 minutes by IV pump. Patients were observed for six hours in the ED after drug administration. Those experiencing a second seizure were admitted to the hospital. RESULTS: One hundred patients completed the study. Recurrent alcohol-related seizures occurred in ten of 49 patients (20.4%) in the phenytoin group and in 12 of 51 patients (23.5%) in the placebo group. chi 2 analysis revealed no statistically significant difference between the two groups (chi 2 = 0.142; P = .706). The 95% confidence interval for the difference was -0.13 to + 0.19. The relative risk of recurrence between groups was 0.868 with a 95% confidence interval of 0.412 to 1.826. CONCLUSION: No significant benefit of phenytoin administration in the prevention of recurrent alcohol-related seizures during a six-hour observation period was demonstrated.

Adult↗