Management of severe malnutrition at a rural facility in Angola: The unexplained cause of death

摘要

Does postictal electrochnical heterogeneity reflect ditterences in seizure termination mechanisms in etiologically and syn-dromically diverse epilepsies? What bearing do these have on SUDEP? Clinical and EEG patterns of seizure termination suggest that different mechanisms operate in different situations, although none of these have been convincingly explained in humans. The 3-4 Hz generalized spike-wave discharges of the typical absence seizure terminate abruptly with an almost immediate clinical and electrographic return to the pre-seizure baseline. It has been hypothesized that the seizure termination mechanism here involves a switch-like desynchronization rather than exhaustion of neurotransmitter release, the latter potentially inducing longer lasting neuronal dysfunction than observed in absence seizures (23). Such neuronal dysfunction is usually evident in the postictal state of generalized convulsions in the form of PGES or high amplitude regional/generalized slowing of the EEG and the attendant clinical features of confusion, cognitive slowing, and even postictal coma.