Chemical-Induced Seizures: Mechanisms, Consequences and Treatment

Seizures Associated with Warfare Nerve Agents: Pathophysiology, Clinical Symptoms and Supportive Interventions

Author(s): Oleg Dolkart, Ron Ben-Abraham, Avi A Weinbroum

Pp: 17-28 (12)

DOI: 10.2174/978160805274511101010017

* (Excluding Mailing and Handling)

Abstract

Until more recently, the effects of exposure to chemical warfare agents were a remote area of clinical practice, which concerned military specialists, microbiologists, and toxicologists. Since the World Trade Center attack in New York City in September 2001, there has been real concern about the possible impact of nerve agents (NA) released by terrorists on civilian population. In the pre- and intra-hospital settings, anesthesiologists have since become more involved in the preparedness of such potential mass casualty events together with administrative officials. The former create protocols to improve casualty rescue, management, and outcome, while the latter building up medical contingents, drilling interventional and logistic protocols and provide early and late medical and psychological life support to the care providers and the population.

Exposure to warfare NA intoxicants can cause brain damage, long-term cognitive and behavioral deficits, and even death. In the acute phase of the intoxication, brain damage is primarily caused by intense seizure activity induced by these agents. Also, hypoxia and asphyxia are associated with seizures; however, these may be pre-terminal conditions.

This review will elaborate in detail pre-hospital and intra-hospital management of NA in terms of seizures. Other aspects of medical and administrative attendance associated with these chaotic situations are reviewed elsewhere and will be refereed accordingly. Pathophysiology and clinical management of current trends of life support will be addressed.

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      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Trial Access" as access_base_text, CASE j.type WHEN 111 THEN true ELSE false END as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_trail` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 314538714 and j.to_ip >=314538714 )) and ((j.from_date <= 1739835127 and j.to_date >= 1739835127 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 1689) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Subscribed" as access_base_text, false as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_corporate` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 314538714 and j.to_ip >=314538714 )) and ((j.from_date <= 1739835127 and j.to_date >= 1739835127 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 1689) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Token Based Access" as access_base_text, false as terms_popup, "R" as content_download_type, j.uc_id as restricted_user_access_key, "v" as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_token` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 314538714 and j.to_ip >=314538714 )) and ((j.from_date <= 1739835127 and j.to_date >= 1739835127 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 1689)
      590μsalphaeurekaselec_live_10_06_2022UserAccess.php#1266
      Backtrace
      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1549
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • select b.banner_link, b.banner_name, b.banner_script, b.banner_remarks, b.banner_file_name, b.banner_placement, bd.content_type, bd.content_id from `tbl_banner` as `b` inner join `tbl_banner_detail` as `bd` on `bd`.`banner_id` = `b`.`banner_id` inner join `users` as `u` on `u`.`id` = `b`.`updated_by` where `b`.`banner_ebook` = 1 and `bd`.`content_type` = 'B' and `bd`.`content_id` = 912 and `b`.`banner_from_date` <= 1739835127 and `b`.`banner_to_date` >= 1739835127 and `b`.`banner_status` = 'A' order by `b`.`banner_id` desc
      1.07msalphaeurekaselec_live_10_06_2022Banner.php#95
      Bindings
      • 0: 1
      • 1: B
      • 2: 912
      • 3: 1739835127
      • 4: 1739835127
      • 5: A
      Backtrace
      • 13. app/Models/Banner.php:95
      • 14. app/Http/helpers.php:404
      • 17. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 18. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    • select count(*) as aggregate from `uc_cart_products` where cart_id='0a6cfc7fb4126a387aac120894f40f7a'
      180μsalphaeurekaselec_live_10_06_2022Cart.php#271
      Backtrace
      • 15. app/Models/Cart.php:271
      • 16. view::layouts._header:260
      • 18. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 20. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    App\Models\Chapter
    1Chapter.php#?
    App\Models\Keywords
    1Keywords.php#?
    App\Models\Ebook
    1Ebook.php#?
        _token
        RzbPM2c6SE3BUAaZhkwUjN45yTKixuYBcC7TOFwv
        uc_cart_id
        0a6cfc7fb4126a387aac120894f40f7a
        _previous
        array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/1689" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        PHPDEBUGBAR_STACK_DATA
        []
        path_info
        /chapter/1689
        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
        request_query
        []
        
        request_request
        []
        
        request_headers
        0 of 0
        array:17 [ "x-https" => array:1 [ 0 => "1" ] "host" => array:1 [ 0 => "alpha.eurekaselect.com" ] "priority" => array:1 [ 0 => "u=0, i" ] "cookie" => array:1 [ 0 => "wayfindertarget=eyJpdiI6IlJBMURybUFwOVp5QS8vZG9wSUUxcnc9PSIsInZhbHVlIjoidHNiVklOZnlaN0NLZFRrZjhtUVI3L3Y4cW5zM1QzVkRlOU9UMUw4N1N4RT0iLCJtYWMiOiJiZjRkNjQzNWFkODA5MjQ5YzU2MzZiYzcwZmY1NTA1ZDA2OGYzMThiNWFhYzkyMjY3YjExMzE1ZDQ5NGI3OGFlIiwidGFnIjoiIn0%3D; XSRF-TOKEN=eyJpdiI6IkkzOGdlTUM4L3BlQWIwN2tWWm00SFE9PSIsInZhbHVlIjoiSVkxNVpiUGt6NDh4R3hxT0l3dGxkTGhOWTJQbThWeXQ2Ukpqc3AyT0VnWllqZW53RlNlYk10SWFBdzhqbzJoTzFSV1A0N3dxUHIxb0lVYU50WERIVjAwd1FaYzVUMnhnallsTkcxcFM2bzVzOU5zc1EyZGgwNnYyZWpmaUdUTEciLCJtYWMiOiI3MDc2NDQwM2E3YmI3ZjkxZjYyNzRkNTcwZmExYzEzZTMyYjMyOWViYzkzODNjMjg4NTkyNjAwMmEyZjI1NWI0IiwidGFnIjoiIn0%3D; alphaeurekaselectnet_session=eyJpdiI6Ik53bG5ObVNFQVpTZWt1ZUNuNmxjNmc9PSIsInZhbHVlIjoicVZJN2ZwK2t5aVVUbjUvMVNFZ1NWdVRiV1M4ZExxL3hUaG1CUzNaR05SYzhDTlk0Q1NnOGw5NmVNYTlqaXV1TENyWU1KbXd3L1JLNllXQ29rczIwMmNIOWNyQmdQZ2ZzRi95TmtiTlVxYXphWU4zTEoyRkNXQnNIcGxLMmpIdFciLCJtYWMiOiJmZjhmZGVhNzBlNjAxNzg4NWQ3NmY3OGVhMTA2Y2YzZWFjMmYyNTYwZTRiYWM4ZGYyNzg2NGE4NDU0Y2U3MzQxIiwidGFnIjoiIn0%3Dwayfindertarget=eyJpdiI6IlJBMURybUFwOVp5QS8vZG9wSUUxcnc9PSIsInZhbHVlIjoidHNiVklOZnlaN0NLZFRrZjhtUVI3L3Y4cW5zM1QzVkRlOU9UMUw4N1N4RT0iLCJtYWMiOiJiZjRkNjQzNWFkODA5" ] "accept-encoding" => array:1 [ 0 => "gzip, deflate, br, zstd" ] "sec-fetch-dest" => array:1 [ 0 => "document" ] "sec-fetch-user" => array:1 [ 0 => "?1" ] "sec-fetch-mode" => array:1 [ 0 => "navigate" ] "sec-fetch-site" => array:1 [ 0 => "none" ] "accept" => array:1 [ 0 => "text/html,application/xhtml+xml,application/xml;q=0.9,image/avif,image/webp,image/apng,*/*;q=0.8,application/signed-exchange;v=b3;q=0.7" ] "user-agent" => array:1 [ 0 => "Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)" ] "upgrade-insecure-requests" => array:1 [ 0 => "1" ] "sec-ch-ua-platform" => array:1 [ 0 => ""Windows"" ] "sec-ch-ua-mobile" => array:1 [ 0 => "?0" ] "sec-ch-ua" => array:1 [ 0 => ""HeadlessChrome";v="129", "Not=A?Brand";v="8", "Chromium";v="129"" ] "cache-control" => array:1 [ 0 => "no-cache" ] "pragma" => array:1 [ 0 => "no-cache" ] ]
        request_cookies
        0 of 0
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        response_headers
        0 of 0
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        session_attributes
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        array:5 [ "_token" => "RzbPM2c6SE3BUAaZhkwUjN45yTKixuYBcC7TOFwv" "uc_cart_id" => "0a6cfc7fb4126a387aac120894f40f7a" "_previous" => array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/1689" ] "_flash" => array:2 [ "old" => [] "new" => [] ] "PHPDEBUGBAR_STACK_DATA" => [] ]
        ClearShow all
        Date ↕MethodURLData
        #12025-02-17 23:32:07GET/chapter/1689112193