Detection of epileptiform activity by different noninvasive EEG methods in complex partial epilepsy

✍ Scribed by Douglas S. Goodin; Michael J. Aminoff; Kenneth D. Laxer

• Publisher: John Wiley and Sons
• Year: 1990
• Tongue: English
• Weight: 500 KB
• Volume: 27
• Category: Article
• ISSN: 0364-5134
• DOI: 10.1002/ana.410270317

✦ Synopsis

to improve muscle strength 1111, and lactate, another potential chelator of calcium ions, was shown to aggravate myasthenic weakness 112).

Changes in total and ionized serum calcium concentrations during plasmapheresis result from two sources: the use of ACD for anticoagulation and the replacement of plasma by calcium-poor albumin solution. Plasmapheresis reduces total and ionized calcium concentration by 15 to 20% [13-15}, and when only ACD is infused without plasma removal, a decrease in [Ca*+J of up to 33% may occur . These changes in calcium levels produce mild or no symptoms in nonmyasthenic patients. Transient worsening of myasthenic weakness during plasmapheresis has been previously reported 1163, but its association with calcium levels has not been discussed.

It seems reasonable to state that some myasthenic patients may be highly sensitive to citrate-induced decreases in [Ca2+]. This fact may justify an effort to monitor ionized calcium levels and to supplement calcium vigorously during plasmapheresis, as has been our practice recently.