Does status epilepticus per se cause cerebrospinal fluid pleocytosis in the absence of infection? (P5.088)
Why this work is in the frame
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Bibliographic record
Abstract
OBJECTIVE:To assess whether status epilepticus primarily increases the white blood cells (WBCs) in the cerebral spinal fluid (CSF), in the absence of an underlying central nervous system (CNS) infection. BACKGROUND:Advancements in electroencephalography monitoring have led to timely diagnosis of status epilepticus. However, treatment of an underlying cerebral infection may be delayed in cases with minor CSF pleocytosis, presumed to be caused by prolonged seizures. Conversely, mild pleocytosis secondary to seizures could lead to administration of unnecessary and powerful antimicrobial drugs. Therefore, it is important to determine whether status epilepticus per se increases WBCs in CSF. DESIGN/METHODS:This is a retrospective study with chart review. Patients with status epilepticus who were admitted to Royal University Hospital Intensive Care Unit (ICU) since 2010 were identified by the electronic database search for International Classification of Diagnosis (ICD) code for status epilepticus. Patients with CNS infection were excluded. Pleocytosis was defined as CSF WBC count 蠅 5 x 106/L. RESULTS:A total of 67 charts were reviewed. Out of those, 64 charts met the criteria of SE with no CNS infection. Of those, 26 had a lumber puncture performed within 24-48 hours of admission. The CSF laboratory analysis disclosed a mean CSF WBC count of 1.35 ± 1.34 (x 106 L), mean CSF protein concentration of 0.29±0.40 (g/L) and mean CSF glucose concentration of 4.57±0.47 (mmol/L). CONCLUSIONS:In our sample, status epilepticus did not increase WBCs in the CSF indicating that any increase in WBCs could be due to concurrent infection. Based on this finding, starting empirical antibiotic and antiviral treatment is important in the setting of prolonged seizures when the WBCs are elevated. Study Supported by:University of Saskatchewan Research Funds
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it