Convulsive status epilepticus treatment

As status epilepticus progresses into the later stages the evidence for treatment becomes less robust until we are depending upon short case series and case reports for the treatment of refractory status epilepticus. Most of the literature deals with critically ill patients and those in the aftermath of convulsive status epilepticus with sparse data on treatment approaches for NCSE in patients who have only mild.

Convulsive seizures and probably seizures prolonged enough to constitute convulsive status epilepticus SE were known in antiquity and convulsive status has been described in the medical literature for the past few centuries.

Convulsive status epilepticus treatment. Convulsive status epilepticus CSE is a medical emergency with an associated high mortality and morbidity. It is defined as a convulsive seizure lasting more than 5 min or consecutive seizures without recovery of consciousness. Successful management of CSE depends on rapid administration of adequate doses of anti-epileptic drugs AEDs.

The exact choice of AED is less important than rapid treatment. CSE should be treated aggressively and quickly with confirmation of treatment success with epileptiform electroencephalographic EEG as a transition to non-convulsive status epilepticus is common. If the patient is not fully awake EEG should be continued for at least 24 h.

How aggressively to treat refractory non-convulsive SE NCSE or intermittent non-convulsive seizures is less clear and requires. Emergency AED therapy for convulsive status epilepticus published in 2004 Stage or status. Premonitory stage pre-hospital Diazepam 10 mg to 20 mg given rectally repeated once 15 minutes later if status continues to threaten or midazolam 10 mg given buccally.

If seizures continue treat as below. ALL patients with status epilepticus should be treated with a conventional anti-epileptic agent eg. Levetiracetam regardless of whether the seizure responds to benzodiazepine.

If the benzodiazepine works you still need to follow up. Adrenocorticotropic hormone IVIg corticosteroids magnesium sulfate and pyridoxine have been used in special situations but have not been studied for CRSE. For the treatment of established convulsive SE ie not RSE LEV VPA and fosphenytoin are likely equally effective but whether this is also true for CRSE is unknown.

Convulsive seizures and probably seizures prolonged enough to constitute convulsive status epilepticus SE were known in antiquity and convulsive status has been described in the medical literature for the past few centuries. NCSE however was unknown to early epileptologists. There are clearly many other causes of altered consciousness and behavior and the relationship between spells.

Status epilepticus is one of the major neurological emergency situations requiring immediate medical treatment. Rapid and sufficient treatment is essential to optimize outcome and to reduce mortality. Here we give an overview about the recent recommendations for the treatment of SE in the prehospital and hospital setting.

Status epilepticus is a medical emergency requiring prompt definitive management. Although the outcome of status epilepticus is mainly determined by its cause the duration of CSE is also important. A timely approach may be more important than specific pharmacological intervention.

The objectives in acute management of CSE are to. There is considerable controversy about whether to treat NCSE as aggressively as convulsive status epilepticus and there are no randomized studies upon which to base treatment decisions. Most of the literature deals with critically ill patients and those in the aftermath of convulsive status epilepticus with sparse data on treatment approaches for NCSE in patients who have only mild.

Two studies were rated as class II and the remaining 32 were judged to have class III evidence. In adults with convulsive status epilepticus intramuscular midazolam intravenous lorazepam intravenous diazepam and intravenous phenobarbital are established as efficacious as initial therapy Level A. Intramuscular midazolam has superior effectiveness compared to intravenous lorazepam in adults.

Treiman DM Meyers PD Walton NY Collins JF Colling C Rowan AJ et al. A comparison of four treatments for generalized convulsive status epilepticus. Veterans Affairs Status Epilepticus Cooperative Study Group.

N Engl J Med. CrossRef PubMed Google Scholar. Convulsive status epilepticus is a medical emergency and carries a high mortality and morbidity.

Manage and investigate concurrently. Seek to achieve seizure control within the first 1 to 2 hours after the onset of symptoms as this will significantly affect the prognosis. Take an Airway Breathing Circulation ABC approach.

Convulsive Status Epilepticus CSE is most common neurological emergency in childhood. Condition has been defined as a convulsion lasting at least 30 min or recurrent convulsions occurring over a 30-min period without recovery of consciousness. It is generally accepted that early intervention for terminating seizures is beneficial for outcome.

The aim of our study was to evaluate influences. Convulsive status epilepticus CSE is a medical emergency with an associated high mortality and morbidity. It is defined as a convulsive seizure lasting more than 5 min or consecutive seizures without recovery of consciousness.

Successful management of CSE depends on rapid administration of adequate doses of anti-epileptic drugs AEDs. Convulsive status epilepticus is the most serious manifestation of an epileptic diathesis. In the early stages 530 min there exists class A evidence to support the efficacy of benzodiazepines as first-line treatment.

As status epilepticus progresses into the later stages the evidence for treatment becomes less robust until we are depending upon short case series and case reports for the treatment of refractory status epilepticus. In adults with convulsive status epilepticus intramuscular midazolam intravenous lorazepam intravenous diazepam and intravenous phenobarbital are established as efficacious as initial therapy Level A. Intra-muscular midazolam has superior effectiveness compared to intravenous lorazepam in adults with convulsive status epilepticus.

Rarely non-convulsive status epilepticus can present as autism and if suspicions are raised usually a fluctuating course then EEG is indicated. Non-convulsive status epilepticus can follow convulsive status epilepticus and is an important treatable cause of persistent coma following convulsive status epilepticus. How is convulsive status epilepticus treated.

Generalized tonicclonic or convulsive status epilepticus is a medical emergency and every effort should be made to stop the seizures as quickly as possible. Sequelae are more frequent if seizures are not stopped within 60 minutes of onset. The initial approach includes administration of thiamine followed by glucose when glucose levels are low or.