Evidence-Based Guideline: Treatment of Convulsive Status Epilepticus in Children and Adults: Report of the Guideline Committee of the American Epilepsy Society
Tracy A. Glauser,Shlomo Shinnar,David Gloss,Brian K. Alldredge,Ravindra Arya,Jacquelyn L. Bainbridge,Mary A Bare,Thomas P. Bleck,W. Edwin Dodson,Lisa Garrity,Andy Jagoda,Daniel H. Lowenstein,John M. Pellock,James Riviello,Edward P. Sloan,David M. Treiman +15 more
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TLDR
Despite the paucity of well-designed randomized controlled trials, practical conclusions and an integrated treatment algorithm for the treatment of convulsive status epilepticus across the age spectrum (infants through adults) can be constructed.Abstract:
CONTEXT: The optimal pharmacologic treatment for early convulsive status epilepticus is unclear. OBJECTIVE: To analyze efficacy, tolerability and safety data for anticonvulsant treatment of children and adults with convulsive status epilepticus and use this analysis to develop an evidence-based treatment algorithm. DATA SOURCES: Structured literature review using MEDLINE, Embase, Current Contents, and Cochrane library supplemented with article reference lists. STUDY SELECTION: Randomized controlled trials of anticonvulsant treatment for seizures lasting longer than 5 minutes. DATA EXTRACTION: Individual studies were rated using predefined criteria and these results were used to form recommendations, conclusions, and an evidence-based treatment algorithm. RESULTS: A total of 38 randomized controlled trials were identified, rated and contributed to the assessment. Only four trials were considered to have class I evidence of efficacy. Two studies were rated as class II and the remaining 32 were judged to hav...read more
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Part 4: Pediatric Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
Ashish R. Panchal,Jason A. Bartos,Jose G. Cabanas,Michael W. Donnino,Ian R. Drennan,Karen G. Hirsch,Peter J. Kudenchuk,Michael C. Kurz,Eric J. Lavonas,Peter T. Morley,Brian J. O'Neil,Mary Ann Peberdy,Jon C. Rittenberger,Amber J Rodriguez,Kelly N. Sawyer,Katherine Berg,Adult Basic +16 more
TL;DR: The Pediatric Basic and Advanced Life Support Collaborators aim to provide real-time information and guidance to parents and clinicians on how to care for their children during the neonatal intensive care unit and beyond.
Journal ArticleDOI
Randomized Trial of Three Anticonvulsant Medications for Status Epilepticus.
TL;DR: In the context of benzodiazepine-refractory convulsive status epilepticus, the anticonvulsant drugs levetiracetam, fosphenytoin, and valproate each led to seizure cessation and improved alertness by 60 minutes in approximately half the patients, and the three drugs were associated with similar incidences of adverse events.
Journal ArticleDOI
Drug management for acute tonic-clonic convulsions including convulsive status epilepticus in children.
TL;DR: This review provides only low- to very low-quality evidence comparing buccal midazolam with rectal diazepam for the treatment of acute tonic-clonic convulsions and concludes that lorazepam appears to be as effective as diazep am in stopping acute tonics clonic convulsion.
Journal ArticleDOI
European Resuscitation Council Guidelines 2021: Paediatric Life Support.
Patrick Van de Voorde,N. M. Turner,Jana Djakow,Nieves de Lucas,Abel Martinez-Mejias,Dominique Biarent,Robert Bingham,O. Brissaud,Florian Hoffmann,Groa Bjork Johannesdottir,Torsten Lauritsen,Ian Maconochie +11 more
TL;DR: These European Resuscitation Council Paediatric Life Support (PLS) guidelines, are based on the 2020 International Consensus on Cardiopulmonary Resuscitations Science with Treatment Recommendations.
Journal ArticleDOI
Levetiracetam versus phenytoin for second-line treatment of convulsive status epilepticus in children (ConSEPT): an open-label, multicentre, randomised controlled trial
Stuart R Dalziel,Stuart R Dalziel,Meredith L Borland,Meredith L Borland,Jeremy Furyk,Jeremy Furyk,Megan Bonisch,Jocelyn Neutze,Susan Donath,Kate L Francis,Cynthia Sharpe,A. Simon Harvey,A. Simon Harvey,Andrew Davidson,Simon Craig,Simon Craig,Natalie Phillips,Natalie Phillips,S. George,S. George,Arjun Rao,Arjun Rao,Nicholas Cheng,Michael Zhang,Amit Kochar,Christine Brabyn,Ed Oakley,Ed Oakley,Franz E Babl,Franz E Babl +29 more
TL;DR: ConSEPT, an open-label, multicentre, randomised controlled trial conducted in 13 emergency departments in Australia and New Zealand, concluded that levetiracetam is not superior to phenytoin for second-line management of paediatric convulsive status epilepticus.
References
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Guidelines for the Evaluation and Management of Status Epilepticus
Gretchen M. Brophy,Rodney Bell,Jan Claassen,Brian K. Alldredge,Thomas P. Bleck,Tracy A. Glauser,Suzette M. LaRoche,James J. Riviello,Lori Shutter,Michael R. Sperling,David M. Treiman,Paul M. Vespa +11 more
TL;DR: Recommendations were developed based on the literature using standardized assessment methods from the American Heart Association and Grading of Recommendations Assessment, Development, and Evaluation systems, as well as expert opinion when sufficient data were lacking.
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A Comparison of Four Treatments for Generalized Convulsive Status Epilepticus
David M. Treiman,P. D. Meyers,N. Y. Walton,N. Y. Walton,Joseph F. Collins,C Colling,A. J. Rowan,A. J. Rowan,Adrian Handforth,Edward Faught,Edward Faught,V P Calabrese,V P Calabrese,Basim M. Uthman,Basim M. Uthman,R. E. Ramsay,R. E. Ramsay,M B Mamdani +17 more
TL;DR: As initial intravenous treatment for overt generalized convulsive status epilepticus, lorazepam is more effective than phenytoin and it is easier to use.
Journal ArticleDOI
A prospective, population-based epidemiologic study of status epilepticus in Richmond, Virginia
Robert J. DeLorenzo,W. A. Hauser,Alan R. Towne,J. G. Boggs,John M. Pellock,L. Penberthy,L.K. Garnett,C. A. Fortner,Daijin Ko +8 more
TL;DR: Evaluation of the seizure types for adult and pediatric patients demonstrated that both partial and generalized status epilepticus occur with a high frequency in these populations.
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A comparison of lorazepam, diazepam, and placebo for the treatment of out-of-hospital status epilepticus.
Brian K. Alldredge,Alan M. Gelb,S. Marshal Isaacs,Megan D. Corry,Faith Allen,SueKay Ulrich,Mildred D. Gottwald,Nelda O'Neil,John Neuhaus,Mark R. Segal,Daniel H. Lowenstein,Daniel H. Lowenstein +11 more
TL;DR: Benzodiazepines are safe and effective when administered by paramedics for out-of-hospital status epilepticus in adults and Lorazepam is likely to be a better therapy than diazepam.
Journal ArticleDOI
Acute Pain Management: Operative or Medical Procedures and Trauma:
TL;DR: In addition to reviewing the pain guideline, this article includes updated information on ketorolac tromethamine, tramadol, local anesthetics, sedation, regional anesthetic techniques, and the management of opioid adverse effects.