The treatment of super-refractory status epilepticus: a critical review of available therapies and a clinical treatment protocol
Simon Shorvon,Monica Ferlisi +1 more
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TLDR
There is an urgent need for the establishment of a database of outcomes of individual therapies for super-refractory status epilepticus, which is an uncommon but important clinical problem with high mortality and morbidity rates.Abstract:
Super-refractory status epilepticus is defined as status epilepticus that continues or recurs 24 h or more after the onset of anaesthetic therapy, including those cases where status epilepticus recurs on the reduction or withdrawal of anaesthesia. It is an uncommon but important clinical problem with high mortality and morbidity rates. This article reviews the treatment approaches. There are no controlled or randomized studies, and so therapy has to be based on clinical reports and opinion. The published world literature on the following treatments was critically evaluated: anaesthetic agents, anti-epileptic drugs, magnesium infusion, pyridoxine, steroids and immunotherapy, ketogenic diet, hypothermia, emergency resective neurosurgery and multiple subpial transection, transcranial magnetic stimulation, vagal nerve stimulation, deep brain stimulation, electroconvulsive therapy, drainage of the cerebrospinal fluid and other older drug therapies. The importance of treating the identifying cause is stressed. A protocol and flowchart for managing super-refractory status epilepticus is suggested. In view of the small number of published reports, there is an urgent need for the establishment of a database of outcomes of individual therapies.read more
Citations
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Current Treatment for Generalized Convulsive Status Epilepticus in Adults
Li-Kai Tsai,Horng-Huei Liou +1 more
TL;DR: The principle of SE therapy is rapid seizure control and correction of underlying problems, and future well-designed clinical trials are mandatory to establish the standard treatment, especially in settings of established, refractory, and super-refractory SE.
Journal ArticleDOI
Protocolo terapéutico ante una crisis epiléptica en urgencias y estado epiléptico
P. Alonso Singer,M.J. Aguilar-Amat Prior,Javier Oliva Navarro,M. R. Garcia,Exuperio Díez-Tejedor +4 more
TL;DR: In the emergency treatment of Epiléptic seizures, emergency treatment consists of several phases as mentioned in this paper , i.e., high-risk epileptic seizures should be identified, high risk seizure should be detected and high risk status epilepticus should be established, initially with benzodiazepines and then with intravenous antiseptic drugs.
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État de mal épileptique : pratiques actuelles et risque d’interactions médicamenteuses
TL;DR: La prescription de medicaments a risque d’interaction medicamenteuse est frequente chez les patients admis en reanimation pour un EME durant l’annee 2016.
Journal ArticleDOI
Epidemiology, management and outcome of status epilepticus in adults: single-center Italian survey.
Carlotta Mutti,Angelo Sansonetti,Giampiero Monti,Claudia Vener,Irene Florindo,Anna Elisabetta Vaudano,Irene Trippi,Giorgia Bernabè,Liborio Parrino,Lucia Zinno +9 more
TL;DR: In this paper, a 1-year retrospective hospital-based single-center survey on status epilepticus (SE) at Parma Hospital, Northern Italy is provided, with detailed clinical and electrophysiological data.
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Refractory Status Epilepticus: Frequency, Risk Factors, and Impact on Outcome
Stephan A. Mayer,Jan Claassen,Johnny Lokin,Felicia A. Mendelsohn,Lyle J. Dennis,Brian-Fred Fitzsimmons +5 more
TL;DR: Refractory status epilepticus occurs in approximately 30% of patients with SE and is associated with increased hospital length of stay and functional disability, and nonconvulsive SE and focal motor seizures at onset are risk factors for RSE.
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