Title: Management of Status Epilepticus (SE) – Recent Trend
Authors: Dr Arata Kumar Swain, Dr Pradipta Kumar Patel
DOI: http://dx.doi.org/10.18535/jmscr/v3i12.03
Status Epilepticus is a Medical emergency associated with high morbidity and mortality.SE as a seizure that lasts for 20-30 minutes. Prolonged seizures produce CNS damage. Continued epileptic activity may lead to relative cerebral hypoxia and hypoglycemia. The most important factor deciding outcome in SE is the underlying etiology SE should be identified early and treatment initiated as soon as it is clear that a seizure has lasted 5-10 minutes; out-of-hospital administration of intramuscular midazolam or rectal diazepam by paramedics transporting the patient could shorten the duration of SE and hospital stay. Airway, breathing and circulation should be assessed in the emergency department and adequate steps initiated to correct any abnormalities. 1. Bleck TP.Convulsive disorders: Status epilepticus. Clin Neuropharmacol 1991;14:191-08. 2. Treiman DM, meyer PD, Walton NY, et al.A comparison of four treatments for generalized convulsive status epilepticus: Veterans Affairs Status Epilepticus Cooperative Study Group. Neurology 2000;54:340-345. 3. Towne AR, Waterhouse EJ, Boggs JG, et al. Prevalence of nonconvulsive status epilepticus in comatose patients. Neurology 2000;54:340-345. 4. Claassen J, Mayer SA, Kowalski RG, et al. Detection of electrographic seizures with continuous EEG monitoring in critically ill patients. Neurology 2004;62:1743-1748. 5. Mayer SA,Claasen J,Lokin J, et al. Refractory status epilepticus: frequency, risk factors, and impact on out come.Arch Neurol 2002;54:340-345. 6. Wijdicks EF, Parisi JE, Sharbrough FW. Prognostic value of myoclonus status in comatose survivors of cardiac arrest. Ann Neurol 1994;64:267-268. 7. Macdonald RL,Kapur J.Acute cellular alterations in the pippocampus after status epilepticus.Epilepsia 1999;40:S9-20;discussion S21-2. 8. Meldrum BS, Vigouroux RA, Brierley JB. Systemic factors and epileptic brain damage: Prolonged seizures in paralyzed, artificially ventilated baboons.Arch Neurol 1973;29:82-07 9. Hillbom M,pieninkeroinen l,Leone M.Seizures in alcohol-de-pendent patients: Epidemiology, pathophysiology & management CNS.Drugs 2003;17:1013-30. 10. Chin RFM, Neville BGR,Scott RC.Meningitis is a common cause of convulsive status epilepticus with fever. Arch Dis Child 2005;90:66-9. 11. Walton NY, Treiman DM. Response of status epilepticus induced by lithium and pilocarpine to treatment with diazepam.Exp Neurol 1988;101:267-75. 12. Marik PE,Propofol:Therapeutic indications & side-effect.Currpharm Des 2004;10:3639-49. page-16 13. Yaffe K, Lowenstein DH. Prognostic factors of pentobarbital therapy for refractory generalized status epilepticus. Neurology 1993;43:895-900. 14. Gibbs JW, Sombati S,Delorenzo RJ, Coulter DA. Cellular actions of topiramate: Blockade of kainite-evoked inward currents in cultured hippocampal neurons.Epilepsia 2000;41:S10-6. 15. Towne AR, Garnet LK, Waterhouse EJ, Morton LD, DeLorenzo RJ.The use of topiramate in refractory status epilepticus. Neurology 2003;60:332-4.(Page-16) 16. Alexopoulos A, Lachhwani DK, Gupta A, Kotagal P, Harrison AM, Bingaman W, et al. Resective surgery to treat refractory status epilepticus in children with focal epileptogenesis. Neurology 2005;64:567-70. 17. Chin RF,Nevile BG, Scott RC. A systematic review of the epidemiology of status epilepticus.Eur J Neurol 2004;11:800-10. 18. Singhi S,Singhi P,Dass R.Status epilepticus:Emergency man agement. Indian J Pediatr 2003;70:S17-22. 19. Hui AC,Joint GM, Li H,Wong KS. Status epilepticus in Hong Kong Chinese:Etiology,outcome and predictors of death and morbidity.Seizure 2003;12:478-82. 20. Kwong KL,Chang K,Lam SY. Features predicting adverse outcomes of status epilepticus in childhood.Hong Kong Med: J 2004;10:156-9.Abstract
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