Abstract
Status epilepticus is a neurological emergency and immediate recognition is important to be able to control it before deleterious neuronal and systemic effects occur. The aims of this chapter are to aid the clinician in detecting status epilepticus, determining the emergent diagnostic tests and providing information on the administration of appropriate therapy. This chapter describes the clinical features of both convulsive and non-convulsive status epilepticus along with novel treatment options and controversies in management.
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Brophy G, Bell R, Claassen J, Alldredge B, Bleck T, Glauser T et al. Neurocritical Care Society Status Epilepticus Guideline Writing Committee. Guidelines for the evaluation and management of status epilepticus. Neurocrit Care. 2012;17:3–23.
Lowenstein DH, Bleck T, Macdonald R. It’s time to revise the definition of status epilepticus. Epilepsia. 1999;40(i):120–2.
Meierkord H, Boon P, Engelsen B, Gocke K, Shorvon S, Tinuper P, et al. EFNS guideline on the management of status epilepticus in adults. Eur J Neurol. 2010;17:348–55.
Hirsch L, Gaspard N. Status epilepticus. Continuum. 2013;19(3):767–94.
DeLorenzo RJ, Hauser WA, Towne AR, Boggs JG, Pellock JM, Penberthy L, et al. A prospective, population-based epidemiologic study of status epilepticus in Richmond, Virginia. Neurology. 1996;46:1029–35.
Leppik IE, Derivan AT, Homan RW, Walker J, Ramsay RE, Patrick B. Double-blind study of lorazepam and diazepam in status epilepticus. JAMA. 1983;249(11):1452–4.
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. 1998;339(12):792–8.
Alldredge B, Gelb A, Isaacs SM, Corry M, Allen F, Urich S, et al. A comparison of lorazepam, diazepam, and placebo for the treatment of out-of-hospital status epilepticus. N Engl J Med. 2001;345:631–7.
Silbergleit R, Durkalski V, Lowenstein D, Conwit R, Pancioli A, Palesch Y et al; NETT Investigators. Intramuscular versus intravenous therapy for prehospital status epilepticus. N Engl J Med. 2012; 366(7):591–600.
Agarwal P, Kumar N, Chandra R, Gupta G, Antony AR, Garg N. Randomized study of intravenous valproate and phenytoin in status epilepticus. Seizure. 2007;16(6):527–32.
Kellinghaus C, Berning S, Stögbauer F. Intravenous lacosamide or phenytoin for treatment of refractory status epilepticus. Acta Neurol Scand. 2014;129(5):294–9.
Shorvon S, Ferlisi M. The outcome of therapies in refractory and super-refractory convulsive status epilepticus and recommendations for therapy. Brain. 2012;135:2314–28.
Jagoda A, Riggio S. Refractory status epilepticus in adults. Ann Emerg Med. 1993;22:1337–48.
Bleck T. Advances in the management of refractory status epilepticus. Crit Care Med. 1993;21:955–7.
Hanley D, Kross J. Use of Midazolam in the treatment of refractory status epilepticus. Clin Ther. 1998;20:1093–105.
Stecker MM, Kramer TH, Raps EC, O’Meeghan R, Dulaney E, Skaar DJ. Treatment of refractory status epilepticus with propofol. Epilepsia. 1998;39:18–26.
Mayer SA, Claassen J, Lokin J, Mendelsohn F, Dennis LJ, Fitzsimmons BF. Refractory status epilepticus: frequency, risk factors and impact on outcome. Arch Neurol. 2002;59:205–10.
Shorvon S, Ferlisi M. The treatment of super-refractory status epilepticus: a critical review of available therapies and a clinical treatment protocol. Brain. 2011;134:2802–18.
Prasad A, Worrall B, Bertram E, Bleck T. Propofol and Midazolam in the treatment of refractory status epilepticus. Epilepsia. 2001;42(3):380–6.
Claassen J, Hirsch L, Emerson R, Mayer S. Treatment of refractory status epilepticus with pentobarbital, propofol, or midazolam: a systematic review. Epilepsia. 2002;43(2):146–53.
Huff JS, Melnick E, TOmaszewski C, Thiessen M, Jagoda A, Fesmire F. Clinical policy: critical issues in the evaluation and management of adult patients presenting to the emergency department with seizures. Ann Emerg Med. 2014;63:437–47.
Rossetti AO, Logroscino G, Bromfield EB. Refractory status epilepticus: effect of treatment aggressiveness on prognosis. Arch Neurol. 2005;62(11):1698–702.
Mirsattari SM, Sharpe MD, Young GB. Treatment of refractory status epilepticus with inhalational anesthetic agents: isoflurane and desflurane. Arch Neurol. 2004;61(8):1254–9.
Kaplan PW. The clinical features, diagnosis, and prognosis of nonconvulsive status epilepticus. Neurologist. 2005;11(6):348–61. Review.
Bleck TP. Management approaches to prolonged seizures and status epilepticus. Epilepsia. 1999;40 Suppl 1:S59–63; discussion S64–6.
Shneker BF, Fountain NB. Assessment of acute morbidity and mortality in nonconvulsive status epilepticus. Neurology. 2003;61(8):1066–73.
Claassen J, Mayer SA, Kowalski RG, Emerson RG, Hirsch LJ. Detection of electrographic seizures with continuous EEG monitoring in critically ill patients. Neurology. 2004;62(10):1743–8.
Beniczky S, Hirsch LJ, Kaplan PW, Pressler R, Bauer G, Aurlien H et al. Unified EEG terminology and criteria for nonconvulsive status epilepticus. Epilepsia. 2013;54 Suppl 6:28–9.
Kaplan PW. Nonconvulsive status epilepticus. Neurology. 2003;61(8):1035–6.
Wasterlain CG, Chen JW. Mechanistic and pharmacologic aspects of status epilepticus and its treatment with new antiepileptic drugs. Epilepsia. 2008;49 Suppl 9:63–73.
Maganti R, Gerber P, Drees C, Chung S. Nonconvulsive status epilepticus. Epilepsy Behav. 2008;12(4):572–86.
Caraballo RH, Vining E. Ketogenic diet. HandbClin Neurol. 2012;108:783–93.
Thakur K, Probasco J, Hocker S, Roehl K, Henry B, Kossoff E, et al. Ketogenic diet for adults in super-refractory status epilepticus. Neurology. 2014;82:665–70.
Corry JJ, Dhar R, Murphy T, Diringer MN. Hypothermia for refracotyr status epilepticus. Neurocrit Care. 2008;9:189–97.
Kamel H, Cornes SB, Hegde M, Hall SE, Josephson SA. Electroconvulsive therapy for refractory status epilepticus: a case series. Neurocrit Care. 2010;12:204–10.
Broomall E, Natale JE, Grimason M, Goldstein J, Smith CM, Chang C, et al. Pediatric super-refractory status epilepticus treated with allopregnanolone. Ann Neurol. 2014;76(6):911–5.
Hocker S. Systemic complications of status epilepticus- an update. Epilepsy & Behavior. 2015;49:83–7.
Wijdicks E. The multifaceted care of status epilepticus. Epilepsia. 2013;54 Suppl 6:61–3.
Belcour D, et al. Prevalence and risk factors of stress cardiomyopathy after convulsive status epilepticus in ICU patients. Crit Care Med. 2015;43(10):2164–70.
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Shah, J.N., Luis, C.O.V.S. (2017). Status Epilepticus. In: Hyzy, R. (eds) Evidence-Based Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-319-43341-7_38
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DOI: https://doi.org/10.1007/978-3-319-43341-7_38
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