Guidelines for Status Epilepticus: Are We There Yet?
- Simon Shorvon
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Guidelines are a curate’s egg. They are to be welcomed for the obvious reason that clinicians need advice, and especially so in emergency settings, and the simple fact that in status epilepticus, for instance, the adoption of a protocol improves outcome. Also, it is important to take a scientific approach to the evaluation of evidence, and guidelines offer this potential. Herein, however, lie their drawbacks. Hard evidence is scarce on the ground in many clinical situations and where strictly evidence-based recommendations only are made in a guideline, the guidelines tend to be bland and self-evident. Conversely, where the guideline strays from the evidence-based path, there is an inevitable adoption of subjective and selective opinion. The therapy of status epilepticus presents a classic example of this problem.
In this issue, ‘Guidelines for the evaluation and management of status epilepticus’ are published . The authors, who were appointed by the Neurocritical Care Society, recogn
- Borphy G, Bell R, Claasen J, ALldredge B, Bleck T, Glauser T, LaRoche S, Riviello J, Shutter L, Sperling M, Treiman D, Vespa P. Guidelines for the evaluation and management of status epilepticus. Neurocrit Care. 2012. doi:10.1007/s12028-012-9695-z.
- Jaeschke R, Guyatt GH, Dellinger P, Schunemann H, Levy MM, Kunz R, Norris S, Bion J. Use of GRADE grid to reach decisions on clinical practice guidelines when consensus is elusive. BMJ. 2008;337:a744. CrossRef
- Guidelines for Status Epilepticus: Are We There Yet?
Volume 17, Issue 1 , pp 1-2
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- Humana Press Inc
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- Simon Shorvon (1)
- Author Affiliations
- 1. UCL Institute of Neurology, London, United Kingdom