Abstract
This paper reviews the clinical trials in acute repetitive seizures and in tonic-clonic status epilepticus. There are good randomised controlled studies on the use of benzodiazepines in early status epilepticus, but an inadequate trial base in the later stages. Therapy has therefore to be based on open studies, although in the later stages there is also a dearth of open data. Tonic-clonic status epilepticus is a medical emergency and a condition with a significant mortality. The lack of information compromises optimal therapy. This paper reviews the reasons for the lack of data and the problems associated with collecting data. It is proposed that, in the first instance, the best way of improving the quality of evidence would be a multinational case registry of existing practice.
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Updated following presentation and discussion at the 2011 Progress in Epileptic Disorders Workshop on “Antiepileptic Drug Trials: will the future challenge the past” held at the Chaeauform’ La Maison des Contes, Dareizé, 69490, France. The workshop was partly supported by an educational grant from UCB. The program was under the exclusive responsibility of a Scientific Committee composed by Prs. Philippe Ryvlin (France), Emilio Perucca (Italy), Jackie French (USA), Steve White (USA), Graeme Sills (UK) and Alexis Arzimanoglou (France).
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Shorvon, S. Clinical trials in acute repetitive seizures and status epilepticus. Epileptic Disord. 14, 138–147 (2012). https://doi.org/10.1684/epd.2012.0514
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DOI: https://doi.org/10.1684/epd.2012.0514