Intensive Care Management of Status Epilepticus
Status epilepticus (SE) is defined as 5 min or more of continuous seizure activity (clinical and/or electrographic), or recurrent seizure activity without returning to baseline between seizures. SE is a major medical emergency associating a heterogeneous set of electro-clinical presentations, among which we distinguish SE with prominent motor symptoms, which is usually easy to recognize on clinical grounds, and SE without prominent motor symptoms, also called nonconvulsive SE (NCSE), in which the symptoms may be minimal or negative. Management of SE in the ICU concurrently combines symptomatic general measures, antiepileptic treatment appropriate for the electrical and clinical pattern in the patient initiated on an emergency basis. Investigations to identify and correct the cause of SE itself should be performed simultaneously. The use of continuous EEG monitoring is an important part of the management of SE. Here all these important elements are successively and methodically explained to help the bedside physicians for the intensive care management of status epilepticus.
KeywordsStatus epilepticus Critical care Mechanical ventilation Anticonvulsants/therapeutic use Etiology Complications Emergencies Acute disease
Conflicts of Interest
I have no conflicts of interest to declare.
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