Neurologic Drugs (Anti-Epileptic, Anti-Dystonic)

Abstract

Many neurological diseases may cause acute respiratory failure (ARF) due to involvement of bulbar respiratory center, spinal cord, motoneurons, peripheral nerves, neuromuscular junction, or skeletal muscles. Respiratory emergencies in neurological disease may occur at onset or more often along the chronic course of the disease.

Epileptic seizures are a common cause for presentation to acute medical services; among these we can find status epilepticus, epileptic encephalopathies, and developmental epileptic encephalopathies.

Early polytherapy, most frequently combining benzodiazepine with a second-line drug or an NMDA receptor antagonist, might potentially increase seizure control with relatively minor increase in side effects. Although many preclinical studies support novel drugs and early polytherapy in status epilepticus, human studies are scarce and inconclusive. Currently, evidence is lacking to recommend specific combinations of these new agents.

Status dystonicus, also known as dystonic storm or dystonic crisis, is a life-threatening movement disorder emergency. Although considered rare (only about 100 published cases), status dystonicus is most likely an underreported condition, heterogeneous in its etiology, pathogenesis, presentation, course, and outcome. Dystonic state management should also be multidisciplinary and follow clinical severity step.