Abstract
The treatment of status epilepticus (SE) has evolved considerably over the last 20 years. The recognition of the many patients who have nonconvulsive SE (NCSE) and nonconvulsive seizures (NCS) and the availability of newer antiepileptic drugs (AED) have prompted this evolution of the treatment paradigm. This chapter will provide a brief overview of the various definitions of SE, how the definition of status has evolved over the years, and how this impacts the approach to treatment. The difference between NCSE and NCS will be discussed in terms of their classification and how this impacts the aggressiveness of treatment. This chapter will focus on treatment with nonsedating (AEDs); sedating AEDs will be discussed elsewhere.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Hirsch LJ, Gaspard N. Status epilepticus. Continuum (Minneap Minn). 2013;19(3):767–94.
Husain AM, Horn GJ, Jacobson MP. Non-convulsive status epilepticus: usefulness of clinical features in selecting patients for urgent EEG. J Neurol Neurosurg Psychiatry. 2003;74(2):189–91.
Brophy GM, Bell R, Claassen J, et al. Guidelines for the evaluation and management of status epilepticus. Neurocrit Care. 2012;17(1):3–23.
Commission on Terminology of the International League Against Epilepsy. A proposed international classification of epileptic seizures. Epilepsia. 1964;5:297–306.
Treatment of convulsive status epilepticus. Recommendations of the Epilepsy Foundation of America’s Working Group on Status Epilepticus. JAMA. 1993;270:854–9.
Al-Mufti F, Claassen J. Neurocritical care status epilepticus review. Crit Care Clin. 2014;30:751–64.
Mazarati AM, Wasterlain CG, Sankar R, Shin D. Self-sustaining status epilepticus after brief electrical stimulation of the perforant path. Brain Res. 1998;801:251–3.
Chen WY, Wasterlain CG. Status epilepticus: pathophysiology and management in adults. Lancet Neurol. 2006;5:246–56.
Lowenstein DH, Bleck T, Macdonald RL. It’s time to revise the definition of status epilepticus. Epilepsia. 1999;40:120–2.
Vespa PM, Nuwer MR, Nenov V, et al. Increased incidence and impact of nonconvulsive and convulsive seizures after traumatic brain injury as detected by continuous electroencephalographic monitoring. J Neurosurg. 1999;91(5):750–60.
Walker MC. Treatment of nonconvulsive status epilepticus. Int Rev Neurobiol. 2007;81:287–29712.
Mayer SA, Claassen J, Lokin J, Mendelsohn F, Dennis LJ, Fitzsimmons B-F. Refractory status epilepticus: frequency, risk factors, and impact on outcome. Arch Neurol. 2002;59:205–10.
Ferlisi M, Shorvon S. The outcome of therapies in refractory and super-refractory convulsive status epilepticus and recommendations for therapy. Brain. 2012;135:2314–28.
Betjemann JP, Lowenstein DH. Status epilepticus in adults. Lancet Neurol. 2015;14(6):615–24. pii: S1474-4422(15)00042-3.
Meldrum BS, Vigouroux RA, Brierley JB. Systemic factors and epileptic brain damage. Prolonged seizures in paralyzed, artificially ventilated baboons. Arch Neurol. 1973;29:82.
Vespa PM, Miller C, McArthur D, et al. Nonconvulsive electrographic seizures after traumatic brain injury result in a delayed, prolonged increase in intracranial pressure and metabolic crisis. Crit Care Med. 2007;35(12):2830–6.
Litt B, Wityk RJ, Hertz SH, et al. Nonconvulsive status epilepticus in the critically ill elderly. Epilepsia. 1998;39(11):1194–202.
Spatola M, Alvarez V, Rossetti AO. Benzodiazepine overtreatment in status epilepticus is related to higher need of intubation and longer hospitalization. Epilepsia. 2013;54(8):e99–102.
Sutter R, Marsch S, Fuhr P, et al. Anesthetic drugs in status epilepticus: risk or rescue?: a 6-year cohort study. Neurology. 2014;82:656–64.
Marchi N, Novy J, Faouzi M, et al. Status epilepticus: impact of therapeutic coma on outcome. Crit Care Med. 2015;43(5):1003–9.
Abend NS, Dlugos DJ, Hahn CD, et al. Use of EEG monitoring and management of non-convulsive seizures in critically ill patients: a survey of neurologists. Neurocrit Care. 2010;12(3):382–9.
Abend NS, Arndt DH, Carpenter JL, et al. Electrographic seizures in pediatric ICU patients: cohort study of risk factors and mortality. Neurology. 2013;81:383–91.
Topjian AA, Gutierrez-Colina AM, Sanchez SM, et al. Electrographic status epilepticus is associated with mortality and worse short-term outcome in critically Ill children. Crit Care Med. 2013;31:215–23.
Sinha SR, Smart SO, Husain AM. Seizure burden score: a quantitative description of seizure intensity in continuous EEG recordings. Epilepsia. 2013;54(Suppl 6):106–24. Abstract. http://onlinelibrary.wiley.com/doi/10.1111/epi.12292/epdf.
Kapur J, Macdonald RL. Rapid seizure-induced reduction of benzodiazepine and Zn2+ sensitivity of hippocampal dentate granule cell GABAA receptors. J Neurosci. 1997;17:7532.
Treiman DM, Meyers PD, Walton NY, 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 BK, Gelb AM, Isaacs SM, Corry MD, Allen F, Ulrich S, Gottwald MD, O’Neil N, Neuhaus JM, Segal MR, Lowenstein DH. A comparison of lorazepam, diazepam, and placebo for the treatment of out-of-hospital status epilepticus. N Engl J Med. 2001;345:631–7.
French JA, Gazzola DM. Antiepileptic drug treatment: new drugs and new strategies. Continuum (Minneap Minn). 2013;19(3):643–55.
Kapur J. Prehospital treatment of status epilepticus with benzodiazepines is effective and safe. Epilepsy Curr. 2002;2(4):121–4.
Silbergleit R, Lowenstein D, Durkalski V, et al. Lessons from the RAMPART study—and which is the best route of administration of benzodiazepines in status epilepticus. Epilepsia. 2013;54(6):74–7.
Nakken KO, Lossius MI. Buccal midazolam or rectal diazepam for treatment of residential adult patients with serial seizures or status epilepticus. Acta Neurol Scand. 2011;124(2):99–103.
Alvarez V, Lee JW, Drislane FW, et al. Practice variability and efficacy of clonazepam, lorazepam, and midazolam in status epilepticus: a multicenter comparison. Epilepsia. 2015;56(8):1275–85.
Sivakumar S, Ibrahim M, Parker D, et al. Clobazam: an effective add-on therapy in refractory status epilepticus. Epilepsia. 2015;56(6):e83–9.
Fischer JH, Patel TV, Fischer PA. Fosphenytoin: clinical pharmacokinetics and comparative advantages in the acute treatment of seizures. Clin Pharmacokinet. 2003;42(1):33–58.
Trinka E, Hofler J, Zerbs A, et al. Efficacy and safety of intravenous valproate for status epilepticus: a systematic review. CNS Drugs. 2014;28:623–39.
Yasiry Z, Shorvon SD. The relative effectiveness of five antiepileptic drugs in treatment of benzodiazepine-resistant convulsive status epilepticus: a meta-analysis of published studies. Seizure. 2014;23:167–74.
Boucher BA, Feler CA, Dean JC, et al. The safety, tolerability, and pharmacokinetics of fosphenytoin after intramuscular and intravenous administration in neurosurgery patients. Pharmacotherapy. 1996;16(4):638–45.
Rossetti AO, Bromfield EB. Determinants of success in the use of oral levetiracetam in status epilepticus. Epilepsy Behav. 2006;8(3):651–4.
Alvarez A, Januel JM, Burnand B, Rosetti AO. Second-line status epilepticus treatment: comparison of phenytoin, valproate, and levetiracetam. Epilepsia. 2011;52(7):1292–6.
Swisher CB, Doreswamy M, Husain AM. Use of pregabalin for nonconvulsive seizures and nonconvulsive status epilepticus. Seizure. 2013;22(2):116–8.
Towne AR, Garnett LK, Waterhouse EJ, et al. The use of topiramate in refractory status epilepticus. Neurology. 2003;60(2):332–4.
Doreswamy M, Lassiter T, Husain AM. Use of lacosamide in nonconvulsive seizures in critically ill patients. Epilepsia. 2010. Presented at the American Epilepsy Society annual meeting, 2010: http://www.aesnet.org/go/publications/aes-abstracts/abstractsearch/mode/display/st/husain/sy/2010/sb/All/id/12788.
Hoffler J, Trinka E. Lacosamide as a new treatment option in status epilepticus. Epilepsia. 2013;54(3):393–404.
Yildiz B, Citak A, Ucsel R, et al. Lidocaine treatment in pediatric convulsive status epilepticus. Pediatr Int. 2008;50:35–9.
Hattori H, Yamano T, Hayashi K, et al. Effectiveness of lidocaine infusion for status epilepticus in childhood: a retrospective multi-institutional study in Japan. Brain Dev. 2008;30:504–12.
Beniczky S, Hirsch LJ, Kaplan PW, et al. Unified EEG terminology and criteria for nonconvulsive status epilepticus. Epilepsia. 2013;54(Suppl, 6):28–9.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Wasim, M., Husain, A.M. (2017). Treatment of Status Epilepticus with Nonsedating Antiepileptic Drugs. In: Husain, A., Sinha, S. (eds) Continuous EEG Monitoring. Springer, Cham. https://doi.org/10.1007/978-3-319-31230-9_27
Download citation
DOI: https://doi.org/10.1007/978-3-319-31230-9_27
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-31228-6
Online ISBN: 978-3-319-31230-9
eBook Packages: MedicineMedicine (R0)