Lidocaine for Status Epilepticus in Pediatrics

Zeiler, Frederick A.; Zeiler, K; Teitelbaum, Jeanne; Gillman, Lawrence M.; West, Michael; Kazina, Colin

doi:10.1017/cjn.2015.278

Cited by 12 publications

(4 citation statements)

References 41 publications

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“… 56 Literature on the use of lidocaine in the treatment of SE is focused on its use for neonatal seizures and is beyond the scope of this review. 57 Yamamoto et al 58 in a survey of 194 neonatal ICUs at university hospitals in Japan found that lidocaine was useful in the treatment of neonatal SE.…”

Section: Resultsmentioning

confidence: 99%

Treatment of Super-Refractory Status Epilepticus: A Review

et al. 2021

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Purpose: Super-refractory status epilepticus (SRSE) presents management challenges due to the absence of randomized controlled trials and a plethora of potential medical therapies. The literature on treatment options for SRSE reports variable success and quality of evidence. This review is a sequel to the 2020 American Epilepsy Society (AES) comprehensive review of the treatment of convulsive refractory status epilepticus (RSE). Methods: We sought to determine the effectiveness of treatment options for SRSE. We performed a structured literature search (MEDLINE, Embase, CENTRAL, CINAHL) for studies on reported treatments of SRSE. We excluded antiseizure medications (ASMs) covered in the 2016 AES guideline on the treatment of established SE and the convulsive RSE comprehensive review of the 2020 AES. Literature was reviewed on the effectiveness of vagus nerve stimulation, ketogenic diet (KD), lidocaine, inhalation anesthetics, brain surgery, therapeutic hypothermia, perampanel, pregabalin (PGB), and topiramate in the treatment of SRSE. Two authors reviewed each therapeutic intervention. We graded the level of the evidence according to the 2017 classification scheme of the American Academy of Neurology. Results: For SRSE (level U; 39 class IV studies total), insufficient evidence exists to support that perampanel, PGB, lidocaine, or acute vagus nerve stimulation (VNS) is effective. For children and adults with SRSE, insufficient evidence exists to support that the KD is effective (level U; 5 class IV studies). For adults with SRSE, insufficient evidence exists that brain surgery is effective (level U, 7 class IV studies). For adults with SRSE insufficient, evidence exists that therapeutic hypothermia is effective (level C, 1 class II and 4 class IV studies). For neonates with hypoxic-ischemic encephalopathy, insufficient evidence exists that therapeutic hypothermia reduces seizure burden (level U; 1 class IV study). For adults with SRSE, insufficient evidence exists that inhalation anesthetics are effective (level U, 1 class IV study) and that there is a potential risk of neurotoxicity. Conclusion: For patients with SRSE insufficient, evidence exists that any of the ASMs reviewed, inhalational anesthetics, ketogenic diet, acute VNS, brain surgery, and therapeutic hypothermia are effective treatments. Data supporting the use of these treatments for SRSE are scarce and limited mainly to small case series and case reports and are confounded by differences in patients’ population, and comedications, among other factors.

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Section: Resultsmentioning

confidence: 99%

Treatment of Super-Refractory Status Epilepticus: A Review

et al. 2021

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“…Electrographic or electro-clinical seizures frequently recur during weaning of pharmacologic coma medications [ 97 , 98 , 99 , 100 ], indicating that pharmacologic coma should be considered as a window during which specific therapies can be instituted for some status epilepticus etiologies and during which other anti-seizure medications can be initiated to provide additional coverage. Only case reports and series are available to guide management at this stage, and the options include topiramate [ 101 , 102 , 103 , 104 , 105 , 106 , 107 ], lacosamide [ 108 , 109 , 110 ], phenobarbital [ 111 , 112 , 113 , 114 ], ketamine [ 115 , 116 , 117 , 118 , 119 ], pyridoxine [ 120 , 121 , 122 , 123 , 124 , 125 ], neurosteroids [ 126 ], lidocaine [ 127 , 128 , 129 ], the ketogenic diet [ 90 , 102 , 130 , 131 , 132 , 133 , 134 , 135 , 136 ], therapeutic hypothermia [ 137 , 138 , 139 , 140 , 141 ], immunomodulation [ 142 , 143 ], epilepsy surgery [ 115 , …”

Section: Management Of Refractory Status Epilepticusmentioning

confidence: 99%

Management of Status Epilepticus in Children

Smith

McGinnis

Walleigh

et al. 2016

JCM

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Status epilepticus is a common pediatric neurological emergency. Management includes prompt administration of appropriately selected anti-seizure medications, identification and treatment of seizure precipitant(s), as well as identification and management of associated systemic complications. This review discusses the definitions, classification, epidemiology and management of status epilepticus and refractory status epilepticus in children.

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“…Other marketed drugs such as lidocaine, felbamate, pregabalin, and gabapentin are used in SE, although the evidence is scarce [148][149][150]. Many unmarketed drugs for epilepsy treatment are being developed or studied with the goal of improving seizure control (adenosine-releasing silk, AMP-X-0079, 2-deoxy-glucose, huperzine A, imepitoin, minoclycine, NAX 801-2, pitolisant, PRX0023, VLB-01, glibenclamide, P2X7 receptor antagonist) [151][152][153][154][155][156][157][158][159][160].…”

Section: Othersmentioning

confidence: 99%

Novel drugs and early polypharmacotherapy in status epilepticus

Amengual‐Gual

Fernández

Wainwright

2019

Seizure

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Rescue medications for status epilepticus (SE) have a relatively high rate of failure. The purpose of this review is to summarize the evidence for the efficacy of novel drugs and early polypharmacotherapy for SE. Method: Literature review. Results: New drugs and treatment strategies aim to target the pathophysiology of SE in order to improve seizure control and outcomes. Changes at the synapse level during SE include a progressive decrease in synaptic GABA A receptors and increase in synaptic NMDA receptors. These changes tend to promote self-sustaining seizures. Current SE guidelines recommend a rapid stepwise treatment using benzodiazepines in monotherapy as the firstline treatment, targeting GABA A synaptic receptors. Novel treatment approaches target GABA A synaptic and extrasynaptic receptors with allopregnanolone, and NMDA receptors with ketamine. Novel rescue treatments used for SE include topiramate, brivaracetam, and perampanel, which are already marketed in epilepsy. Some available drugs not marketed for use in epilepsy have been used in the treatment of SE, and other agents are being studied for this purpose. Early polytherapy, most frequently combining a benzodiazepine with a secondline 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 SE, human studies are scarce and inconclusive. Currently, evidence is lacking to recommend specific combinations of these new agents. Conclusions: Novel drugs and strategies target the underlying pathophysiology of SE with the intent to improve seizure control and outcomes.

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Lidocaine for Status Epilepticus in Pediatrics

Cited by 12 publications

References 41 publications

Treatment of Super-Refractory Status Epilepticus: A Review

Treatment of Super-Refractory Status Epilepticus: A Review

Management of Status Epilepticus in Children

Novel drugs and early polypharmacotherapy in status epilepticus

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