Status Epilepticus in Adults: A Review of Diagnosis and Treatment

Abstract

Status epilepticus is a medical emergency that requires rapid diagnosis and treatment. Nonconvulsive status epilepticus is frequently underdiagnosed and therefore undertreated, which can lead to permanent neuronal damage resulting in disability or death. Despite the frequent occurrence and morbidity associated with status epilepticus, this topic has received little attention within the literature. A systematic approach to treatment should start with management of airway, breathing, and circulation, followed by administration of benzodiazepines and intravenous antiepileptic drugs, and rapid escalation of therapy to prevent morbidity and mortality. Armed with the information in this article, nurses will have a higher-level understanding of what to do when encountering a patient in status epilepticus. (Critical Care Nurse. 2016; 36[2]:62-73)

Status Epilepticus Triggers Time-Dependent Alterations in Microglia Abundance and Morphological Phenotypes in the Hippocampus

“…Status epilepticus (SE) is defined by the occurrence of prolonged “non-stop” seizures that last for at least 5 min ( 1 ). In the United States, it is estimated that up to 41 out of 100K individuals are affected by SE, and that one or two SE events can increase the risk of future unprovoked seizures by 40–52 and 73%, respectively ( 1 ).…”

“…Status epilepticus (SE) is defined by the occurrence of prolonged “non-stop” seizures that last for at least 5 min ( 1 ). In the United States, it is estimated that up to 41 out of 100K individuals are affected by SE, and that one or two SE events can increase the risk of future unprovoked seizures by 40–52 and 73%, respectively ( 1 ). SE is a clinical emergency for which rapid intervention can help to prevent or reduce the risk for subsequent neuronal injury and neurological sequelae that includes epilepsy and cognitive disturbances ( 1 , 2 ).…”

“…In the United States, it is estimated that up to 41 out of 100K individuals are affected by SE, and that one or two SE events can increase the risk of future unprovoked seizures by 40–52 and 73%, respectively ( 1 ). SE is a clinical emergency for which rapid intervention can help to prevent or reduce the risk for subsequent neuronal injury and neurological sequelae that includes epilepsy and cognitive disturbances ( 1 , 2 ). Extensive evidence supports that SE provokes an array of inflammatory responses including activation of microglial cells, the resident immune cells of the CNS, which are thought to contribute to the neuropathology and pathophysiology of epilepsy ( 3 , 4 ).…”

Inhibition of p38 MAPK regulates epileptic severity by decreasing expression levels of A1R and ENT1

“…The imbalance of excitatory and inhibitory neurotransmission is a common mechanism of epilepsy. Status epilepticus (Se) is a state in which failure of the epileptic termination mechanism or an abnormality of the epileptic initiation mechanism leads to long-term epileptic seizures and requires emergency administration of antiepileptic drugs (2). Failure to terminate Se over time results in neuronal damage and death, and neural network changes (3).…”

Estado epiléptico en adultos: caracterización de pacientes monitorizados por videoelectroencefalograma

“…1 Se ha descrito en la literatura una incidencia anual de 12,6 por 100.000 personas al año y en la unidad de cuidados intensivos se puede presentar en 19%. 2,3 De los pacientes con EE 12 a 43% progresan a un estado refractario y 10 a 15% a uno superrefractario. 4,5 La incidencia parece lograr su pico máximo en mayores de 50 años y menores de 10 años; aunque se ha descrito una incidencia mayor en hombres, estimaciones recientes sugieren que las cifras son similares en ambos sexos.…”