Treatment of Acute Seizures and Status Epilepticus

Abstract

Overt status epilepticus and persistent obtundation after a witnessed clinical seizure are neurologic emergencies. Early recognition and intervention in the electroclinical syndrome of status epilepticus reduces morbidity, although treatment of the underlying etiology is also critical. This review outlines key concepts related to status epilepticus, delineates an approach to the early management of status epilepticus, and highlights novel but practical approaches in the evaluation and treatment of refractory status epilepticus, emphasizing the use of a treatment algorithm. This review is written from the perspective of the intensive care unit clinician, and the approach and opinions expressed stem from clinical experience and review of the current literature. Particular attention is given to an overall approach to the management of convulsive status epilepticus in adults and older children as well as exploring novel approaches and diagnostic tools that may prove useful in difficult-to-control status epilepticus.

Etiology, clinical course and response to the treatment of status epilepticus in children: A 16-year single-center experience based on 602 episodes of status epilepticus

“…Costello and Cole recommended aggressive management of SE and highlighted that giving an appropriate dose of the first-and second-line anticonvulsive medication is very important. 7 The excessive dose of initial medications is far less associated with SE morbidity compared to prolonged seizure activity and treatment in ICU. It is suggested that neurologists with EEG knowledge should be consulted during the early stage of SE treatment.…”

“…It is suggested that neurologists with EEG knowledge should be consulted during the early stage of SE treatment. 7 This manuscript presents a single center experience concerning etiology, clinical course and response to the treatment of a large number of convulsive SE episodes, with particular emphasis on the most complicated group of patients with superrefractory SE.…”

Statistical features based epileptic seizure EEG detection - an efficacy evaluation

“…Epileptic seizures, which are abnormal synchronization of neural activity, results in characteristic discharges in the EEG pattern [1]. Spikes, polyspikes, spike-and-wave complex, sharp waves are the commonly seen rhythms in EEG pattern indicative of epileptic seizure [2], [3].…”

Management of Prolonged Seizures During Electroconvulsive Therapy

“…If still not possible to control the seizure, guidelines for ICU level care of intractable seizures should be followed. [5]…”