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Semin Neurol 2015; 35(06): 621-628
DOI: 10.1055/s-0035-1564304
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Current Trends in Treatment of Status Epilepticus and Refractory Status Epilepticus

Authors

  • John P. Betjemann

    1   Department of Neurology, University of California, San Francisco, California
Further Information

Publication History

Publication Date:
23 November 2015 (online)

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Abstract

Status epilepticus is a heterogeneous disorder with varied definitions and presentations. Taken together, all forms of status epilepticus carry significant morbidity and mortality, much of which is dictated by the underlying etiology. Generalized convulsive status epilepticus, which represents a common form, is a true neurologic emergency that requires emergent management. Treatment focuses on stabilizing the patient and aggressive medical management to achieve the timely termination of seizures. For other forms of status epilepticus including nonconvulsive and focal status epilepticus, the goal remains early seizure termination, but the use of intravenous medications should be weighed against the risks associated with these therapies. The diagnostic evaluation of status epilepticus is guided by the patient's history and should be broad, including a screen for toxins, electrolytes, structural abnormalities, and central nervous system infectious and autoimmune/inflammatory etiologies. Considerable research is still needed to improve our understanding of the mechanisms, consequences, and therapy of status epilepticus.

Keywords

seizures - status epilepticus - refractory status epilepticus - epidemiology - prehospital treatment - diagnostic evaluation