Status epilepticus – präklinische und initiale stationäre Versorgung

Ein Status epilepticus ist ein häufiger neurologischer Notfall. Die Ursachen sind vielfältig, daher kann die klinische Einordnung herausfordernd sein. Das schnelle und sichere Management in der Akutphase ist jedoch prognostisch entscheidend. Dieser Beitrag zeigt, welche Diagnostik und Therapie in der Initialphase eines Status epilepticus hilfreich und sinnvoll sind.

Schlüsselwörter

Neurologische Notfälle - Epilepsie - Anfallssuppressiva - Akutmaßnahmen - Stufentherapie

• Literatur

• 1 Jallon P, Coeytaux A, Galobardes B. et al. Incidence and case-fatality rate of status epilepticus in the Canton of Geneva. Lancet 1999; 353: 1496
• 2 Knake S, Rosenow F, Vescovi M. et al. Incidence of status epilepticus in adults in Germany: a prospective, population-based study. Epilepsia 2001; 42: 714-718
• 3 Trinka E, Cock H, Hesdorffer D. et al. A definition and classification of status epilepticus – Report of the ILAE Task Force on Classification of Status Epilepticus. Epilepsia 2015; 56: 1515-1523
• 4 Jenssen S, Gracely EJ, Sperling MR. How long do most seizures last? A systematic comparison of seizures recorded in the epilepsy monitoring unit. Epilepsia 2006; 47: 1499-1503
• 5 Theodore WH, Porter RJ, Albert P. et al. The secondarily generalized tonic-clonic seizure: a videotape analysis. Neurology 1994; 44: 1403-1407
• 6 Chen JW, Wasterlain CG. Status epilepticus: pathophysiology and management in adults. Lancet Neurol 2006; 5: 246-256
• 7 Shorvon S. The outcome of tonic-clonic status epilepticus. Curr Opin Neurol 1994; 7: 93-95
• 8 Fisher RS, Cross JH, French JA. et al. Operational classification of seizure types by the International League Against Epilepsy: Position Paper of the ILAE Commission for Classification and Terminology. Epilepsia 2017; 58: 522-530
• 9 Devinsky O, Gazzola D, LaFrance WC. Differentiating between nonepileptic and epileptic seizures. Nat Rev Neurol 2011; 7: 210-220
• 10 Avbersek A, Sisodiya S. Does the primary literature provide support for clinical signs used to distinguish psychogenic nonepileptic seizures from epileptic seizures?. J Neurol Neurosurg Psychiatry 2010; 81: 719-725
• 11 De Paola L, Terra VC, Silvado CE. et al. Improving first responders' psychogenic nonepileptic seizures diagnosis accuracy: Development and validation of a 6-item bedside diagnostic tool. Epilepsy Behav 2016; 54: 40-46
• 12 Brophy GM, Bell R, Claassen J. et al. Guidelines for the evaluation and management of status epilepticus. Neurocrit Care 2012; 17: 3-23
• 13 Chin RF, Neville BG, Scott RC. A systematic review of the epidemiology of status epilepticus. Eur J Neurol 2004; 11: 800-810
• 14 DeLorenzo RJ, Hauser WA, Towne AR. et al. A prospective, population-based epidemiologic study of status epilepticus in Richmond, Virginia. Neurology 1996; 46: 1029-1035
• 15 Towne AR. Epidemiology and outcomes of status epilepticus in the elderly. Int Rev Neurobiol 2007; 81: 111-127
• 16 Sánchez Fernández I, Abend NS, Agadi S. et al. Time from convulsive status epilepticus onset to anticonvulsant administration in children. Neurology 2015; 84: 2304-2311
• 17 Kämppi L, Mustonen H, Soinila S. Analysis of the delay components in the treatment of status epilepticus. Neurocrit Care 2013; 19: 10-18
• 18 Shorvon S, Walker M. Status epilepticus in idiopathic generalized epilepsy. Epilepsia 2005; 46: 73-79
• 19 Prasad K, Al-Roomi K, Krishnan PR. et al. Anticonvulsant therapy for status epilepticus. Cochrane Database Syst Rev 2005; 4: CD003723
• 20 Navarro V, Dagron C, Elie C. et al. Prehospital treatment with levetiracetam plus clonazepam or placebo plus clonazepam in status epilepticus (SAMUKeppra): a randomised, double-blind, phase 3 trial. Lancet Neurol 2016; 15: 47-55
• 21 Silbergleit R, Durkalski V, Lowenstein D. et al. Intramuscular versus intravenous therapy for prehospital status epilepticus. N Engl J Med 2012; 366: 591-600
• 22 Trinka E, Höfler J, Leitinger M. et al. Pharmacologic treatment of status epilepticus. Expert Opin Pharmacother 2016; 17: 513-534
• 23 Schabelman E, Kuo D. Glucose before thiamine for Wernicke encephalopathy: a literature review. J Emerg Med 2012; 42: 488-494
• 24 Glauser T, Shinnar S, Gloss D. et al. Evidence-Based Guideline: Treatment of Convulsive Status Epilepticus in Children and Adults: Report of the Guideline Committee of the American Epilepsy Society. Epilepsy Curr 2016; 16: 48-61
• 25 Rosenow F, Weber J. Status epilepticus im Erwachsenenalter, S2k-Leitlinie 2020. In: Deutsche Gesellschaft für Neurologie, Hrsg. Leitlinien für Diagnostik und Therapie in der Neurologie. Accessed May 19, 2024 at: https://dgn.org/leitlinie/status-epilepticus-im-erwachsenenalter
• 26 Chamberlain JM, Kapur J, Shinnar S. et al. Efficacy of levetiracetam, fosphenytoin, and valproate for established status epilepticus by age group (ESETT): a double-blind, responsive-adaptive, randomised controlled trial. Lancet 2020; 395: 1217-1224
• 27 Kellinghaus C, Rossetti AO, Trinka E. et al. Factors predicting cessation of status epilepticus in clinical practice: Data from a prospective observational registry (SENSE). Ann Neurol 2019; 85: 421-432
• 28 Kohle F, Madlener M, Bruno EF. et al. Status epilepticus and benzodiazepine treatment: Use, underdosing and outcome – insights from a retrospective, multicentre registry. Seizure 2023; 107: 114-120
• 29 Rosenow F, Knake S. Recent and future advances in the treatment of status epilepticus. Ther Adv Neurol Disord 2008; 1: 33-42