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Semin Neurol 2008; 28(5): 668-681
DOI: 10.1055/s-0028-1105978
© Thieme Medical Publishers

Seizures and Status Epilepticus in the Intensive Care Unit

Wendy C. Ziai1 , 2 , 3 , Peter W. Kaplan1
  • 1Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 2Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 3Department of Anesthesia and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
Further Information

Publication History

Publication Date:
29 December 2008 (online)

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ABSTRACT

Persistent seizures and failure to regain consciousness following witnessed seizure activity require emergency neurological consultation. Although outcome is largely dependent on underlying cause, early maximal anticonvulsant therapy is critical to reducing morbidity. This review covers important concepts in the clinical and EEG diagnosis of status epilepticus, and discusses treatment algorithms for single and recurrent seizures, emphasizing the need to rationalize therapy depending on the presumed duration of seizure activity. The review takes the perspective of the neurological consultant in the intensive care unit, and considers all pharmacological approaches available to the intensivist as described in the current literature and from clinical experience.

KEYWORDS

Neurological emergencies - status epilepticus - nonconvulsive status epilepticus - refractory status epilepticus - intensive care

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Wendy C ZiaiM.D. M.P.H. 

Departments of Neurology, Neurosurgery, and Anesthesia and Critical Care Medicine, The Johns Hopkins Hospital

600 North Wolfe Street, Meyer 8-140, Baltimore, MD 21287

Email: weziai@jhmi.edu