Abstract. CASTELLANOS, Rafael Gustavo; BARRIOS PERALTA, Elkin; SUAREZ, Jorge and NARINO, Daniel. Focus on adult status epilepticus: Considerations. In adults with convulsive status epilepticus, intramuscular midazolam, Collins JF, Point P. Treatment of status epilepticus if first drug fails. Epilepsia. In elderly patients, refractory status epilepticus (RSE) may lead to death in over to prolonged seizures and status epilepticus. Epilepsia. ;S59–

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Estatus epiléptico | Medicina Intensiva (English Edition)

The GABA-A agonist diazepam is less effective in ameliorating SE when administered after perforant path stimulation than when administered before. In adults, compared to the first therapy, the second therapy is less effective while esttaus third therapy is substantially less effective Level A. Intramuscular midazolam versus intravenous diazepam for treatment of seizures in epiileptico pediatric emergency department: A similar spectrum of cardiorespiratory complications was seen in both the phenobarbital arm hypoventilation, Most of the enzyme-inducing AEDs such as phenobarbitone, phenytoin, carbamazepine, and lamotrigine are contraindicated in porphyria as they increase the porphyrin production.

Epilepsia ; 53 7: The propofol infusion syndrome is a potentially fatal condition characterized by severe metabolic acidosis, hyperlipidemia, rhabdomyolysis, and cardiovascular collapse.

Epilepsy Res ; Sodium valproate vs phenytoin in status epilepticus: Intravenous lacosamide as successful treatment for nonconvulsive status epilepticus after failure of first-line therapy. Recently, new regimens that avoid assisted ventilation have been tried in the management of SE. Having clear recommendations may make it easier for parents to convey their needs to schools and schools to be provided with the appropriate resources.

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Status epilepticus // International League Against Epilepsy

Respiratory depression, defined as having a need for assisted ventilation because of a drop in oxygen saturation or a reduction in respiratory rate or effort, was reported in 1. A study of 6- to year-old children with ongoing seizures in the emergency department compared IV lorazepam with intranasal lorazepam both 0. During this phase, cerebral blood flow is increased due to increased cerebral metabolic demands.

The guideline’s conclusions and recommendations were based on criteria detailed in Table 2. In the class I Veterans Affairs status epilepticus study, there were no significant differences in adverse-event rates between lorazepam, diazepam, phenobarbital, and phenytoin Respiratory and cardiac symptoms are the most common encountered treatment-emergent adverse events associated with IV anticonvulsant administration in adults with status epilepticus level A.

It can be infused using standard intravenous solutions, whereas phenytoin should not be given in dextrose-containing fluids because of drug precipitation. IV VPA had an overall efficacy of General measures As with any critically ill patient, the first step in the management of a patient with SE would be to ensure an adequate airway and to provide respiratory support.

Treating repetitive seizures with a rectal diazepam formulation: Nat Rev Neurosci ; 9 5: Current evidence indicates that lorazepam administered intravenously in out-of-hospital settings by paramedics or in emergency room settings is superior to diazepam and phenytoin in abolishing SE in a short period of time.

Status epilepticus

Neurosurgical treatment of refractory status epilepticus In selected cases of RSE that have failed to respond to medical management, surgical intervention can be considered epilepttico a last resort. The pathophysiology of propofol infusion syndrome: Antibiotics especially in older adults or in patients with renal impairment.


Pediatr Crit Care Med. The goal of therapy is the rapid termination of both clinical and electrical seizure activity, since appropriate and timely therapy of status epilepticus estattus the associated mortality and morbidity 9. Class III trials identified similar rates of respiratory depression with IV benzodiazepine use 3549 Comparative study of intranasal midazolam and intravenous diazepam sedation for procedures and seizures.

For prehospital settings or where the three first-line benzodiazepine options are not available, rectal diazepam, intranasal midazolam, and buccal midazolam are reasonable initial therapy alternatives level B. It has been postulated that this may occur due to a mechanistic shift from inadequate GABAergic inhibitory receptor—mediated transmission to excessive NMDA excitatory receptor—mediated transmission.


Probably any convulsive seizure that lasts more than 2 min deserves to be estafus as SE. The patients could receive a second dose of medication if the seizures continued after 10 minutes. The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two receding years.

To avoid injuries to oral structures, one should resist the urge to forcibly introduce a tongue depressor or other hard objects between locked teeth. Epidemiology It has been estimated that up tocases of SE occur annually in the US, with 55, associated deaths.

Midazolam versus diazepam for the treatment of status epilepticus in children and young adults: