Status epilepticus - time is brain and treatment considerations.

Abstract:

PURPOSE OF REVIEW:Status epilepticus is a neurological emergency associated with high morbidity and mortality. There is a lack of robust data to guide the management of this neurological emergency beyond the initial treatment. This review examines recent literature on treatment considerations including the choice of continuous anesthetics or adjunctive anticonvulsant, the cause of the status epilepticus, and use of nonpharmacologic therapies. RECENT FINDINGS:Status epilepticus remains undertreated and mortality persists to be unchanged over the past 30 years. New anticonvulsant choices, such as levetiracetam and lacosamide have been explored as alternative emergent therapies. Anecdotal reports on the use of other generation anticonvulsants and nonpharmacologic therapies for the treatment of refractory and super-refractory status epilepticus have been described.Finally, recent evidence has examined etiology-guided management of status epilepticus in certain patient populations, such as immune-mediated, paraneoplastic or infectious encephalitis and anoxic brain injury. SUMMARY:Randomized clinical trials are needed to determine the role for newer generation anticonvulsants and nonpharmacologic modalities for the treatment of epilepticus remains and evaluate the long-term outcomes associated with continuous anesthetics.

journal_name

Curr Opin Crit Care

authors

Der-Nigoghossian C,Rubinos C,Alkhachroum A,Claassen J

doi

10.1097/MCC.0000000000000661

subject

Has Abstract

pub_date

2019-12-01 00:00:00

pages

638-646

issue

6

eissn

1070-5295

issn

1531-7072

journal_volume

25

pub_type

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