Neurocritical care: status epilepticus review

Crit Care Clin. 2014 Oct;30(4):751-64. doi: 10.1016/j.ccc.2014.06.006.

Abstract

Status epilepticus (SE) is a life-threatening medical and neurologic emergency requiring prompt recognition and treatment. SE may be classified into convulsive and nonconvulsive, based on the presence of rhythmic jerking of the extremities. Refractory status epilepticus is defined as ongoing seizures failing to respond to first- and second-line anticonvulsant drug therapy and carries a high morbidity and mortality. Treatment efficacy, morbidity, and mortality are directly related to delays in starting therapy. Benzodiazepines are first-line therapy, usually followed by phenytoin/fosphenytoin. A low threshold should exist for obtaining an urgent electroencephalogram.

Keywords: Continuous electroencephalogram monitoring; Convulsions; Intensive care unit; Nonconvulsive; Refractory status epilepticus; Status epilepticus; Treatment.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anticonvulsants / therapeutic use*
  • Benzodiazepines / therapeutic use
  • Critical Care / methods*
  • Electroencephalography
  • Emergency Medical Services / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Phenytoin / analogs & derivatives
  • Phenytoin / therapeutic use
  • Practice Guidelines as Topic
  • Status Epilepticus / diagnosis*
  • Status Epilepticus / drug therapy*
  • Treatment Outcome
  • Young Adult

Substances

  • Anticonvulsants
  • Benzodiazepines
  • Phenytoin
  • fosphenytoin