[Status epilepticus. Rational diagnosis and current therapeutic concepts]. 1999

S Schwarz, and S Schwab, and W Hacke
Neurologische Klinik, Universität Heidelberg.

Status epilepticus (SE) is defined as a seizure persisting over 10 min or repeated seizures without recovery between the attacks. SE is a frequent medical emergency with a high mortality, requiring aggressive and prompt treatment and a systematic, coordinated approach. A variety of new drugs has been introduced for the treatment of SE, including midazolam, propofol, fosphenytoin, and valproate. However, there are very few controlled clinical trials. Benzodiazepines are highly effective in terminating the SE in most patients and should be used as initial treatment. Phenytoin and Phenobarbital are employed if Benzodiazepines are not successful. The optimal therapeutic approach for the patient with refractory SE remains to be defined. Refractory SE has a poor prognosis and should be treated in a specialized ICU with EEG-monitoring. Barbiturates, propofol, and midazolam are substances that can be used alternatively.

UI MeSH Term Description Entries
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013226 Status Epilepticus A prolonged seizure or seizures repeated frequently enough to prevent recovery between episodes occurring over a period of 20-30 minutes. The most common subtype is generalized tonic-clonic status epilepticus, a potentially fatal condition associated with neuronal injury and respiratory and metabolic dysfunction. Nonconvulsive forms include petit mal status and complex partial status, which may manifest as behavioral disturbances. Simple partial status epilepticus consists of persistent motor, sensory, or autonomic seizures that do not impair cognition (see also EPILEPSIA PARTIALIS CONTINUA). Subclinical status epilepticus generally refers to seizures occurring in an unresponsive or comatose individual in the absence of overt signs of seizure activity. (From N Engl J Med 1998 Apr 2;338(14):970-6; Neurologia 1997 Dec;12 Suppl 6:25-30) Absence Status,Complex Partial Status Epilepticus,Generalized Convulsive Status Epilepticus,Non-Convulsive Status Epilepticus,Petit Mal Status,Simple Partial Status Epilepticus,Grand Mal Status Epilepticus,Status Epilepticus, Complex Partial,Status Epilepticus, Electrographic,Status Epilepticus, Generalized,Status Epilepticus, Generalized Convulsive,Status Epilepticus, Grand Mal,Status Epilepticus, Non-Convulsive,Status Epilepticus, Simple Partial,Status Epilepticus, Subclinical,Electrographic Status Epilepticus,Generalized Status Epilepticus,Non Convulsive Status Epilepticus,Status Epilepticus, Non Convulsive,Status, Absence,Status, Petit Mal,Subclinical Status Epilepticus

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