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Generalized Convulsive Status Epilepticus

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Abstract

Status epilepticus (SE) is a common neurological emergency associated with high morbidity and mortality [1]. SE is broadly classified based solely on the presence or absence of convulsions into convulsive SE (CSE) and nonconvulsive SE (NCSE). Early institution of appropriate treatment is associated with good outcomes.

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References

  1. Fountain NB. Status epilepticus: risk factors and complications. Epilepsia. 2000;41:S23–30.

    Article  Google Scholar 

  2. Chin RFM, Neville BGR, Scott RC. A systematic review of the epidemiology of status epilepticus. Eur J Neurol. 2004;11:800–10.

    Article  CAS  Google Scholar 

  3. DeLorenzo RJ, Hauser WA, Towne AR, et al. A prospective, population-based epidemiologic study of status epilepticus in Richmond, Virginia. Neurology. 1996;46:1029–35.

    Article  CAS  Google Scholar 

  4. Hesdorffer DC, Logroscino G, Cascino G, Annegers JF, Hauser WA. Incidence of status epilepticus in Rochester, Minnesota, 1965–1984. Neurology. 1998;50:735–41.

    Article  CAS  Google Scholar 

  5. Logroscino G, Hesdorff DC, Cascino G, Annegers JF, Hauser WA. Time trends in incidence, mortality, and case-fatality after first episode of status epilepticus. Epilepsia. 2001;42:1031–5.

    Article  CAS  Google Scholar 

  6. Coeytaux A, Jallon P, Galobardes B, Morabia A. Incidence of status epilepticus in French-speaking Switzerland: (EPISTAR). Neurology. 2000;55:693–7.

    Article  CAS  Google Scholar 

  7. Knake S, Rosenow F, Vescovi M, et al. Incidence of status epilepticus in adults in Germany: a prospective, population-based study. Epilepsia. 2001;47:714–8.

    Article  Google Scholar 

  8. Rossetti AO, Logroscino G, Bromfield EB. Refractory status epilepticus: effect of treatment aggressiveness on prognosis. Arch Neurol. 2005;62:1698–702.

    Article  Google Scholar 

  9. Al-Mufti F, Claassen J. Neurocritical care—status epilepticus review. Crit Care Clin. 2014;30:751–64.

    Article  Google Scholar 

  10. Trinka E, Cock H, Hesdorffer D, et al. A definition and classification of status epilepticus—report of the ILAE Task Force on Classification of Status Epilepticus. Epilepsia. 2015;56:1515–23.

    Article  Google Scholar 

  11. Kapur J, Macdonald RL. Rapid seizure-induced reduction of benzodiazepine and Zn2+ sensitivity of hippocampal dentate granule cell GABAA receptors. J Neurosci. 1997;17:7532–40.

    Article  CAS  Google Scholar 

  12. Jones DM, Esmaeil N, Maren S, Macdonald RL. Characterization of pharmacoresistance to benzodiazepines in the rat Li-pilocarpine model of status epilepticus. Epilepsy Res. 2002;50:301–12.

    Article  CAS  Google Scholar 

  13. DeLorenzo RJ, Waterhouse EJ, Chum F, et al. Persistent nonconvulsive status epilepticus after control of convulsive status epilepticus. Epilepsia. 1998;39:833–40.

    Article  CAS  Google Scholar 

  14. Brophy GM, Bell R, Claassen J, et al. Guidelines for the evaluation and management of status epilepticus. Neurocrit Care. 2012;17:3–23.

    Article  Google Scholar 

  15. Berg AT, Berkovic SF, Brodie MJ, et al. Revised terminology and concepts for organization of seizures and epilepsies: report of the ILAE Commission on Classification and Terminology, 2005–2009. Epilepsia. 2010;51:676–85.

    Article  Google Scholar 

  16. Foreman B, Hirsch LJ. Epilepsy emergencies: diagnosis and management. Neurol Clin. 2012;30:11–41.

    Article  Google Scholar 

  17. DeLorenzo RJ, Pellock JM, Towne AR, Boggs JG. Epidemiology of status epilepticus. J Clin Neurophysiol. 1995;12:316–25.

    Article  CAS  Google Scholar 

  18. Lowenstein DH, Alldredge BK. Status epilepticus at an urban public hospital in the 1980s. Neurology. 1993;43:483–8.

    Article  CAS  Google Scholar 

  19. Garzon E, Fernandez RM, Sakamoto AC. Analysis of clinical characteristics and risk factors for mortality in human status epilepticus. Seizure. 2003;12:337–45.

    Article  Google Scholar 

  20. Misra UK, Kalita J, Patel R. Sodium valproate vs. phenytoin in status epilepticus: a pilot study. Neurology. 2006;67:340–2.

    Article  CAS  Google Scholar 

  21. Murthy JMK, Jayalaxmi SS, Kanikannan MA. Convulsive status epilepticus: clinical profile in a developing country. Epilepsia. 2007;48:2217–23.

    PubMed  Google Scholar 

  22. Shorvon S. Definition, classification and frequency of status epilepticus. In: Shorvon S, editor. Status epilepticus, its clinical features and treatment in children and adults. Cambridge: Cambridge University Press; 1994. p. 21–30.

    Chapter  Google Scholar 

  23. Shorvon S, Ferlisi M. The treatment of super-refractory status epilepticus: a critical review of available therapies and a clinical treatment protocol. Brain. 2011;134:2802–18.

    Article  Google Scholar 

  24. Trinka E, Hofler J, Leitinger M, Brigo F. Pharmacotherapy for status epilepticus. Drugs. 2015;75:1499–521.

    Article  CAS  Google Scholar 

  25. Silbergleit R, Durkalshki V, Lowenstein D, et al. Intramuscular versus intravenous therapy for prehospital status epilepticus. N Engl J Med. 2012;366:591–600.

    Article  CAS  Google Scholar 

  26. Trinka E, Kalviainen R. 25 years of advances in definition, classification and treatment of status epilepticus. Seizure. 2017;44:65–73. https://doi.org/10.1016/j.seizure.2016.11.001.

    Article  PubMed  Google Scholar 

  27. Yasiry Z, Shorvon SD. The relative effectiveness of five antiepileptic drugs in treatment of benzodiazepine-resistant convulsive status epilepticus: a meta-analysis of published studies. Seizure. 2014;23:167–74.

    Article  Google Scholar 

  28. Rossetti AO, Lowenstein DH. Management of refractory status epilepticus in adults: still more questions than answers. Lancet Neurol. 2011;10:922–30.

    Article  Google Scholar 

  29. Holtkamp M, Othman J, Buchheim K, Meierkord H. Predictors and prognosis of refractory status epilepticus treated in a neurological intensive care unit. J Neurol Neurosurg Psychiatry. 2005;76:534–9.

    Article  CAS  Google Scholar 

  30. Mayer SA, Claassen J, Lokin J, Mendelsohn F, Dennis LJ, Fitzsimmons BF. Refractory status epilepticus: frequency, risk factors, and impact on outcome. Arch Neurol. 2002;59:205–10.

    Article  Google Scholar 

  31. Garzon E, Fernandez RM, Sakamoto AC. Analysis of clinical characteristics and risk factors for mortality in human status epilepticus. Seizure. 2003;12:337–45.

    Article  Google Scholar 

  32. Herman ST, Abend NS, Bleck TP, et al. Consensus statement on continuous EEG in critically ill adults and children, Part I: indications. J Clin Neurophysiol. 2015;32:87–95.

    Article  Google Scholar 

  33. Meldrum BS. Excitotoxicity and epileptic brain damage. Epilepsy Res. 1991;10:55–61.

    Article  CAS  Google Scholar 

  34. Kapur J, Macdonald RL. Rapid seizure-induced reduction of benzodiazepine and Zn21 sensitivity of hippocampal dentate granule cell GABAA receptors. J Neurosci. 1997;17:7532–40.

    Article  CAS  Google Scholar 

  35. Rossetti AO. Which anesthetic should be used in the treatment of refractory status epilepticus? Epilepsia. 2007;48(Suppl 8):52–5.

    Article  Google Scholar 

  36. Claassen J, Hirsch LJ, Emerson RC, et al. Treatment of refractory status epilepticus with pentobarbital, propofol, or midazolam: a systematic review. Epilepsia. 2002;43:146–53.18.

    Article  CAS  Google Scholar 

  37. Horn P, Oddo M, Schmitt SE. Electroencephalography. In: Le Roux DP, Levine MJ, Kofke WR, editors. Monitoring in neurocritical care. Philadelphia: Elsevier Sunders; 2014. p. 246–56.

    Google Scholar 

  38. Kowalski RC, Ziai WC, Rees RN, et al. Third-line antiepileptic therapy and outcome in status epilepticus: the impact of vasopressor use and prolonged mechanical ventilation. Crit Care Med. 2012;40:2677–84.

    Article  CAS  Google Scholar 

  39. Sutter R, Marsh S, Fuhr P, Kaplan PW, Ruegg S. Anesthetic drugs in status epilepticus—risk or rescue? A six-year cohort study. Neurology. 2013;82:656–64.

    Article  Google Scholar 

  40. Marchi NA, Novy J, Faouzi M, Stahli C, Burnand B, Rossetti AO. Status epilepticus: impact of therapeutic coma on outcome. Crit Care Med. 2015;43:1003–9.

    Article  Google Scholar 

  41. Sutter R, Kaplan PE. Can anesthetic treatment worsen outcome in status epilepticus? Epilepsy Behav. 2015;49:294–7.

    Article  Google Scholar 

  42. Alvarez V, Lee JW, Westover MB, et al. Therapeutic coma for status epilepticus: differing practices in a prospective multicenter study. Neurology. 2016;87:1650–9.

    Article  CAS  Google Scholar 

  43. Cuero MR, Varelas PN. Super-refractory status epilepticus. Curr Neurol Neurosci Rep. 2015;15:74.

    Article  Google Scholar 

  44. Tian L, Li Y, Xue X, et al. Super-refractory status epilepticus in West China. Acta Neurol Scand. 2015;132:1–6.

    Article  CAS  Google Scholar 

  45. Martin B, Kapur J. A combination of ketamine and diazepam synergistically controls refractory status epilepticus induced by cholinergic stimulation. Epilepsia. 2008;49:248–55.

    Article  CAS  Google Scholar 

  46. Hsieh C, Sung PS, Tsai JJ, et al. Terminating prolonged refractory status epilepticus using ketamine. Clin Neuropharmacol. 2010;33:165–7.

    Article  Google Scholar 

  47. Sabharwal V, Ramsay E, Martinez R, et al. Propofol-ketamine combination therapy for effective control of super-refractory status epilepticus. Epilepsy Behac. 2015;52:264–6.

    Article  Google Scholar 

  48. Fang Y, Wang X. Ketamine for treatment of refractory status epilepticus. Seizure. 2015;30:14–20.

    Article  Google Scholar 

  49. Borris DJ, Bertram EH, Kapur J. Ketamine controls prolonged status epilepticus. Epilepsy Res. 2000;42:117–22.

    Article  CAS  Google Scholar 

  50. Zeiler FA, Teitelbaum J, Gillman LM, West M. NMDA antagonists for refractory seizures. Neurocrit Care. 2014;20:502–13.

    Article  CAS  Google Scholar 

  51. Wusthoff CJ, Kranick SM, Morley JF, Christina Bergqvist AG. The ketogenic diet in treatment of two adults with prolonged nonconvulsive status epilepticus. Epilepsia. 2010;51:1083–5.

    Article  CAS  Google Scholar 

  52. Thakur KR, Probasco JC, Hocker SE, et al. Ketogenic diet for adults in super-refractory status epilepticus. Neurology. 2014;82:665–70.

    Article  CAS  Google Scholar 

  53. Khawaja AM, DeWolfe JL, Miller DW, Szaflarski JP. New-onset refractory status epilepticus (NORSE)—the potential role for immunotherapy. Epilepsy Behav. 2015;47:17–23.

    Article  Google Scholar 

  54. Lopinto-Khouey C, Sperling MR. Autoimmune status epilepticus. Curr Treat Options Neurol. 2013;15:545–56.

    Article  Google Scholar 

  55. Wijidicks EFM. The multifaceted care of status epilepticus. Epilepsia. 2013;54(Suppl 6):61–3.

    Article  Google Scholar 

  56. Hocker S. Systemic complications of status epilepticus—an update. Epilepsy Behav. 2015;49:83–7.

    Article  Google Scholar 

  57. Alldredge BK, Gelb AM, Isaacs SM, et al. A comparison of lorazepam, diazepam, and placebo for the treatment of out-of-hospital statue epilepticus. N Engl J Med. 2001;345:631–7.

    Article  CAS  Google Scholar 

  58. Novy J, Logroscino G, Rossetti AO. Refractory status epilepticus: a prospective observational study. Epilepsia. 2010;51:251–6.

    Article  Google Scholar 

  59. Claassen J, Lokin JK, Fitsimmons BF, et al. Predictors of functional disability and mortality after status epilepticus. Neurology. 2002;58:139–42.

    Article  CAS  Google Scholar 

  60. Treiman DM, Meyers PD, Walton NY, et al. A comparison of four treatments for generalized convulsive status epilepticus. Veterans Affairs Status Epilepticus Cooperative Study Group. N Engl J Med. 1998;339:792–8.

    Article  CAS  Google Scholar 

  61. Kantanen AM, Reinikainen M, Parvianen L, et al. Incidence and mortality of super-refractory status epilepticus in adults. Epilepsy Behav. 2015;49:131–4.

    Article  Google Scholar 

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Murthy, J.M.K. (2019). Generalized Convulsive Status Epilepticus. In: Singh, M., Bhatia, R. (eds) Emergencies in Neurology . Springer, Singapore. https://doi.org/10.1007/978-981-13-5866-1_8

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  • DOI: https://doi.org/10.1007/978-981-13-5866-1_8

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