Detection and Treatment of Refractory Status Epilepticus in the Intensive Care Unit

2008 ◽  
Vol 25 (4) ◽  
pp. 181-186 ◽  
Author(s):  
Frank W. Drislane ◽  
Maria R. Lopez ◽  
Andrew S. Blum ◽  
Donald L. Schomer
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Status Epilepticus ◽  
Refractory Status Epilepticus ◽  
Refractory Status

scholarly journals Refractory Status Epilepticus: Experience in a Neurological Intensive Care Unit

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
O. H. Hernandez ◽  
J. F. Zapata ◽  
M. Jimenez ◽  
M. Massaro ◽  
A. Guerra ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Status Epilepticus ◽  
Refractory Status Epilepticus ◽  
Short Term ◽  
Neurological Intensive Care Unit ◽  
Term Outcome ◽  
Neurological Intensive Care ◽  
Refractory Status ◽  
Short Term Outcome

Introduction. Refractory status epilepticus (RSE) has significant morbidity and mortality, and its management requires an accurate diagnosis and aggressive treatment. Objectives. To describe the experience of management of RSE in a neurological intensive care unit (NeuroICU) and determine predictors of short-term clinical outcome. Methods. We reviewed cases of RSE from September 2007 to December 2008. Management was titrated to findings on continuous video EEG (cVEEG). We collected patients’ demographics, RSE etiology, characteristics of seizures, cVEEG findings, treatments, and short-term outcome. Control of RSE was to achieve burst suppression pattern or electrographic cessation of ictal activity. Results. We included 80 patients; 63.8% were in coma, 25% had subclinical seizures, and 11.3% had focal activity. 51.3% were male and mean age was 45 years. Etiology was neurological lesion in 75.1%, uncontrolled epilepsy in 20%, and systemic derangements in 4.9%. 78.8% were treated with general anesthesia and concomitant anticonvulsant drugs. The control of RSE was 87.5% of patients. In-hospital mortality was 22.5%. The factors associated with unfavorable short-term outcome were coma and age over 60 years. Conclusions. RSE management guided by cVEEG is associated with a good seizure control. A multidisciplinary approach can help achieve a better short-term functional outcome in noncomatose patients.

Perampanel Treatment for Refractory Status Epilepticus in a Neurological Intensive Care Unit

2019 ◽  
Vol 31 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Chen-Jui Ho ◽  
Chih-Hsiang Lin ◽  
Yan-Ting Lu ◽  
Fu-Yuan Shih ◽  
Che-Wei Hsu ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Status Epilepticus ◽  
Refractory Status Epilepticus ◽  
Neurological Intensive Care Unit ◽  
Neurological Intensive Care ◽  
Refractory Status

Surgical treatment of refractory status epilepticus in children

2013 ◽  
Vol 12 (4) ◽  
pp. 360-366 ◽  
Author(s):  
Sanjiv Bhatia ◽  
Faiz Ahmad ◽  
Ian Miller ◽  
John Ragheb ◽  
Glenn Morrison ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Status Epilepticus ◽  
Intensive Care Unit Stay ◽  
Surgical Intervention ◽  
Refractory Status Epilepticus ◽  
High Dose ◽  
High Morbidity ◽  
Ictal Spect ◽  
Refractory Status

Object Refractory status epilepticus (RSE) is a life-threatening neurological emergency associated with high morbidity and mortality. Affected patients often require prolonged intensive care and can suffer multiple complications. Surgical intervention to control RSE is rarely used but can obviate the risks of prolonged seizures and intensive care treatment. Authors of the present study analyzed their experience with the surgical management of patients suffering from RSE. Methods The Epilepsy Surgery Database at Miami Children's Hospital was reviewed for patients who had undergone surgery for RSE. Clinical presentation, electrophysiological profile, radiological data, surgical details, and postoperative course were evaluated. Results Between 1990 and 2012, 15 patients underwent surgery for uncontrolled seizures despite high-dose medical suppressive therapy. The mean preoperative duration of status epilepticus was 8 weeks. Ictal SPECT and FDG-PET imaging in conjunction with intraoperative electrophysiological studies helped to outline the extent of resection. Surgical intervention controlled seizures in all patients and facilitated the transition out of intensive care. Adverse events related to a prolonged intensive care unit stay included sepsis and respiratory complications. Four patients had worsened neurological function, developing hemiparesis and dysphasia. There was no operative mortality. Conclusions Surgical intervention can successfully control refractory partial status epilepticus, prevent associated morbidity, and decrease intensive care unit stay. Ictal SPECT and PET are valuable in guiding resection.

Antiepileptic Drugs

2018 ◽  
Author(s):  
Eelco F. M. Wijdicks ◽  
Sarah L. Clark
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Status Epilepticus ◽  
Antiepileptic Drugs ◽  
Refractory Status Epilepticus ◽  
Convulsive Status Epilepticus ◽  
Refractory Status ◽  
Focal Status Epilepticus

Patients are often admitted to the neurosciences intensive care unit specifically for the treatment of a series of seizures or focal status epilepticus. Far more urgent is convulsive status epilepticus, which requires multiple intravenously administered antiepileptic drugs. The choices are different when the patient is in status epilepticus and refractoriness is mostly due to pharmacologic resistance. Use of an algorithm for decision making is common in the management of refractory status epilepticus. Antiepileptic drugs often interact with other antiepileptic drugs. This chapter discusses the use of antiepileptic drugs available to treat seizures, recurrent seizures, status epilepticus, and refractory status epilepticus.

High-dose thiopental in the treatment of refractory status epilepticus in intensive care unit

Neurology ◽  
2002 ◽  
Vol 59 (8) ◽  
pp. 1249-1251 ◽  
Author(s):  
I. Parviainen ◽  
A. Uusaro ◽  
R. Kalviainen ◽  
E. Kaukanen ◽  
E. Mervaala ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Status Epilepticus ◽  
Refractory Status Epilepticus ◽  
High Dose ◽  
Refractory Status
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