Refractory Generalised Convulsive Status Epilepticus

  title={Refractory Generalised Convulsive Status Epilepticus},
  author={Reetta K{\"a}lvi{\"a}inen and Kai J. Eriksson and Ilkka Parviainen},
  journal={CNS Drugs},
The patient with status epilepticus has continuous or rapidly repeating seizures. Generalised convulsive status epilepticus (GCSE) is the most common form of the disorder and is a life-threatening condition that requires prompt medical management. Status epilepticus that does not respond to first-line benzodiazepines (lorazepam or diazepam) or to second-line antiepileptic drugs (phenytoin/fosphenytoin, phenobarbital or valproate) is usually considered refractory and requires more aggressive… 
Pharmacologic management of convulsive status epilepticus in childhood
The incidence of convulsive status epilepticus in children is approximately 20–50/100,000/year, and is an emergency requiring prompt medical intervention. Prolonged seizures lasting over 5 min are
Pharmacologic management of convulsive status epilepticus
The incidence of convulsive status epilepticus in children is approximately 20–50/100,000/year, and is an emergency requiring prompt medical intervention. Prolonged seizures lasting over 5 min are
Treatment of convulsive status epilepticus.
  • D. Treiman
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    International review of neurobiology
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Continuous Infusion Antiepileptic Medications for Refractory Status Epilepticus: A Review for Nurses
The purpose of this review was to summarize the available RSE literature focusing on CIV midazolam, pentobarbital, propofol, and ketamine, and to serve as a primer for nurses providing care to these patients.
Drugs Commonly Used to Treat Refractory Status Epilepticus in Clinical Practice
Polytherapy may be considered a feasible choice for treating RSE when single-drug treatment for SE fails, and seven drugs that are commonly used to treat RSE are described.
The outcome of therapies in refractory and super-refractory convulsive status epilepticus and recommendations for therapy.
An approach to therapy, divided into first-line, second-line and third-line therapy, is suggested on the basis of this outcome evaluation, noting the importance of treatments directed at the cause of the status epilepticus, and of supportive ITU care.
Therapie des Status epilepticus
In patients with previous epilepsy a phase of increasing seizure activity (premonitory status) often heralds overt GCSE in which continuous epileptic activity prevails, leading to management of established GCSE prompts.
Status epilepticus in dogs and cats, part 2: treatment, monitoring, and prognosis.
To discuss current anticonvulsant drug options and advances in treatment of status epilepticus (SE) and to review the prognosis associated with SE, a lack of evidence demonstrating clear benefit to the use of specific therapeutics for benzodiazepine-refractory SE is reviewed.
Pharmacological Management of Seizures and Status Epilepticus in Critically Ill Patients
To prevent seizures and further complications in critically ill patients with acute neurological disease or injury, short-term seizure prophylaxis should be considered in certain patients.
Seizures and status epilepticus in the critically ill.


A comparison of four treatments for generalized convulsive status epilepticus. Veterans Affairs Status Epilepticus Cooperative Study Group.
As initial intravenous treatment for overt generalized convulsive status epilepticus, lorazepam is more effective than phenytoin and it is easier to use.
  • S. Shorvon
  • Medicine, Psychology
    Journal of neurology, neurosurgery, and psychiatry
  • 2001
The physiological changes in status can be divided into two phases, the transition from phase 1 to 2 occurring after about 30–60 minutes of continuous seizures, and there is an increasing risk of cerebral damage as the status progresses.
Effects of long barbiturate anaesthesia on eight children with severe epilepsy.
Positive results were more often achieved when the treatment lag was less than 12 months, and good effect seemed to be associated with an anaesthesia which is deep and long enough to produce loss of consciousness and spontaneous reactions, and an electroencephalographic pattern of burst-suppression.
Refractory status epilepticus: frequency, risk factors, and impact on outcome.
Refractory status epilepticus occurs in approximately 30% of patients with SE and is associated with increased hospital length of stay and functional disability, and nonconvulsive SE and focal motor seizures at onset are risk factors for RSE.
The current state of treatment of status epilepticus
Recent advances and practical issues related to the clinical care of patients with status epilepticus are reviewed, concentrating on recent advances in the diagnosis and treatment of status epileptus.
Treatment of status epilepticus: a survey of neurologists
Rectally administered lorazepam appeared to be particularly valuable (100 per cent efficacy) when venous access was not possible and significantly fewer patients treated with lorzepam required additional anticonvulsants to terminate the seizure.
Intravenous Valproate Associated With Significant Hypotension in the Treatment of Status Epilepticus
To the authors' knowledge, this is the first report of significant hypotension associated with intravenous valproate in the treatment of status epilepticus in the pediatric population.
Status epilepticus in children: aetiology, treatment, and outcome
It is concluded that early and prompt use of barbiturate anaesthesia should be encouraged, and may explain the low morbidity figures in status epilepticus patients treated at Tampere University Hospital.
Clinical and EEG features of status epilepticus in comatose patients
It is concluded that recognition of SE in comatose patients may require both clinical and EEG evaluation since either approach by itself may fail to establish the diagnosis.