Status Epilepticus and Acute Repetitive Seizures in Children, Adolescents, and Young Adults: Etiology, Outcome, and Treatment

@article{Mitchell1996StatusEA,
  title={Status Epilepticus and Acute Repetitive Seizures in Children, Adolescents, and Young Adults: Etiology, Outcome, and Treatment},
  author={Wendy G. Mitchell},
  journal={Epilepsia},
  year={1996},
  volume={37}
}
  • W. Mitchell
  • Published 1 February 1996
  • Medicine, Psychology
  • Epilepsia
Summary: Status epilepticus (SE) is one of the most common neurologic emergencies in children, adolescents, and young adults. SE may be due to acute neurologic conditions such as meningitis, encephalitis, or stroke, complicated febrile seizures, intractable epilepsy, degenerative diseases, intoxication, or may be the first manifestation of epilepsy. Initial treatment of convulsive SE is usually with an intravenous benzodiazepine (BZD) [lorazepam (LZP) or diazepam (DZP)], phenobarbital (PB), or… 

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Nonconvulsive status epilepticus (SE) accounts for approximately one‐quarter of all cases of SE and treatment includes antiepileptic drug(s) (AEDs) and avoidance of seizure precipitants.

Recurrent status epilepticus in children

Recurrent status epilepticus occurs primarily in children with an underlying neurological abnormality, and reoccurs in this group despite conventional antiepileptic drug therapy.

Admissions to a pediatric intensive care unit for status epilepticus: A 10‐year experience

Most cases of status epilepticus were caused by epilepsy, atypical febrile seizure, encephalitis, meningitis, or metabolic disease, and the prognosis was good in most surviving cases, more so if the neurologic development of the child was normal before the status epileptus.

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LOR is a safe and effective acute anticonvulsant agent for in-hospital control of SE in the pediatric age group and in patients requiring sequential doses, LOR becomes progressively less effective.

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Operative treatment should be considered in patients with RSE in whom a focus of seizure onset can be demonstrated and who are reasonably considered surgical candidates.

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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.

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The results indicate that alcohol abuse is a common cause of SE and that SE may be the first presentation of alcohol‐related seizures, and the outcome of patients with alcohol-related SE compares favorably with that of patientswith SE due to other causes, but recovery of these patients may be complicated by a prolonged postictal state.
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