The management of status epilepticus.

@article{Marik2004TheMO,
  title={The management of status epilepticus.},
  author={Paul Ellis Marik and Joseph Varon},
  journal={Chest},
  year={2004},
  volume={126 2},
  pages={
          582-91
        }
}
Status epilepticus is a major medical emergency associated with significant morbidity and mortality. Status epilepticus is best defined as a continuous, generalized, convulsive seizure lasting > 5 min, or two or more seizures during which the patient does not return to baseline consciousness. Lorazepam in a dose of 0.1 mg/kg is the drug of first choice for terminating status epilepticus. Patients who continue to have clinical or EEG evidence of seizure activity after treatment with lorazepam… 

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References

SHOWING 1-10 OF 112 REFERENCES
Status epilepticus.
TLDR
Current opinions about the classification, aetiology and pathophysiology of adult generalised convulsive status epilepticus are reviewed and practical management strategies for treatment of this life-threatening condition are details.
Status epilepticus: new concepts.
Generalized convulsive status epilepticus is a neurological emergency characterized by abnormally prolonged seizures. This review emphasizes recent developments that bear on our understanding of the
Treatment of convulsive status epilepticus. Recommendations of the Epilepsy Foundation of America's Working Group on Status Epilepticus.
TLDR
Common to all patients is the need for a clear plan, prompt administration of appropriate drugs in adequate doses, and attention to the possibility of apnea, hypoventilation, or other metabolic abnormalities.
Comparison of Status Epilepticus with Prolonged Seizure Episodes Lasting from 10 to 29 Minutes
TLDR
This study was initiated to compare cases of Status epilepticus and 10 to 29‐min seizure episodes seen within the same period, and to include seizure episodes lasting ≥10 min in the definition of SE.
Propofol in the treatment of convulsive status epilepticus: a report of four cases.
TLDR
Four cases of convulsive status due to severe encephalopathy of various etiology are described, which were resistant to diazepam and other drugs and remitted only after treatment with propofol.
Persistent Nonconvulsive Status Epilepticus After the Control of Convulsive Status Epilepticus
TLDR
The present study was initiated to determine whether control of CSE by standard treatment protocols was sufficient to terminate electrographic seizures.
Successful treatment of amoxapine-induced refractory status epilepticus with propofol (diprivan)
TLDR
The case of a 30-year-old woman who presented with an amoxapine overdose that deteriorated into status epilepticus refractory to conventional therapy is reported, and propofol given by intravenous bolus and maintenance infusion successfully halted the patient's seizure activity.
Complex partial status epilepticus: a recurrent problem.
TLDR
Twenty patients with complex partial status epilepticus were identified retrospectively from a specialist neurology hospital, and none of the patients showed any marked evidence of cognitive or neurological deterioration.
Refractory status epilepticus
  • T. Bleck
  • Medicine
    Current opinion in critical care
  • 2005
TLDR
Refractory status epilepticus, while a challenge to the intensivist, can be treated with drugs that are commonly used by intensivists, both for the short and the longer terms.
Modern concepts of status epilepticus.
TLDR
Among 60 cases of status epilepticus, there were 45 cases of convulsive status and 15 cases of nonconvulsive or confusional status, and Diagnosis was determined by characteristic changes in the electroencephalogram.
...
...