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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

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jueves, 20 de agosto de 2020

Status Epilepticus

Taming The SRU
Taming The SRU - By Goff Carl - August 17, 2020
Table 2: A stepwise approach to the management of generalized convulsive status epilepticus. Adapted from cited article Betjemann et al. [10]
"TAKE HOME POINTS:
  • Generalized convulsive status epilepticus (GCSE) must be managed emergently as it is unlikely to spontaneously resolve and can result in permanent neurologic injury.
  • Treatment should begin after 5 minutes of seizure activity with a goal for seizure resolution by 30 minutes.
  • Subtle convulsive status epilepticus should be identified and treated in similar fashion to GCSE
  • Treatment should include a stepwise approach beginning with benzodiazepines followed by an anti-epileptic drug (AED). Any one of three AEDs including levetiracetam, fosphenytoin and valproate may be used.
  • Continuous infusion of anesthetic agents may be necessary and will require additional support including securing the airway.
  • Ketamine has previously shown benefit in super refractory status epilepticus and may soon become a useful modality in the transport setting as an earlier intervention."