Time is brain: Review of emergency management of status epilepticus in adults
Status epilepticus (SE) is a serious complication of epilepsy that warrants both rapid and appropriate emergency management for better outcomes in terms of mortality and morbidity. The initial management of SE in emergency department (ED) involves a rapid neurological assessment and initiation of su...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | Current Medical Issues |
| Subjects: | |
| Online Access: | http://www.cmijournal.org/article.asp?issn=0973-4651;year=2021;volume=19;issue=4;spage=269;epage=273;aulast=Madhiyazhagan |
| _version_ | 1798034274411085824 |
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| author | Mamta Madhiyazhagan |
| author_facet | Mamta Madhiyazhagan |
| author_sort | Mamta Madhiyazhagan |
| collection | DOAJ |
| description | Status epilepticus (SE) is a serious complication of epilepsy that warrants both rapid and appropriate emergency management for better outcomes in terms of mortality and morbidity. The initial management of SE in emergency department (ED) involves a rapid neurological assessment and initiation of supportive therapy. Benzodiazepines are the recommended first-line treatment based on high-quality evidence, among them intramuscular (IM) midazolam IM was found to be as effective as intravenous lorazepam. However, it is important to understand that speedy drug delivery and adequate initial dose are of prime importance than selection of drug. Recent evidence shows all three second-line drugs, namely, valproate, fosphenytoin, and levetiracetam are alike in cessation of SE with similar incidence of adverse events. In refractory SE, the therapeutic options include the use of bolus dose followed by infusion of propofol, midazolam, ketamine, lacosamide, and phenobarbital. Magnesium sulfate is safe and superior in the management of eclamptic SE prompt and appropriate management in ED is the key to early cessation of SE, leading to better outcomes. |
| first_indexed | 2024-04-11T20:42:04Z |
| format | Article |
| id | doaj.art-d03233395234411d9220f63420cb1e56 |
| institution | Directory Open Access Journal |
| issn | 0973-4651 2666-4054 |
| language | English |
| last_indexed | 2024-04-11T20:42:04Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Current Medical Issues |
| spelling | doaj.art-d03233395234411d9220f63420cb1e562022-12-22T04:04:11ZengWolters Kluwer Medknow PublicationsCurrent Medical Issues0973-46512666-40542021-01-0119426927310.4103/cmi.cmi_53_21Time is brain: Review of emergency management of status epilepticus in adultsMamta MadhiyazhaganStatus epilepticus (SE) is a serious complication of epilepsy that warrants both rapid and appropriate emergency management for better outcomes in terms of mortality and morbidity. The initial management of SE in emergency department (ED) involves a rapid neurological assessment and initiation of supportive therapy. Benzodiazepines are the recommended first-line treatment based on high-quality evidence, among them intramuscular (IM) midazolam IM was found to be as effective as intravenous lorazepam. However, it is important to understand that speedy drug delivery and adequate initial dose are of prime importance than selection of drug. Recent evidence shows all three second-line drugs, namely, valproate, fosphenytoin, and levetiracetam are alike in cessation of SE with similar incidence of adverse events. In refractory SE, the therapeutic options include the use of bolus dose followed by infusion of propofol, midazolam, ketamine, lacosamide, and phenobarbital. Magnesium sulfate is safe and superior in the management of eclamptic SE prompt and appropriate management in ED is the key to early cessation of SE, leading to better outcomes.http://www.cmijournal.org/article.asp?issn=0973-4651;year=2021;volume=19;issue=4;spage=269;epage=273;aulast=Madhiyazhaganstatus epilepticusantiepileptic drugsemergency departmentrefractory status epilepticus |
| spellingShingle | Mamta Madhiyazhagan Time is brain: Review of emergency management of status epilepticus in adults Current Medical Issues status epilepticus antiepileptic drugs emergency department refractory status epilepticus |
| title | Time is brain: Review of emergency management of status epilepticus in adults |
| title_full | Time is brain: Review of emergency management of status epilepticus in adults |
| title_fullStr | Time is brain: Review of emergency management of status epilepticus in adults |
| title_full_unstemmed | Time is brain: Review of emergency management of status epilepticus in adults |
| title_short | Time is brain: Review of emergency management of status epilepticus in adults |
| title_sort | time is brain review of emergency management of status epilepticus in adults |
| topic | status epilepticus antiepileptic drugs emergency department refractory status epilepticus |
| url | http://www.cmijournal.org/article.asp?issn=0973-4651;year=2021;volume=19;issue=4;spage=269;epage=273;aulast=Madhiyazhagan |
| work_keys_str_mv | AT mamtamadhiyazhagan timeisbrainreviewofemergencymanagementofstatusepilepticusinadults |