Status epilepticus first line treatment








Neurology 1 Status Epilepticus Portal - CALS

7/20/2014
02:33 | Author: Molly Young

Status epilepticus first line treatment
Neurology 1 Status Epilepticus Portal - CALS

If these are not treated promptly, these may evolve into status epilepticus.4. Benzodiazepines: The first-line treatment for status epilepticus is benzodiazepines.

The usual dose of phenobarbital is 20 mg/kg at a rate of 50 to 75 mg/minute IV.6. Phenobarbital has been shown to be effective for the treatment of status epilepticus, but has a significant depressant effect on respiratory drive, level of consciousness, and blood pressure, especially if administered after a benzodiazepine.6 Thus, use of phenobarbital in older children and adults is recommended only if benzodiazepine and phenytoin therapy has failed, there is not another good alternative for treatment, and blood pressure and respiratory support is immediay available.

Midazolam (Versed) may be used as a slow IV bolus of 0.2 mg/kg followed by continuous infusion of 0.75 to 10 µg/kg/minute.6 Midazolam appears to be the most potent of the benzodiazepines, but it has a shorter anti-epileptic half-life than lorazepam.4.

Diagnostic Studies Perform initial diagnostic studies in conjunction with initial therapeutic measures.

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Status epilepticus in adults - UpToDate

5/19/2014
12:26 | Author: Chloe Allen

Status epilepticus first line treatment
Status epilepticus in adults - UpToDate

Although exact definitions vary, the term status epilepticus generally refers to the seizures following first- and second-line drug therapy, was noted in nearly 30 [5] to 43 [6] percent Treatment of convulsive status epilepticus.

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Although not associated with increased mortality, refractory status epilepticus was linked to prolonged hospitalization and poorer functional outcomes. ETIOLOGY. Refractory status epilepticus, defined as ongoing seizures following first- and second-line drug therapy, was noted in nearly 30 to 43 percent of patients with status epilepticus. In contrast, inadequate serum levels of antiepileptic drugs (AEDs) were associated significantly more often with nonrefractory than with refractory status epilepticus (28 versus 0 percent, respectively).

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Review of Levetiracetam as a First Line Treatment in Status

3/18/2014
02:39 | Author: Nicholas Clark

Status epilepticus first line treatment
Review of Levetiracetam as a First Line Treatment in Status

With the advent of new antiepileptic drugs comes the potential for significant advances in the emergent management of status epilepticus.

Studies indicate that levetiracetam is an attractive option in patients who are unable to be treated with traditional first-line therapies. This may serve as a catalyst for the exploration of levetiracetam as a first-line medication. Perhaps the greatest potential advantages to levetiracetam are its pharmacologic properties and restricted morbidity via minimal side effect and interaction profiles. Although existing clinical evidence is inadequate, the recommendations of the Neurocritical Care Society for the management of status show a potential for an expanding role of levetiracetam in the management of status with its inclusion of recommended drugs that may be selected in the urgent management of status.

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Intravenous Levetiracetam as first-line treatment of status epilepticus

11/27/2014
06:28 | Author: Chloe Allen

Status epilepticus first line treatment
Intravenous Levetiracetam as first-line treatment of status epilepticus

Intravenous Levetiracetam as first-line treatment of status epilepticus in the elderly. Fattouch J, Di Bonaventura C, Casciato S, Bonini F, Petrucci S, Lapenta L.

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National Library of Medicine 8600 Rockville Pike, Bethesda MD, 20894 USA. National Center for Biotechnology Information, U.S.

The aim of this pilot study was to evaluate the short-term efficacy/safety of intravenously administered LEV (IVLEV) as the treatment of choice for SE in the elderly.

All the patients presented concomitant medical conditions (arrhythmias/respiratory distress/hepatic diseases). As the traditional therapy for SE was considered unsafe, IVLEV was used as first-line therapy (loading dose of 1500 mg/100 ml/15 min, mean maintenance daily dose of 2500 mg/24 h) administered during video-EEG monitoring. Two patients had a previous diagnosis of epilepsy; in the remaining seven, SE was symptomatic. We enrolled nine elderly patients (five female/four male; median age 78 years) with SE. SE was convulsive in five and non-convulsive in four.

No adverse events or changes in the ECG/laboratory parameters were observed. These data suggest that IVLEV may be an effective/safe treatment for SE in the elderly. In all the patients but one, IVLEV was effective in the treatment of SE and determined either the disappearance of (7/8), or significant reduction in (1/8), epileptic activity; no patient relapsed in the subsequent 24 h.

Treatment in the elderly can be complicated by serious side effects associated with traditional drugs. Status epilepticus is a condition of prolonged/repetitive seizures that often occurs in the elderly.

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Clinical experience with intravenous valproate as first-line treatment

9/26/2014
04:25 | Author: Molly Young

Status epilepticus first line treatment
Clinical experience with intravenous valproate as first-line treatment

Clinical experience with intravenous valproate as first-line treatment of status epilepticus and seizure clusters in selected populations. Lapenta.

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The aim of this study was to evaluate the efficacy and safety of intravenous valproate (i.v. VPA) as first-line treatment of status epilepticus (SE) and seizure clusters in selected patient populations.

National Center for Biotechnology Information, U.S. National Library of Medicine 8600 Rockville Pike, Bethesda MD, 20894 USA.

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VPA as first-line therapy of SE in patients with medical conditions contraindicating the use of traditional first-line antiepileptic drugs for SE, and in those presenting with specific forms of SE. Our study shows the clinical relevance of i.v.

No significant adverse effects were detected. In 15 out of 23 patients (65%), i.v. VPA was effective. In our population, we retrospectively identified three different subgroups: patients with cardiorespiratory comorbidities discouraging the use of traditional SE first-line drugs, patients with specific epileptic subsyndromes (such as idiopathic generalized epilepsy), and patients affected by psycho-organic syndromes.

We evaluate the response of SE to i.v. Liver function and serum ammonia tests were conducted after 24 and 72 h of treatment. ECG tracing was monitored before, during, and after infusion. We enrolled 23 patients (11 females and 12 males; mean age: 61 years) with SE who received i.v. therapy and short-term outcome. VPA as first-line therapy (25 mg/kg in 100 mL saline infused over 15 min).

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