Convulsive status epilepticus
- 1 October 1999
- journal article
- Published by Springer Science and Business Media LLC in Current Treatment Options in Neurology
- Vol. 1 (4), 359-369
- https://doi.org/10.1007/s11940-999-0025-5
Abstract
Generalized convulsive status epilepticus (GCSE) is a medical emergency that must be treated rapidly and aggressively to prevent neuronal damage. Treatment should be initiated with intravenous lorazepam, 0.1 mg/kg, given at a rate of no more than 2 mg/min. If convulsions persist for more than 10 minutes or recur more than 20 minutes after lorazepam therapy is started, then fosphenytoin (20 mg of phenytoin equivalents per kilogram) should be infused at a rate of no more than 150 mg/min. If convulsions still continue, intravenous general anesthesia with pentobarbital, benzodiazepine drip, or propofol should be initiated after respiratory support has been established. All patients with GCSE who do not recover consciousness should be monitored with electroencephalography (EEG), and any residual epileptiform activity on EEG, including periodic epileptiform discharges (PEDs), should be considered evidence of continuing GCSE and treated aggressively.Keywords
This publication has 29 references indexed in Scilit:
- A pharmacoeconomic evaluation of intravenous fosphenytoin (Cerebyx®) versus intravenous phenytoin (Dilantin®) in hospital emergency departmentsClinical Therapeutics, 1996
- The intensive care treatment of convulsive status epilepticus in the UKAnaesthesia, 1995
- Excitotoxicity and Selective Neuronal Loss in EpilepsyBrain Pathology, 1993
- Generalized Convulsive Status Epilepticus in the AdultEpilepsia, 1993
- Valproic acid treatment of experimental status epilepticusEpilepsy Research, 1992
- Intravenous midazolam for the treatment of refractory status epilepticusCritical Care Medicine, 1992
- Pentobarbital and EEG Burst Suppression in Treatment of Status Epilepticus Refractory to Benzodiazepines and PhenytoinEpilepsia, 1990
- Excitotoxity and the NMDA receptorTrends in Neurosciences, 1987
- Increased damage after ischemic stroke in patients with hyperglycemia with or without established diabetes mellitusAmerican Journal Of Medicine, 1983
- Management of Status EpilepticusThe New England Journal of Medicine, 1982