Practice variations in the management of status epilepticus.

Neurocritical Care
Aaron M CookNeurocritical Care Pharmacy Study Group

Abstract

Numerous anticonvulsant agents are now available for treating status epilepticus (SE). However, a paucity of data is available to guide clinicians in the initial treatment of seizures or SE. This study describes the current strategies being employed to treat SE in the U.S.A. Fifteen American academic medical centers completed a retrospective, multicenter, observational study by reviewing 10-20 of the most recent cases of SE at their institution prior to December 31, 2009. A multivariate analysis was performed to determine factors associated with cessation of seizures. A total of 150 patients were included. Most patients with SE had a seizure disorder (58%). SE patients required a median of 3 AEDs for treatment. Three quarters of patients received a benzodiazepine as first-line therapy (74.7%). Phenytoin (33.3%) and levetiracetam (10%) were commonly used as the second AED. Continuous infusions of propofol, barbiturate, or benzodiazepine were used in 36% of patients. Median time to resolution of SE was 1 day and was positively associated with presence of a complex partial seizure, AED non-compliance prior to admission, and lorazepam plus another AED as initial therapy. Prolonged ICU length of stay and topiramate therapy prior to ...Continue Reading

References

Jul 1, 1995·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·R J DeLorenzoJ G Boggs
Apr 2, 1998·The New England Journal of Medicine·D H Lowenstein, B K Alldredge
Dec 17, 1998·Neurology·R D Sheth, B E Gidal
Nov 14, 2000·Epilepsy Research·D J BorrisJ Kapur
Sep 8, 2001·The New England Journal of Medicine·B K AlldredgeD H Lowenstein
Nov 29, 2001·The Annals of Pharmacotherapy·B M Hodges, J E Mazur
Dec 31, 2003·Epilepsy & Behavior : E&B·Meriem K Bensalem, Toufic A Fakhoury
Mar 10, 2004·Neurology·Andrew Tarulli, Francis W Drislane
Aug 17, 2005·European Neurology·Andrea O Rossetti, Edward B Bromfield
Jan 24, 2006·Seizure : the Journal of the British Epilepsy Association·Nitin C PatelAndrew N Wilner
Feb 21, 2006·Lancet Neurology·James W Y Chen, Claude G Wasterlain
Dec 13, 2006·Epilepsy Research·Sven RupprechtGeorg Hagemann
Sep 23, 2008·Epilepsy Research·Harald Prüss, Martin Holtkamp
Jan 10, 2009·Epilepsy & Behavior : E&B·Christoph KellinghausMichael Besselmann
Jan 7, 2010·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·H MeierkordUNKNOWN European Federation of Neurological Societies
Jan 26, 2010·Clinical Neuropharmacology·Cheng-Yang HsiehChin-Wei Huang
Sep 28, 2010·Acta Neurologica Scandinavica·C KellinghausE Trinka
Jan 5, 2011·Acta Neurologica Scandinavica·M Z KoubeissiN J Azar
Jan 21, 2011·Neurocritical Care·Haley GoodwinJohn J Lewin
Mar 1, 2011·Seizure : the Journal of the British Epilepsy Association·Johannes Michael AlbersRainer Dziewas
Apr 22, 2011·Journal of Pharmacy Practice·Eljim P Tesoro, Gretchen M Brophy
Feb 18, 2012·The New England Journal of Medicine·Robert SilbergleitUNKNOWN NETT Investigators

❮ Previous
Next ❯

Citations

May 18, 2013·Current Neurology and Neuroscience Reports·Panayiotis N VarelasMarek A Mirski
Jun 10, 2014·Current Treatment Options in Neurology·Nicholas S Abend, Tobias Loddenkemper
Feb 28, 2016·Current Treatment Options in Neurology·Eric H GroverLawrence J Hirsch
Aug 13, 2015·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·R PatejdlT Noack
Sep 11, 2013·Epilepsy Research·Kristin RantschJohannes Rösche
Apr 27, 2016·Epilepsy & Behavior : E&B·Yan-Ting LuMeng-Han Tsai
Feb 7, 2019·Pharmacotherapy·Aaron M Cook, Jimmi Hatton-Kolpek
Feb 1, 2017·Neurology. Clinical Practice·Sarah L ClarkSara E Hocker
Jun 1, 2016·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Jonathan E KurzUNKNOWN Investigators for the Approaches and Decisions in Acute Pediatric TBI Trial
Jun 4, 2015·Expert Review of Neurotherapeutics·Xuefeng WangRong Chen
Feb 4, 2016·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·Vincent Alvarez, Andrea O Rossetti
Aug 23, 2017·Expert Review of Neurotherapeutics·Michael O Kinney, Peter W Kaplan
Nov 28, 2019·The New England Journal of Medicine·Jaideep KapurUNKNOWN NETT and PECARN Investigators
Dec 14, 2018·The Annals of Pharmacotherapy·Ryan DasGuptaDanielle Burghardt
Oct 17, 2020·Archives of Disease in Childhood·Ibtihal AbdelgadirColin Powell

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.