Critical Management of Status Epilepticus
Journal Title: Journal of Clinical Intensive Care and Medicine - Year 2017, Vol 2, Issue 1
Abstract
Seizure is clinical manifestation of sudden disruption of the normal electrical activity of cortical neurons. The brain electrical activity is periodically disturbed, alteration in neural cell integrity, increase in firing impulses and spread to adjacent normal neurons result in temporary brain dysfunction with alterations in consciousness, behavior or motor function. It may be triggered by illness, infection, stress, stroke, brain tumor, or the underlying cause may not completely understand. Status epilepticus (SE) is a medical emergency and requires prompt diagnosis and treatment. Treatment includes general support measures, drugs to suppress epileptic activity and relieving the underlying condition. Refractory SE requires admission to an intensive care unit (ICU) to allow adequate monitoring and support of respiratory, metabolic and hemodynamic functions and cerebral electrical activity. For SE treatment, benzodiazepines are the first line antiepileptic agents, and if benzodiazepines fail to control seizures, Phenytoin is usually indicated; Phenobarbital or Valproate may also be considered. For refractory SE, Propofol and Thiopental represent first line agents after careful assessment of potential risks. In refractory SE, general anesthesia may be required. There is currently no unique consensus for definite treatment option of RSE. In this review, the management protocol of seizure, assessment, monitoring, and different alternative therapy would be discussed.
Authors and Affiliations
Farahnaz Fallahian, Seyed Mohammad Reza Hashemian
Sinking Skin Flap Syndrome
A previously healthy 26-year-old gentleman, referred from a state hospital with history of alleged fall from 10 feet height at a construction site on the same day. Glasgow coma scale (GCS) at that hospital was E2 V2 M5....
Clinico-epidemiological characteristics and survival outcome of patients with hypertensive crisis at Kassala Hospital, Eastern Sudan
Introduction: Hypertensive crisis (HC) is recognized consequence of inadequate blood pressure (BP) control. A hypertensive crisis is further divided into hypertensive emergency (HT-E) and hypertensive urgency (HT-U). Me...
Evaluation of unexplained clinical features of hepatic diseases through biopsies among hospitalized children: A cross-sectional study in Lahore, Pakistan
Objectives: There are variations in therapeutic regimens of different liver diseases. The accurate diagnosis ensures prompt recovery from these diseases. The present study aimed to evaluate the underlying causes of unexp...
Ontario wait time strategy to solve long waiting problem
The Ontario government has been battling with the issue of extensive wait times in hospitals for several years. Although there are many complex reasons that stem off of the issues of wait times, such as available in pati...
Chemotherapy Exposure and outcomes of Chronic Lymphoid Leukemia Patients
This study describes chemotherapy exposure, healthcare utilization, overall survival (OS) and progression-free survival (PFS) among patients diagnosed with chronic lymphoid leukemia (CLL). Newly diagnosed CLL patients wh...