Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-848d4c4894-75dct Total loading time: 0 Render date: 2024-05-27T11:00:31.084Z Has data issue: false hasContentIssue false

14 - Status Epilepticus

from Section 3 - Neurological Emergencies

Published online by Cambridge University Press:  02 November 2023

By
Matthew L. Wong
Edited by
Kaushal Shah  and
Jarone Lee
Edited in association with
Clark G. Owyang  and
Benjamin Christian Renne
Kaushal Shah
Affiliation:
Weill Cornell Medical Center, New York
Jarone Lee
Affiliation:
Massachusetts General Hospital, Boston
Clark G. Owyang
Affiliation:
Weill Cornell Medical Center, New York
Benjamin Christian Renne
Affiliation:
Massachusetts General Hospital, Boston
Get access

Summary

  • In generalized convulsive status epilepticus (GCSE), a seizure lasts longer than 5 minutes or two seizures occur without an interval return to baseline.

  • The most common error in managing status epilepticus is not administering enough benzodiazepine. If the patient is refractory to benzodiazepines, there are multiple appropriate agents for second-line treatment (e.g., levetiracetam, valproate, fosphenytoin). A timely and early intubation may be the safest option and provide the best outcome for the patient.

  • Nonconvulsive status epilepticus (NCSE) presents without muscle involvement, and may be suspected clinically, but needs electroencephalography (EEG) to make the diagnosis.

Keywords

seizurebenzodiazepinesantiepilepticsEEG
Type
Chapter
Information
Practical Emergency Resuscitation and Critical Care , pp. 124 - 130
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Kapur, J, Elm, J, Chamberlain, J, et al. Randomized trial of three anticonvulsant medications for status epilepticus. N Engl J Med 2019;381(22):2103–2113. https://doi.org/10.1056/NEJMoa1905795CrossRefGoogle ScholarPubMed
Silbergleit, R, Durkalski, V, Lowenstein, D, et al. Intramuscular versus intravenous therapy for prehospital status epilepticus. N Engl J Med 2012;366:591–600.CrossRefGoogle ScholarPubMed
Treiman, DM, Meyers, PD, Walton, NY, et al. A comparison of four treatments for generalized convulsive status epilepticus. Veterans Affairs Status Epilepticus Cooperative Study Group. N Engl J Med 1998;339:792–798.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×