Generalized convulsive status epilepticus in adults and

Emerg. Med. Clin. North Am. · Feb 2011

Generalized convulsive status epilepticus in adults and children: treatment guidelines and protocols.

Generalized convulsive status epilepticus (GCSE) has a high morbidity and mortality, such that the rapid delivery of anticonvulsant therapy should be initiated within minutes of seizure onset to prevent permanent neuronal damage. GCSE is not a specific disease but is a manifestation of either a primary central nervous system (CNS) insult or a systemic disorder with secondary CNS effects. ⋯ First-line therapies for seizures and status epilepticus include the use of a benzodiazepine, followed by an infusion of a phenytoin with a possible role for intravenous valproate or phenobarbital. If these first-line medications fail to terminate the GCSE, treatment includes the continuous infusion of midazolam, pentobarbital, or propofol.

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- Peter Shearer and James Riviello.
- Department of Emergency Medicine, Mount Sinai School of Medicine, New York, NY, USA. shearerp@nychhc.org
- Emerg. Med. Clin. North Am. 2011 Feb 1; 29 (1): 51-64.
AbstractGeneralized convulsive status epilepticus (GCSE) has a high morbidity and mortality, such that the rapid delivery of anticonvulsant therapy should be initiated within minutes of seizure onset to prevent permanent neuronal damage. GCSE is not a specific disease but is a manifestation of either a primary central nervous system (CNS) insult or a systemic disorder with secondary CNS effects. It is mandatory to look for an underlying cause. First-line therapies for seizures and status epilepticus include the use of a benzodiazepine, followed by an infusion of a phenytoin with a possible role for intravenous valproate or phenobarbital. If these first-line medications fail to terminate the GCSE, treatment includes the continuous infusion of midazolam, pentobarbital, or propofol.Copyright © 2011. Published by Elsevier Inc.

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Generalized convulsive status epilepticus in adults and children: treatment guidelines and protocols.

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