• Curr Opin Crit Care · Apr 2017

    Review

    Advancements in the critical care management of status epilepticus.

    • Andrew Bauerschmidt, Andrew Martin, and Jan Claassen.
    • Division of Neurocritical Care, Department of Neurology, Columbia University, New York, New York, USA.
    • Curr Opin Crit Care. 2017 Apr 1; 23 (2): 122-127.

    Purpose Of ReviewStatus epilepticus has a high morbidity and mortality. There are little definitive data to guide management; however, new recent data continue to improve understanding of management options of status epilepticus. This review examines recent advancements regarding the critical care management of status epilepticus.Recent FindingsRecent studies support the initial treatment of status epilepticus with early and aggressive benzodiazepine dosing. There remains a lack of prospective randomized controlled trials comparing different treatment regimens. Recent data support further study of intravenous lacosamide as an urgent-control therapy, and ketamine and clobazam for refractory status epilepticus. Recent data support the use of continuous EEG to help guide treatment for all patients with refractory status epilepticus and to better understand epileptic activity that falls on the ictal-interictal continuum. Recent data also improve our understanding of the relationship between periodic epileptic activity and brain injury.SummaryMany treatments are available for status epilepticus and there are much new data guiding the use of specific agents. However, there continues to be a lack of prospective data supporting specific regimens, particularly in cases of refractory status epilepticus.

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