The most frequent cause in epileptic patients is drug change or noncompliance and in the nonepileptic patients are cerebrovascular diseases, head trauma, drug toxicity and metabolic. Status epilepticus manifests as many different syndromes, each defined by distinctive clinical features and electroencephalography eeg findings. The status epilepticus treatment requires prompt intervention to control the general patients conditions and seizures. Status epilepticus status epilepticus is a neurological emergency that requires prompt care. In elderly patients, refractory status epilepticus rse may lead to death in over to prolonged seizures and status epilepticus. Therefore its early recognition and treatment is crucial.
The most frequent cause in epileptic patients is drug change or noncompliance and in the nonepileptic patients are cerebrovascular diseases, head trauma, drug. Jan 27, 2016 estatus epileptico manejo en urgencias 1. The prognosis depends on the duration and the phase in which the appropriate treatment is, age, ethiology, comorbidities and complications. In adults with convulsive status epilepticus, intramuscular midazolam, collins jf, point p. Alejandro villatoro martinez urgencias medico quirurgicas american british cowdray medical center. This paper includes the cpg chapter dedicated to emergency situations in seizures and epilepsy, which may present as a first seizure, an unfavorable outcome in a patient with known epilepsy, or status epilepticus as the most severe manifestation. Diagnostico y tratamiento oportuno del estado epileptico. A definition and classification of status epilepticus report of the ilae task force on classification of status epilepticus. Two class iii studies involved intranasal lorazepam. Status epilepticus is a common neurological emergency with considerable associated healthcare costs, morbidity, and mortality.
In status epilepticus seizures appear in close succession or dont stop. Status epilepticus is the most common neurological emergency in children. The goal of this current guideline is to provide evidencebased answers to efficacy, safety, and tolerability questions regarding the treatment of convulsive status epilepticus and to synthesize these answers into a treatment algorithm. Intramuscular midazolam has superior effectiveness compared with iv lorazepam in adults with convulsive status epilepticus without established iv access level a. Guidelines for the evaluation and management of status. Causes, prognoses, and treatments differ, and optimal evaluation and treatment requires an. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Status epilepticus is a medical and neurologic emergency that requires prompt evaluation and treatment.
It represents a frequently medical emergency with elevated costs and high morbimortality. There are several definitions of status epilepticus and classifications by etiology. This term has also been labeled as subtle status 12 30. For the purposes of these guidelines we will focus on the acutely ill. While the aes guideline was developed prior to the ilaes revised definition of status epilepticus trinka et al. Enfoque del estatus epileptico en adultos scielo colombia. Refractory status epilepticus is a seizure that continues despite treatment with benzodiazepines and antiepileptic drugs. Super refractory status epilepticus is the one that does not respond to anesthetic medication or relapses during its withdrawal. The diagnosis and treatment must be continuous from the first minutes to its resolution. Unfortunately, there is still no consensus on several of its aspects, from its definition to its treatment. Status epilepticus is when seizure last 30 minutes or when a patient has two o more sequential crisis without a full recovery of consciousness between episodes.
Ten percent in average of the patients with epilepsy could suffer status epilepti. It is a serious condition that requires prompt medical attention. Estado epileptico, epilepsia, refractario, anti convulsivantes. Oscar miguel oliva meza hernandez, ximena ochoa morales. Status epileptico, tratamiento, diagnostico, drogas. Status epilepticus in adults john p betjemann, daniel h lowenstein status epilepticus is a common neurological emergency with considerable associated healthcare costs, morbidity, and mortality. It may occur both in patients with a history of epilepsy and without it in which the latter is usually the manifestation of an acute central nervous system illness. Las causas mas comunes y facilmente reconocibles del. Diagnostico y tratamiento oportuno del estado epileptico en. Manejo medico y farmacologico del estatus epileptico asociacion. The actual status epilepticus guides are recommending earlier management in terms of time in patients with not. Pdf introduction status epilepticus is a major public health problem.
Treatment of status epilepticus if first drug fails. Stroke, h ipoxia, alteraciones metabolicas e intoxicacion por alcohol. Status epilepticus international league against epilepsy. Status epilepticus is a neurological emergency that requires prompt care.
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