Refractory status epilepticus

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Refractory status epilepticus is a potentially life-threatening medical emergency. It requires early diagnosis and treatment. There is a lack of consensus upon its semantic definition of whether it is status epilepticus that continues despite treatment with benzodiazepine and one antiepileptic medication (AED), i.e., Lorazepam + phenytoin. Others regard refractory status epilepticus as failure of benzodiazepine and 2 antiepileptic medications, i.e., Lorazepam + phenytoin + phenobarb. Up to 30% patients in SE fail to respond to two antiepileptic drugs (AEDs) and 15% continue to have seizure activity despite use of three drugs. Mechanisms that have made the treatment even more challenging are GABA-R that is internalized during status epilepticus and upregulation of multidrug transporter proteins. All patients of refractory status epilepticus require continuous EEG monitoring. There are three main agents used in the treatment of RSE. These include pentobarbital or thiopental, midazolam and propofol. RSE was shown to result in mortality in 35% cases, 39.13% of patients were left with severe neurological deficits, while another 13% had mild neurological deficits.

Original languageEnglish
JournalAnnals of Indian Academy of Neurology
Volume17
Issue numberSUPPL. 1
DOIs
StatePublished - 2014
Externally publishedYes

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Status Epilepticus
Anticonvulsants
Lorazepam
Phenytoin
Benzodiazepines
Thiopental
Midazolam
Propofol
Pentobarbital
Therapeutics
Semantics
gamma-Aminobutyric Acid
Early Diagnosis
Electroencephalography
Seizures
Emergencies
Up-Regulation
Mortality
Pharmaceutical Preparations
Proteins

All Science Journal Classification (ASJC) codes

  • Clinical Neurology

Cite this

Refractory status epilepticus. / Singh, Sanjay; Agarwal, Shubhi; Faulkner, Michele A.

In: Annals of Indian Academy of Neurology, Vol. 17, No. SUPPL. 1, 2014.

Research output: Contribution to journalArticle

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