| Status epilepticus. | |
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MedLine Citation:
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PMID: 20174493 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Status epilepticus (SE) is a medical emergency associated with significant morbidity and mortality. SE is defined as a continuous seizure lasting more than 30 min, or two or more seizures without full recovery of consciousness between any of them. Based on recent understanding of the pathophysiology, it is now considered that any seizure that lasts more than 5 min probably needs to be treated as SE. GABAergic mechanisms play a crucial role in terminating seizures. When the seizure persists, GABA-mediated mechanisms become ineffective and several other putative mechanisms of seizure suppression have been recognized. Early treatment of SE with benzodiazepines, followed if necessary by fosphenytoin administration, is the most widely followed strategy. About a third of patients with SE may have persistent seizures refractory to the first-line medications. They require aggressive management with second-line medications such as barbiturates, propofol, or other agents. In developing countries where facilities for assisted ventilation are not readily available, it may be helpful to use nonsedating antiepileptic drugs (such as sodium valproate, levetiracetam, or topiramate) at this stage. It is important to recognize SE and institute treatment as early as possible in order to avoid a refractory state. It is equally important to attend to the general condition of the patient and to ensure that the patient is hemodynamically stable. This article reviews current knowledge regarding the management of convulsive SE in adults. |
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Authors:
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Ajith Cherian; Sanjeev V Thomas |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Annals of Indian Academy of Neurology Volume: 12 ISSN: 1998-3549 ISO Abbreviation: Ann Indian Acad Neurol Publication Date: 2009 Jul |
Date Detail:
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Created Date: 2010-02-22 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101273955 Medline TA: Ann Indian Acad Neurol Country: India |
Other Details:
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Languages: eng Pagination: 140-53 Citation Subset: - |
Affiliation:
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Department of General Medicine, Medical College, Trivandrum, Kerala, India. |
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