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01-04-2017 | What's New in Intensive Care

What’s new in refractory status epilepticus?

Authors: Stephane Legriel, Mauro Oddo, Gretchen M. Brophy

Published in: Intensive Care Medicine | Issue 4/2017

Excerpt

Refractory status epilepticus (RSE) is defined by persistent seizures, resistant to first-line (benzodiazepines) and second-line (“classic” anticonvulsant therapy, such as valproate, phenytoin/fosphenytoin or levetiracetam), usually requiring general anesthesia and continuous electroencephalogram (EEG) monitoring [1]. This is of particular importance since up to 43 % of patients with status epileptics will progress to RSE. Rossetti and Bleck recently proposed an update on the management of status epilepticus [2]. Here, we have reviewed recent literature on convulsive RSE in adults, aiming to summarize advantages/disadvantages and comparative studies of “standard” intravenous anesthetics (propofol, midazolam, barbiturates) and describe the emerging use of the alternative anesthetic agent, ketamine. Wehave also proposed an algorithm for the management of RSE in the ICU. …

Brophy GM, Bell R, Claassen J, Alldredge B, Bleck TP, Glauser T, Laroche SM, Riviello JJ Jr, Shutter L, Sperling MR, Treiman DM, Vespa PM, Committee NCSSEGW (2012) Guidelines for the evaluation and management of status epilepticus. Neurocrit Care 17:3–23CrossRefPubMed

Rossetti AO, Bleck TP (2014) What’s new in status epilepticus? Intensive Care Med 40:1359–1362CrossRefPubMed

Parviainen I, Uusaro A, Kalviainen R, Mervaala E, Ruokonen E (2006) Propofol in the treatment of refractory status epilepticus. Intensive Care Med 32:1075–1079CrossRefPubMed

Iyer VN, Hoel R, Rabinstein AA (2009) Propofol infusion syndrome in patients with refractory status epilepticus: an 11-year clinical experience. Crit Care Med 37:3024–3030CrossRefPubMed

Fernandez A, Lantigua H, Lesch C, Shao B, Foreman B, Schmidt JM, Hirsch LJ, Mayer SA, Claassen J (2014) High-dose midazolam infusion for refractory status epilepticus. Neurology 82:359–365CrossRefPubMedPubMedCentral

Parviainen I, Uusaro A, Kalviainen R, Kaukanen E, Mervaala E, Ruokonen E (2002) High-dose thiopental in the treatment of refractory status epilepticus in intensive care unit. Neurology 59:1249–1251CrossRefPubMed

Bellante F, Legros B, Depondt C, Creteur J, Taccone FS, Gaspard N (2016) Midazolam and thiopental for the treatment of refractory status epilepticus: a retrospective comparison of efficacy and safety. J Neurol 263:799–806CrossRefPubMed

Claassen J, Hirsch LJ, Emerson RG, Mayer SA (2002) Treatment of refractory status epilepticus with pentobarbital, propofol, or midazolam: a systematic review. Epilepsia 43:146–153CrossRefPubMed

Prabhakar H, Kalaivani M (2015) Propofol versus thiopental sodium for the treatment of refractory status epilepticus. Cochrane Database Syst Rev 25:CD009202

10.

Rossetti AO, Milligan TA, Vulliemoz S, Michaelides C, Bertschi M, Lee JW (2011) A randomized trial for the treatment of refractory status epilepticus. Neurocrit Care 14:4–10CrossRefPubMed

11.

Gaspard N, Foreman B, Judd LM, Brenton JN, Nathan BR, McCoy BM, Al-Otaibi A, Kilbride R, Fernandez IS, Mendoza L, Samuel S, Zakaria A, Kalamangalam GP, Legros B, Szaflarski JP, Loddenkemper T, Hahn CD, Goodkin HP, Claassen J, Hirsch LJ, Laroche SM (2013) Intravenous ketamine for the treatment of refractory status epilepticus: a retrospective multicenter study. Epilepsia 54:1498–1503CrossRefPubMedPubMedCentral

12.

Legriel S, Pico F, Tran-Dinh YR, Lemiale V, Bedos JP, Resche-Rigon M, Cariou A (2016) Neuroprotective effect of therapeutic hypothermia versus standard care alone after convulsive status epilepticus: protocol of the multicentre randomised controlled trial HYBERNATUS. Ann Intensive Care 6:54CrossRefPubMedPubMedCentral

13.

Mirsattari SM, Sharpe MD, Young GB (2004) Treatment of refractory status epilepticus with inhalational anesthetic agents isoflurane and desflurane. Arch Neurol 61:1254–1259CrossRefPubMed

14.

Thakur KT, Probasco JC, Hocker SE, Roehl K, Henry B, Kossoff EH, Kaplan PW, Geocadin RG, Hartman AL, Venkatesan A, Cervenka MC (2014) Ketogenic diet for adults in super-refractory status epilepticus. Neurology 82:665–670CrossRefPubMedPubMedCentral

15.

Bayrlee A, Ganeshalingam N, Kurczewski L, Brophy GM (2015) Treatment of super-refractory status epilepticus. Curr Neurol Neurosci Rep 15:66CrossRefPubMed

16.

Claassen J, Taccone FS, Horn P, Holtkamp M, Stocchetti N, Oddo M, Neurointensive Care Section of the European Society of Intensive Care M (2013) Recommendations on the use of EEG monitoring in critically ill patients: consensus statement from the neurointensive care section of the ESICM. Intensive Care Med 39:1337–1351CrossRefPubMed

Title: What’s new in refractory status epilepticus?
Authors: Stephane Legriel
Mauro Oddo
Gretchen M. Brophy
Publication date: 01-04-2017
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 4/2017
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-016-4501-6

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What’s new in refractory status epilepticus?

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