Pharmacotherapy for status epilepticus springerlink. It is associated with high rates of mortality and morbidity associated serious brain damage, respiratory infections, feeding problems. Srse carries a high risk of morbidity and a high mortality rate ranging from 23 to 57% 2, 3. Srse is defined as status epilepticus that continues 24 h or more after the onset of anesthesia, including those cases in which the status epilepticus recurs on the reduction or withdrawal of anesthesia. Refractory and superrefractory status epilepticus indian pediatrics. Refractory status epilepticus rse can be defined as status.
Pediatric intensive care treatment of uncontrolled status epilepticus. Treatment of refractory and superrefractory status. Status epilepticus and beyond acute and critical care. Status epilepticus, refractory status epilepticus, and super. With the use of the proposed protocol, combining midazolam and phenytoin. Superrefractory status epilepticus explained youtube. Super refractory status epilepticus is defined as status epilepticus that continues or recurs 24 h or more after the onset of anaesthetic therapy, including those cases where status epilepticus.
Pdf treatment of established status epilepticus researchgate. Pediatric status epilepticus treatment algorithm combining current guidelines. Pdf pharmacotherapy for status epilepticus researchgate. Guidelines for the evaluation and management of status epilepticus. Dsmb chair of clinical trials of allopregnenolone for superrefractory status epilepticus. Refractory to first and secondline antiepileptic agents. Many of the recommended doses or targeted therapeutic levels are higher than referenced in the literature and based upon expert opinions at nyph.
Super refractory status epilepticus is a status epilepticus that continues for. Refractory status epilepticus is defined as status epilepticus. Andrew cole, md of massachusetts general hospital and harvard medical school explains superrefractory status epilepticus. Status epilepticus superrefractory fires epilepsy anesthesia pediatric. The american epilepsy society guidelines published in. Treatment of refractory and superrefractory status epilepticus ncbi.
Super refractory status epilepticus is a medical emergency neces sitating aggressive treatment for early control seizures. Ketamine for the treatment of refractory status epilepticus. Refractory status epilepticus seizure european journal of epilepsy. Pdf status epilepticus is the most severe form of epilepsy, with a high. Many factors often combine to lower the patients seizure threshold. Refractory to two antiepileptic agents and general anesthesia treatment for 24 hours. Incidence and mortality of superrefractory status epilepticus in adults. Superrefractory status epilepticusstatus epilepticus that continues or recurs 24 hours or more after the onset of anesthetic therapyis a medical emergency. The treatment of superrefractory status epilepticus. Transitioning treatment from status epilepticus to super refractory status epilepticus david roy, pharmd pgy1 pharmacy resident.
Refractory status epilepticus rse is continued seizures after the failure of two or more aeds. Management of refractory status epilepticus in adults. Table 2 medications used for refractory status epilepticus rse. Management of superrefractory status epilepticus with. Common intravenous agents such as diazepam, lorazepam, midazolam, and phenytoin used to treat rse have frequent problems with toxicity or efficacy 35. The term superrefractory status epilepticus was introduced during the londoninnsbruck colloquium on status epilepticus in 2011 and refers to status epilepticus that continues or recurs 24 h or. Superrefractory status epilepticus superrse refers to drugresistant status.