Status epilepticus: emergency management.
Status Epilepticus (SE) is a medical emergency and requires prompt and aggressive treatment. Stabilization of airway, breathing and circulation and expeditious termination of seizures are immediate goals. Intravenous benzodiazepines-diazepam, midazolam or lorazepam and phenytoin are the first line drugs recommended for termination of seizures. Diazepam (or midazolam), thiopental and propofol infusion are useful for control of Refractory SE (RSE). Newer drugs are being investigated for use in SE. We prefer diazepam infusion. In children the mortality from SE ranges from 3-10% and the morbidity is twice. Mortality and morbidity are highest with SE associated with CNS infections, which is the most important cause of SE in our country. The outcome depends on the underlying etiology, age, rapidity of SE and adequacy of care. Adherence to a time-framed protocol in the emergency department helps in improving the final outcome.
Singhi
Sunit
S
Department of Pediatrics, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh-160 012, India. drsinghi@glide.net.in
Singhi
Pratibha
P
Dass
Rashna
R
D000927:Anticonvulsants / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use; D002648:Child; D002985:Clinical Protocols; D004632:Emergency Medical Services / Q000379:methods*; D006801:Humans; D010672:Phenytoin / Q000627:therapeutic use; D011379:Prognosis; D013226:Status Epilepticus / Q000145:classification / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome
D000927:Anticonvulsants; D001569:Benzodiazepines; D010672:Phenytoin