[Current diagnosis and treatment of status epilepticus].
We reviewed the current diagnosis and treatment of status epilepticus (SE). The SE is defined as the condition in which a seizure persists for a sufficient length of time or is repeated frequently enough that recovery between attacks does not occur. Until recently, the most popular duration of seizures qualifying as SE has been 30 min. Nonetheless some clinicians suggest that the duration of the seizures that qualifies the SE should be shorter. In clinical settings the diagnosis of SE could be difficult without EEGs in patients who have complex partial SE or subtle SE, as their manifestation is coma without apparent motor sings. Pseudo-SE (psychogenic seizures) should be included in the differential diagnosis. Antiepileptic treatment should be administered immediately according to the protocol once the diagnosis of SE is made. In patients with refractory SE, general anesthesia with propofol or midazolam is recommended. Repetitive transcranial magnetic stimulation to the brain is effective for the treatment of SE in experimental animals, however further studies are necessary for clinical use.
Akamatsu
Naoki
N
Tsuji
Sadatoshi
S
D000768:Anesthesia, General; D000818:Animals; D000927:Anticonvulsants / Q000008:administration & dosage; D003422:Critical Care; D003937:Diagnosis, Differential; D004558:Electric Stimulation; D004569:Electroencephalography; D004574:Electromagnetic Fields; D006801:Humans; D008874:Midazolam; D015742:Propofol; D013226:Status Epilepticus / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors
D000927:Anticonvulsants; D008874:Midazolam; D015742:Propofol