Status epilepticus: pathophysiology and management in adults.
As in Clark and Prout's classic work, we identify three phases of generalised convulsive status epilepticus, which we call impending, established, and subtle. We review physiological and subcellular changes that might play a part in the transition from single seizures to status epilepticus and in the development of time-dependent pharmacoresistance. We review the principles underlying the treatment of status epilepticus and suggest that prehospital treatment is beneficial, that therapeutic drugs should be used in rapid sequence according to a defined protocol, and that refractory status epilepticus should be treated with general anaesthesia. We comment on our preference for drugs with a short elimination half-life and discuss some therapeutic choices.
Department of Neurology and Brain Research Institute, Geffen School of Medicine at UCLA, and VA Greater Los Angeles Health Care System, Los Angeles, CA 90073, USA.
James W Y
JW
Chen
Claude G
CG
Wasterlain
D000768:Anesthesia, General / Q000379:methods; D000818:Animals; D006801:Humans; D008954:Models, Biological; D018696:Neuroprotective Agents / Q000627:therapeutic use; D012640:Seizures / Q000209:etiology / Q000628:therapy; D013226:Status Epilepticus / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy*
D018696:Neuroprotective Agents