In nonconvulsive status epilepticus (NCSE), treat to burst-suppression: pro and con.
Dr. Jordan (PRO) argues that when refractory NCSE is combined with acute brain injury, it produces synergistically compounded brain damage that is time dependent. Treating to EEG burst-suppression is the most rapid and effective method for stopping NCSE. The risks of burst-suppression are common to many intensive care interventions and can be minimized with expert management. Dr. Hirsch (CON) argues that treating with coma-inducing medication is highly risky and has a high mortality rate, often due to iatrogenic complications. It remains unclear if nonconvulsive seizures cause permanent neuronal injury. Nonconvulsive seizures should be diagnosed and treated as quickly as possible,but with non-coma-inducing treatments in most cases [corrected]
Jordan
Kenneth G
KG
Jordan NeuroScience, Inc., San Bernardino, California 92404, USA. info@jordaneuro.com
Hirsch
Lawrence J
LJ
D000138:Acidosis / Q000139:chemically induced / Q000401:mortality; D000293:Adolescent; D000927:Anticonvulsants / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D001921:Brain / Q000503:physiopathology; D001930:Brain Injuries / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D003128:Coma / Q000139:chemically induced / Q000401:mortality; D004569:Electroencephalography / Q000187:drug effects* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D011379:Prognosis; D012008:Recurrence; D013226:Status Epilepticus / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed
D000927:Anticonvulsants