Seizures and status epilepticus in the critically ill.
Seizures represent stereotypic electroencephalographic (EEG) and behavioral paroxysms as a consequence of electrical neurologic derangement. Seizures are usually described as focal or generalized motor convulsions; however, nonconvulsive seizures that occur in the absence of motor activity may escape clinical detection. Because of the admission diagnoses and dramatic physiologic and metabolic derangements common to critically ill patients, the entire spectrum of seizure disorders may be encountered in the ICU. Seizures in the ICU are attributable to primary neurologic pathology or secondary to critical illness and clinical management. For optimal treatment, early diagnosis of the seizure type and its cause is important to ensure appropriate therapy. Convulsive status epilepticus requires emergent treatment before irreversible brain injury and severe metabolic disturbances occur.
Mirski
Marek A
MA
Department of Neurology, The Johns Hopkins Hospital, Baltimore, MD 21287, USA. mmirski@jhmi.edu
Varelas
Panayiotis N
PN
D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D003422:Critical Care; D004569:Electroencephalography; D006801:Humans; D007362:Intensive Care Units; D012307:Risk Factors; D012640:Seizures / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D013226:Status Epilepticus / Q000145:classification / Q000503:physiopathology / Q000628:therapy
D000927:Anticonvulsants