Seizures and status epilepticus in the intensive care unit.
Persistent seizures and failure to regain consciousness following witnessed seizure activity require emergency neurological consultation. Although outcome is largely dependent on underlying cause, early maximal anticonvulsant therapy is critical to reducing morbidity. This review covers important concepts in the clinical and EEG diagnosis of status epilepticus, and discusses treatment algorithms for single and recurrent seizures, emphasizing the need to rationalize therapy depending on the presumed duration of seizure activity. The review takes the perspective of the neurological consultant in the intensive care unit, and considers all pharmacological approaches available to the intensivist as described in the current literature and from clinical experience.
Ziai
Wendy C
WC
Department of Neurology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, USA. weziai@jhmi.edu
Kaplan
Peter W
PW
D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects / Q000145:classification; D002985:Clinical Protocols / Q000592:standards; D003128:Coma / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D003422:Critical Care / Q000379:methods* / Q000592:standards; D004569:Electroencephalography / Q000379:methods; D018913:Event-Related Potentials, P300 / Q000502:physiology; D006801:Humans; D007362:Intensive Care Units / Q000592:standards*; D012640:Seizures / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D013226:Status Epilepticus / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*
D000927:Anticonvulsants