Emergency treatment of status epilepticus: current thinking.
Current thinking about the acute treatment of status epilepticus (SE) emphasizes a more aggressive clinical approach to this common life-threatening neurologic emergency. In this review, the authors consider four concepts that can accelerate effective treatment of SE. These include (1) updating the definition of SE to make it more clinically relevant, (2) consideration of faster ways to initiate first-line benzodiazepine therapy in the prehospital environment, (3) moving to second-line agents more quickly in refractory status in the emergency department, and (4) increasing detection and treatment of unrecognized nonconvulsive SE in comatose neurologic emergency patients.
Millikan
Dan
D
Department of Emergency Medicine, University of Michigan Neuro Emergencies Research, Ann Arbor, MI 48106, USA.
Rice
Brian
B
Silbergleit
Robert
R
D000768:Anesthesia, General; D000927:Anticonvulsants / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use; D004569:Electroencephalography; D004632:Emergency Medical Services; D004636:Emergency Service, Hospital; D006801:Humans; D008140:Lorazepam / Q000627:therapeutic use; D008874:Midazolam / Q000627:therapeutic use; D010672:Phenytoin / Q000627:therapeutic use; D013226:Status Epilepticus / Q000175:diagnosis / Q000628:therapy*
D000927:Anticonvulsants; D001569:Benzodiazepines; D010672:Phenytoin; D008140:Lorazepam; D008874:Midazolam