Review article: Convulsive and non-convulsive status epilepticus: an emergency medicine perspective.
Status epilepticus (SE) is divided into convulsive and non-convulsive types; both are associated with significant morbidity and mortality. Although convulsive SE is easily recognized, non-convulsive SE remains an elusive diagnosis as physical signs are varied and subtle. Successful management depends on a comprehensive approach that involves diagnostic testing and pharmacological interventions while ensuring cerebral oxygenation and perfusion at all times. There are a limited number of well-designed studies to support the development of evidence-based recommendations for the management of SE, especially for the management of non-convulsive status. Benzodiazepines, specifically lorazepam, continue to be the most commonly recommended first-line therapy; best treatment for refractory status cases depends on resources available and must be tailored to the individual institution. In order to facilitate care, it is recommended that each institution develop a management protocol for these patients.
Department of Emergency Medicine, Mount Sinai School of Medicine, ne Gustave Levy Place Box1490, New York, NY 10128, USA. amish.shah@mountsinai.org
Amish M
AM
Shah
Anita
A
Vashi
Andy
A
Jagoda
D000927:Anticonvulsants / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D004635:Emergency Medicine; D006801:Humans; D012640:Seizures / Q000209:etiology; D013226:Status Epilepticus / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy
D000927:Anticonvulsants