Generalized convulsive status epilepticus in adults and children: treatment guidelines and protocols.
Generalized convulsive status epilepticus (GCSE) has a high morbidity and mortality, such that the rapid delivery of anticonvulsant therapy should be initiated within minutes of seizure onset to prevent permanent neuronal damage. GCSE is not a specific disease but is a manifestation of either a primary central nervous system (CNS) insult or a systemic disorder with secondary CNS effects. It is mandatory to look for an underlying cause. First-line therapies for seizures and status epilepticus include the use of a benzodiazepine, followed by an infusion of a phenytoin with a possible role for intravenous valproate or phenobarbital. If these first-line medications fail to terminate the GCSE, treatment includes the continuous infusion of midazolam, pentobarbital, or propofol.
Department of Emergency Medicine, Mount Sinai School of Medicine, New York, NY, USA. shearerp@nychhc.org
Peter
P
Shearer
James
J
Riviello
D000328:Adult; D017677:Age Distribution; D000465:Algorithms; D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D019091:Critical Pathways; D004636:Emergency Service, Hospital; D006801:Humans; D015994:Incidence; D007223:Infant; D017410:Practice Guidelines as Topic; D013226:Status Epilepticus / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
D000927:Anticonvulsants