title: Managing Status Epilepticus in the Older Adult.
abstract: The aim of this systematic review was to describe particularities in epidemiology, outcome, and management modalities in the older adult population with status epilepticus. There is a higher incidence of status epilepticus in the older adult population, and it commonly has a nonconvulsive presentation. Diagnosis in this population may be difficult and requires an unrestricted use of EEG. Short and long term associated-mortality are high, and age over 60 years is an independent factor associated with poor outcome. Stroke (acute or remote symptomatic), miscellaneous metabolic causes, dementia, infections hypoxemia, and brain injury are among the main causes of status epilepticus occurrence in this age category. The use of anticonvulsive agents can be problematic as well. Thus, it is important to take into account the specific aspects related to the pharmacokinetic and pharmacodynamic changes in older critically-ill adults. Beyond these precautions, the management may be identical to that of the younger adult, including prompt initiation of symptomatic and anticonvulsant therapies, and a broad and thorough etiological investigation. Such management strategies may improve the vital and functional prognosis of these patients, while maintaining a high overall quality of care.
authors.affiliation: Medico-Surgical Intensive Care Department, Centre Hospitalier de Versailles-Site André Mignot, 177 Rue de Versailles, 78150 Le Chesnay Cedex, France. slegriel@ch-versailles.fr.|INSERM U970, Paris Cardiovascular Research Center, 75015 Paris, France. slegriel@ch-versailles.fr.
authors.forename: Stephane
authors.initials: S
authors.lastname: Legriel
authors.affiliation: Virginia Commonwealth University, Medical College of Virginia Campus, 410 N. 12th Street, Richmond, VA 23298-0533, USA. gbrophy@vcu.edu.
authors.forename: Gretchen M
authors.initials: GM
authors.lastname: Brophy
keywords: adverse effects; anticonvulsant; elderly; older adult; status epilepticus