Anest. intenziv. Med. 2018;29(4):207-216

A new definition of status epilepticus and its pharmacological managementReview Article

O. Strýček^1,*, V. Šrámek²

¹ I. neurologická klinika, Lékařská fakulta, Masarykova univerzita, Fakultní nemocnice u sv. Anny

² Anesteziologicko-resuscitační klinika, Lékařská fakulta Masarykovy univerzity, Fakultní nemocnice u sv. Anny

Status epilepticus is a life-threatening condition with a high mortality rate, requiring urgent therapy. To unify the views on this topic, a new definition has been proposed that reflects the patho-physiology better than the previous one. The new definition particularly highlights time as a major factor in the evolution of status epilepticus and points to the possibility of irreversible changes in the brain caused by the ongoing epileptic activity. The choice of a suitable drug is essential in treating status epilepticus. In addition to the traditional drugs (phenytoin, valproate), new drugs which promise significant benefits are emerging (levetiracetam, lacosamide). Some rescue treatment options (e.g. ketamine) are also mentioned. The choice of appropriately aggressive therapy is important. It is a common mistake to use one treatment guideline for all types of status epilepticus even though it does not fit the clinical picture and can even aggravate the patient's condition. Non-convulsive status epilepticus in particular requires a different approach.

Keywords: status epilepticus; definition; classification; therapy; antiepileptic drugs

Received: May 2, 2018; Accepted: July 6, 2018; Published: August 1, 2018  Show citation