Updates in Refractory Status Epilepticus
Refractory status epilepticus is defined as persistent seizures despite appropriate use of two intravenous medications, one of which is a benzodiazepine. It can be seen in up to 40% of cases of status epilepticus with an acute symptomatic etiology as the most likely cause. New-onset refractory statu...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2018/9768949 |
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| _version_ | 1832554629673517056 |
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| author | Rohit Marawar Maysaa Basha Advait Mahulikar Aaron Desai Kushak Suchdev Aashit Shah |
| author_facet | Rohit Marawar Maysaa Basha Advait Mahulikar Aaron Desai Kushak Suchdev Aashit Shah |
| author_sort | Rohit Marawar |
| collection | DOAJ |
| description | Refractory status epilepticus is defined as persistent seizures despite appropriate use of two intravenous medications, one of which is a benzodiazepine. It can be seen in up to 40% of cases of status epilepticus with an acute symptomatic etiology as the most likely cause. New-onset refractory status epilepticus (NORSE) is a recently coined term for refractory status epilepticus where no apparent cause is found after initial testing. A large proportion of NORSE cases are eventually found to have an autoimmune etiology needing immunomodulatory treatment. Management of refractory status epilepticus involves treatment of an underlying etiology in addition to intravenous anesthetics and antiepileptic drugs. Alternative treatment options including diet therapies, electroconvulsive therapy, and surgical resection in case of a focal lesion should be considered. Short-term and long-term outcomes tend to be poor with significant morbidity and mortality with only one-third of patients reaching baseline neurological status. |
| format | Article |
| id | doaj-art-3f2a4dedd7d148d09d31f71c9b278382 |
| institution | Kabale University |
| issn | 2090-1305 2090-1313 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-3f2a4dedd7d148d09d31f71c9b2783822025-02-03T05:50:58ZengWileyCritical Care Research and Practice2090-13052090-13132018-01-01201810.1155/2018/97689499768949Updates in Refractory Status EpilepticusRohit Marawar0Maysaa Basha1Advait Mahulikar2Aaron Desai3Kushak Suchdev4Aashit Shah5Department of Neurology, Detroit Medical Center and Wayne State University, Detroit, MI 48201, USADepartment of Neurology, Detroit Medical Center and Wayne State University, Detroit, MI 48201, USADepartment of Neurology, Detroit Medical Center and Wayne State University, Detroit, MI 48201, USADepartment of Neurology, Detroit Medical Center and Wayne State University, Detroit, MI 48201, USADepartment of Neurology, Detroit Medical Center and Wayne State University, Detroit, MI 48201, USADepartment of Neurology, Detroit Medical Center and Wayne State University, Detroit, MI 48201, USARefractory status epilepticus is defined as persistent seizures despite appropriate use of two intravenous medications, one of which is a benzodiazepine. It can be seen in up to 40% of cases of status epilepticus with an acute symptomatic etiology as the most likely cause. New-onset refractory status epilepticus (NORSE) is a recently coined term for refractory status epilepticus where no apparent cause is found after initial testing. A large proportion of NORSE cases are eventually found to have an autoimmune etiology needing immunomodulatory treatment. Management of refractory status epilepticus involves treatment of an underlying etiology in addition to intravenous anesthetics and antiepileptic drugs. Alternative treatment options including diet therapies, electroconvulsive therapy, and surgical resection in case of a focal lesion should be considered. Short-term and long-term outcomes tend to be poor with significant morbidity and mortality with only one-third of patients reaching baseline neurological status.http://dx.doi.org/10.1155/2018/9768949 |
| spellingShingle | Rohit Marawar Maysaa Basha Advait Mahulikar Aaron Desai Kushak Suchdev Aashit Shah Updates in Refractory Status Epilepticus Critical Care Research and Practice |
| title | Updates in Refractory Status Epilepticus |
| title_full | Updates in Refractory Status Epilepticus |
| title_fullStr | Updates in Refractory Status Epilepticus |
| title_full_unstemmed | Updates in Refractory Status Epilepticus |
| title_short | Updates in Refractory Status Epilepticus |
| title_sort | updates in refractory status epilepticus |
| url | http://dx.doi.org/10.1155/2018/9768949 |
| work_keys_str_mv | AT rohitmarawar updatesinrefractorystatusepilepticus AT maysaabasha updatesinrefractorystatusepilepticus AT advaitmahulikar updatesinrefractorystatusepilepticus AT aarondesai updatesinrefractorystatusepilepticus AT kushaksuchdev updatesinrefractorystatusepilepticus AT aashitshah updatesinrefractorystatusepilepticus |