Status epilepticus: Analysis of refractory cases
Abstract
Objective: to analyze refractory status epilepticus (SE) cases.
Patients and methods. Fifteen female patients aged 21 to 62 years with refractory SE were comprehensively examined using long-term electroencephalography monitoring. The investigators evaluated the efficiency of treatment regimens with intravenous antiepileptic drugs (AEDs), such as diazepam (DZP); valproic acid (VPA); levetiracetam; and lacosamide and their combinations, at the prehospital and hospital stages, as well as SE therapy complications noted only in the intravenous administration of narcotics (propofol, sodium thiopental).
Results and discussion. A fetal outcome due to multiple organ dysfunction indirectly related to SE was recorded in 2 (13.3%) patients with acute symptomatic status. SE was abolished in the other 13 cases. The preliminary findings may suggest that it is appropriate to prescribe VPA just at the prehospital stage. The co-administration of VPA and DZP substantially enhances the efficiency of SE therapy. The maximum acceptable doses of AEDs using the whole available therapeutic arsenal should be administered within the first hours of acute symptomatic SE.
Patients and methods. Fifteen female patients aged 21 to 62 years with refractory SE were comprehensively examined using long-term electroencephalography monitoring. The investigators evaluated the efficiency of treatment regimens with intravenous antiepileptic drugs (AEDs), such as diazepam (DZP); valproic acid (VPA); levetiracetam; and lacosamide and their combinations, at the prehospital and hospital stages, as well as SE therapy complications noted only in the intravenous administration of narcotics (propofol, sodium thiopental).
Results and discussion. A fetal outcome due to multiple organ dysfunction indirectly related to SE was recorded in 2 (13.3%) patients with acute symptomatic status. SE was abolished in the other 13 cases. The preliminary findings may suggest that it is appropriate to prescribe VPA just at the prehospital stage. The co-administration of VPA and DZP substantially enhances the efficiency of SE therapy. The maximum acceptable doses of AEDs using the whole available therapeutic arsenal should be administered within the first hours of acute symptomatic SE.
About the Authors
B. P. Gladov
A.I. Evdokimov Moscow State University of Medicine and Dentistry
Russian Federation
Department of Nervous System Diseases, Faculty of General Medicine
Russian Federation
Department of Nervous System Diseases, Faculty of General Medicine
O. A. Podgornaya
A.I. Evdokimov Moscow State University of Medicine and Dentistry
Russian Federation
Department of Nervous System Diseases, Faculty of General Medicine
Russian Federation
Department of Nervous System Diseases, Faculty of General Medicine
P. N. Vlasov
A.I. Evdokimov Moscow State University of Medicine and Dentistry
Russian Federation
Department of Nervous System Diseases, Faculty of General Medicine
Russian Federation
Department of Nervous System Diseases, Faculty of General Medicine
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Review
For citations:
Gladov B.P., Podgornaya O.A., Vlasov P.N. Status epilepticus: Analysis of refractory cases. Neurology, Neuropsychiatry, Psychosomatics. 2016;(1S):35-37. (In Russ.) https://doi.org/10.14412/2074-2711-2016-1S-35-37
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