Abstract

OLMOS-LOPEZ, Alejandro et al. Clinical guide. Status epilepticus in children and adults. Rev. mex. neurocienc. [online]. 2019, vol.20, n.2, pp.56-61.  Epub Mar 28, 2022. ISSN 2604-6180.  https://doi.org/10.24875/rmn.m19000049.

A generalized epileptic seizure lasting five or more minutes, or the presence of two or more seizures without recovery of consciousness in thirty minutes, or a focal seizure that persists for more than 10 min or with altered consciousness for 60 min or more duration is called status epilepticus. It can be classified into generalized and focal, motor and non-motor. Its etiology may or may not be recognized. The electroencephalographic pattern shows focal or generalized persistent epileptic activity. It is a dangerous situation, which requires algorithmic management since it is detected, in the emergency Room and if required in the intensive therapy unit. In-hospital management would include the initial ABCDE , hypertonic glucose solution and thiamin if hypoglycemia is detected. Lorazepam (midazolam or diazepam) to juggle seizures, followed by phenytoin, valproate or levetiracetam in impregnation and sustain. If the status epilepticus persists for more than an hour, the patient will be referred to an ICU with intubation and continuous administration of midazolam, propofol or thiopental with intubation and continuous monitoring. If it does not yield with two drugs, it is called refractory epileptic status, and if it continues for 24 h or more, it is recognized as super-refractory. A third of these patients die.

Keywords : Status epilepticus; Seizures; Focal; Generalized; Motor; Acute treatment.