Show simple item record

dc.contributor.authorTrinka Eugen
dc.contributor.authorKälviäinen Reetta
dc.date.accessioned2017-02-20T13:02:57Z
dc.date.available2017-02-20T13:02:57Z
dc.date.issued2016
dc.identifier10.1016/j.seizure.2016.11.001fi_FI
dc.identifier.issn1059-1311
dc.identifier.urihttps://erepo.uef.fi/handle/123456789/339
dc.descriptionArticle
dc.description.abstractPurpose Status epilepticus (SE) requires not only urgent symptomatic treatment with antiepileptic drugs but also rapid identification and treatment of its cause. This narrative review summarizes the most important advances in classification and treatment of SE. Method Data sources included MEDLINE, EMBASE, ClinicalTrials.gov, and back tracking of references in pertinent studies, reviews, and books. Results SE is now defined as “a condition resulting either from the failure of the mechanisms responsible for seizure termination or from the initiation of mechanisms, which lead to abnormally, prolonged seizures (after time point t1). It is a condition, which can have long-term consequences (after time point t2), including neuronal death, neuronal injury, and alteration of neuronal networks, depending on the type and duration of seizures.” A new diagnostic classification system of SE introduces four axes: semiology, aetiology, EEG correlates, and age. For the acute treatment intravenous benzodiazepines (lorazepam, diazepam, clonazepam) and intramuscular midazolam appear as most effective treatments for early SE. In children, buccal or intranasal midazolam are useful alternatives. In established SE intravenous antiepileptic drugs (phenytoin, valproate, levetiracetam, phenobarbital, and lacosamide) are in use. Treatment options in refractory SE are intravenous anaesthetics; ketamine, magnesium, steroids and other drugs have been used in super-refractory SE with variable outcomes. Conclusion Over the past 25 years major advances in definition, classification and understanding of its mechanisms have been achieved. Despite this up to 40% of patients in early status cannot be controlled with first line drugs. The treatment of super-refractory status is still an almost evidence free zone.fi_FI
dc.language.isoENGfi_FI
dc.publisherElsevier BVfi_FI
dc.relation.ispartofseriesSEIZURE
dc.relation.urihttp://dx.doi.org/10.1016/j.seizure.2016.11.001fi_FI
dc.rightsCC BY-NC-ND https://creativecommons.org/licenses/by-nc-nd/4.0/fi_FI
dc.subjectStatus epilepticusfi_FI
dc.subjectClassificationfi_FI
dc.subjectAntiepileptic drugsfi_FI
dc.subjectBenzodiazepinesfi_FI
dc.subjectAnestheticsfi_FI
dc.title25 years of advances in the definition, classification and treatment of status epilepticusfi_FI
dc.typehttp://purl.org/eprint/type/JournalArticle
dc.description.versionfinal draftfi_FI
dc.contributor.departmentSchool of Medicine / Clinical Medicine
uef.solecris.id44415573
eprint.statushttp://purl.org/eprint/status/PeerReviewedfi_FI
dc.type.publicationinfo:eu-repo/semantics/article
dc.rights.accessrights© Elsevier BVfi_FI
uef.citationinfo.issue44
uef.citationinfo.pages65-73
dc.relation.doi10.1016/j.seizure.2016.11.001
dc.description.reviewstatushttp://purl.org/eprint/status/PeerReviewed
dc.format.pagerange65-73
dc.relation.issn1059-1311
dc.relation.issue44


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record