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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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Autores principales: Marawar, Rohit, Basha, Maysaa, Mahulikar, Advait, Desai, Aaron, Suchdev, Kushak, Shah, Aashit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5964484/
https://www.ncbi.nlm.nih.gov/pubmed/29854452
http://dx.doi.org/10.1155/2018/9768949
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author Marawar, Rohit
Basha, Maysaa
Mahulikar, Advait
Desai, Aaron
Suchdev, Kushak
Shah, Aashit
author_facet Marawar, Rohit
Basha, Maysaa
Mahulikar, Advait
Desai, Aaron
Suchdev, Kushak
Shah, Aashit
author_sort Marawar, Rohit
collection PubMed
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.
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spelling pubmed-59644842018-05-31 Updates in Refractory Status Epilepticus Marawar, Rohit Basha, Maysaa Mahulikar, Advait Desai, Aaron Suchdev, Kushak Shah, Aashit Crit Care Res Pract Review Article 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. Hindawi 2018-05-08 /pmc/articles/PMC5964484/ /pubmed/29854452 http://dx.doi.org/10.1155/2018/9768949 Text en Copyright © 2018 Rohit Marawar et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Marawar, Rohit
Basha, Maysaa
Mahulikar, Advait
Desai, Aaron
Suchdev, Kushak
Shah, Aashit
Updates in Refractory Status Epilepticus
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
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5964484/
https://www.ncbi.nlm.nih.gov/pubmed/29854452
http://dx.doi.org/10.1155/2018/9768949
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