• 作者：Ricardo Bernater ; Anal¨ªa Calle ; Ver¨®nica Campanille ; Oscar Mart¨ªnez ; Natalia Paoli ; M¨®nica Perassolo ; Lucas Martin Romano ; Maria Bel¨¦n Viaggio
• 关键词：Estatus epilé ; ptico ; Tratamiento ; Diagnó ; stico ; Fá ; rmacos antiepilé ; pticos
• 刊名：Neurolog¨ªa Argentina
• 出版年：2013
• 出版时间：April-June, 2013
• 年：2013
• 卷：5
• 期：2
• 页码：117-128
• 全文大小：531 K

lass=""h4"">Introduction

Status epilepticus is a major public health problem along the world. It represents a frequently medical emergency with elevated costs and high morbimortality. The prognosis depends on the duration and the phase in which the appropriate treatment is, age, ethiology, comorbidities and complications.

lass=""h4"">Objetives

To establish therapeutic guidelines for those physicians who treat status epilepticus according to medical evidence available to date.

To update the previous guidelines published in 2007 with additional information and new results.

lass=""h4"">Material and methods

We selected articles of clinical relevance from databases MEDLINE and Cochrane.

Randomized clinical trials, meta - analyses, therapeutic guidelines, systematic reviews, cases series and experts opinions were included.

lass=""h4"">Results

After an individualized assessment of different drugs useful for treatment of status epilepticus, we selected those more efficacious for seizures lasting more than 5 minutes. After the analysis, we designed an algorithm according to time of evolution, clinical response and electroencephalography monitoring.

lass=""h4"">Conclusion

Consensus has emerged concerning initial treatment of status epilepticus. For practical purposes treatment should be started after 5 minutes of continuous seizure activity. Treatment of refractory status was established according to the evidence available but the are not enough randomized trials that compare different therapeutic agents for this instance. Continuous EEG monitoring is needed for better management of status epilepticus in advance stages. The alarming high mortality rate of status epilepticus emphasizes the need of an high suspicion index with rapid recognition and urgent treatment.