Open AccessRefractory convulsive status epilepticus in childhood
Author(s) -
Nikola Dimitrijević,
Dragana Bogićević,
Dimitrije Nikolić,
Vesna Mitić,
Nevenka Vunjak,
Snežana Rsovac
Publication year - 2004
Publication title -
srpski arhiv za celokupno lekarstvo
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.135
H-Index - 17
eISSN - 2406-0895
pISSN - 0370-8179
DOI - 10.2298/sarh04s1086d
Subject(s) - medicine , status epilepticus , phenobarbital , phenytoin , refractory (planetary science) , midazolam , etiology , anesthesia , anticonvulsant , convulsion , pediatrics , epilepsy , intensive care medicine , sedation , psychiatry , physics , astrobiology
Refractory convulsive status epilepticus (RCSE) is life-threatening condition, with seizures lasting over one hour and not responding to first and second-line anticonvulsant drug therapy. Any mistreatment or delayed proper treatment significantly increase mortality and neurologic sequelae. First line drugs for convulsion ceasing are benzodiazepines, phenobarbital and phenytoin. In case of refractory status, infusion of midazolam and general anesthesia should be administered. The most important measures of the intensive care are control of vital functions, homeostasis, prevention and therapy for possible brain and systemic complications. Discovery of etiology of status epilepticus is highly important because symptomatic therapy should be administered. Overall mortality rate during RCSE is 13.5%, and is much higher in acute symptomatic group - 28.6%. Early sequelae rate is 40.6%, 27.3% and 70% in idiopathic and acute symptomatic groups, respectively.