About: Refractory and Super-refractory Status Epilepticus

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An Entity of Type : schema:ScholarlyArticle, within Data Space : wasabi.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Refractory and Super-refractory Status Epilepticus
Creator	Arya, Ravindra Garrity, Lisa Samanta, Debopam
Source	PMC
abstract	CONTEXT: Refractory status epilepticus (RSE) and super-refractory status epilepticus (SRSE) are neurological emergencies with considerable mortality and morbidity. In this paper, we provide an overview of causes, evaluation, treatment, and consequences of RSE and SRSE, reflecting the lack of high-quality evidence to inform therapeutic approach. SOURCES: This is a narrative review based on personal practice and experience. Nevertheless, we searched MEDLINE (using PubMed and OvidSP vendors) and Cochrane central register of controlled trials, using appropriate keywords to incorporate recent evidence. RESULTS: Refractory status epilepticus is commonly defined as an acute convulsive seizure that fails to respond to two or more anti-seizure medications including at least one nonbenzodiazepine drug. Super-refractory status epilepticus is a status epilepticus that continues for ≥24 hours despite anesthetic treatment, or recurs on an attempted wean of the anesthetic regimen. Both can occur in patients known to have epilepsy or de novo, with increasing recognition of autoimmune and genetic causes. Electroencephalography monitoring is essential to monitor treatment response in refractory/super-refractory status epilepticus, and to diagnose non-convulsive status epilepticus. The mainstay of treatment for these disorders includes anesthetic infusions, primarily midazolam, ketamine, and pentobarbital. Dietary, immunological, and surgical treatments are viable in selected patients. Management is challenging due to multiple acute complications and long-term adverse consequences. CONCLUSIONS: We have provided a synopsis of best practices for diagnosis and management of refractory/superrefractory status epilepticus and highlighted the lack of sufficient high-quality evidence to drive decision making, ending with a brief foray into avenues for future research.
has issue date	2020-03-30(xsd:dateTime)
bibo:doi	10.1007/s13312-020-1759-0
bibo:pmid	32198865
has license	no-cc
sha1sum (hex)	4bfd55008b49d284ec26f308efae8ef305dfdfab
schema:url	https://doi.org/10.1007/s13312-020-1759-0
resource representing a document's title	Refractory and Super-refractory Status Epilepticus
has PubMed Central identifier	PMC7224023
has PubMed identifier	32198865
schema:publication	Indian Pediatr
resource representing a document's body	covid:4bfd55008b49d284ec26f308efae8ef305dfdfab#body_text
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