Learn About Status Epilepticus

What is the definition of Status Epilepticus?
Status epilepticus (SE) is defined as an extremely rare condition of experiencing prolonged epileptic seizures (convulsions caused by abnormal electrical activity in the brain) lasting longer than five minutes or a single seizure lasting longer than five minutes without a return to consciousness. Status epilepticus is considered to be a medical emergency. Status epilepticus is categorized into three subtypes: 1) Generalized Convulsive Status Epilepticus (GCSE), characterized by convulsions with abnormal, rapid eye movements, drooling, jerking limb movements, and grunting; and 2) Subtle Convulsive Status Epilepticus, characterized by abnormal, rapid eye movements, facial twitching, and subtle jerking of the limbs; and 3) Non-Convulsive status epilepticus (NCSE), also known as Complex Partial Status Epilepticus, characterized by confusion, abnormal, rapid eye movement, an appearance of daydreaming, possible loss of speech, personality changes, and irrational behavior or psychosis).
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What are the symptoms of Status Epilepticus?
Symptoms of status epilepticus vary by individual but may include falling, an appearance of daydreaming, confusion, abnormal, rapid eye movements, facial twitching, muscle spasms, jerking limb movements, clenched teeth, drooling, irregular breathing, grunting or making other unusual sounds, inability or difficulty speaking, irrational behavior or psychosis, and loss of bladder or bowel control. Some individuals with epilepsy may experience visual disturbances (aura) before the onset of a seizure, such as seeing flickering lights or sunbursts.
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What are the current treatments for Status Epilepticus?
Status epilepticus is considered to be a medical emergency and requires urgent treatment to prevent permanent brain damage or death. The main treatments for status epilepticus are anticonvulsant drugs and drugs to prevent seizures, which include acetazolamide, carbamazepine, clonazepam, corticotrophin, corticosteroids, Diastat (diazepam suppository rectal gel), ethosuximide (Zarontin), felbamate (Felbatol), fosphenytoin sodium (cerebyx), lamotrigine (Lamictal), lorazepam, Neurontin (gabapentin), paraldehyde, phenobarbital, phenytoin, primidone, topiramate (Topamax), trimethadione, valproic acid. Depending on the cause, such as a brain tumor or drug resistant temporal lobe epilepsy, some patients with status epilepticus may need surgery after first trying medications to stop the seizures. During a seizure characterized by status epilepticus (five minutes or longer), emergency assistance should be called immediately, while individuals experiencing an epileptic seizure should be protected from injury by removing any sharp or hard objects close by, loosening tight clothing, and placing a flat, soft object under the head. Do not attempt to restrain the individual. If possible, the individual experiencing a seizure should be turned on their side with something soft and flat placed between the teeth. Cardiopulmonary resuscitation (CPR) may be necessary if the individual stops breathing after a seizure has ended. Oxygen may be administered by health professionals. After the seizure has ended, the individual should be allowed to sleep while awaiting emergency services.
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What are the latest Status Epilepticus Clinical Trials?
The Use of Continuous Electroencephalographic (EEG) Monitoring for Cases of Refractory Status Epilepticus: Does it Affect the Final Patient Outcome

Summary: This is a prospective randomized study to investigate the yield of continuous electroencephalogram (cEEG), as a diagnostic tool in intensive care unit (ICU), for patients with refractory status epilepticus (RSE) and the contribution of this test to the patient final outcome, compared with standard medical care. Specifically, the hypothesis is that the use of cEEG for patients with RSE will signifi...

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Refractory Status Epilepticus Treatment (RESET): Quality and Efficacy of Coma Induction

Summary: This study is to investigate the effects of different treatment characteristics regarding the use of intravenous anesthetic drugs (IVADs) as a rescue treatment for refractory Status epilepticus (RSE) on course and outcome. A retrospective data extraction from the digital medical records, the electroencephalographic and microbiologic database of all consecutive adult patients with Status epilepticu...

What are the Latest Advances for Status Epilepticus?
Benzodiazepines in the Management of Seizures and Status Epilepticus: A Review of Routes of Delivery, Pharmacokinetics, Efficacy, and Tolerability.
Optimal Use of Perampanel in the Treatment of Patients with Epilepsy Based on the Clinical Evidence and Characteristics.
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Effect of fenfluramine on seizures and comorbidities in SCN8A-developmental and epileptic encephalopathy: A case series.