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Treatment of refractory status epilepticus in childhood

John M Schreiber1, William D Gaillard

  • 1Department of Neurology, Children's National Medical Center, 111 Michigan Avenue NW, Washington, DC 20010, USA. jschreib@cnmc.org

Current Neurology and Neuroscience Reports
|December 22, 2010
PubMed

Insights

Refractory status epilepticus (RSE) is a prolonged seizure resistant to initial treatment, posing significant risks. This review examines current RSE treatment strategies, focusing on patient selection, medication, and monitoring for improved outcomes.

Area of Science:

  • Neurology
  • Critical Care Medicine

Background:

  • Refractory status epilepticus (RSE) is a neurological emergency accounting for nearly 25% of all status epilepticus cases.
  • RSE is associated with substantial morbidity and mortality, necessitating effective treatment protocols.

Purpose of the Study:

  • To review current treatment strategies for RSE.
  • To provide guidance on patient selection, monitoring, and medication management for RSE.

Main Methods:

  • Review of current literature on RSE treatment.
  • Analysis of various therapeutic agents including nonanesthetic and anesthetic antiepileptic drugs (AEDs).
  • Focus on optimal dosing, administration, efficacy, adverse effects, and treatment duration.

Main Results:

  • Treatment approaches for RSE vary significantly across institutions.
  • Multiple classes of AEDs and other therapies are employed in RSE management.
  • Key considerations include patient selection, precise monitoring, and individualized medication strategies.

Conclusions:

  • Standardized treatment protocols for RSE are lacking.
  • Optimizing medication selection, dosing, and monitoring is crucial for managing RSE.
  • Further research may refine treatment guidelines for refractory status epilepticus.

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