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Seizure cluster: Definition, prevalence, consequences, and management.
Saba Jafarpour1, Lawrence J Hirsch2, Marina Gaínza-Lein3
1Division of Epilepsy and Neurophysiology, Department of Neurology, Boston Children's Hospital, Boston, MA, United States.
Seizure
|June 7, 2018
Summary
Seizure clusters, defined variably, impact quality of life. Rescue medications, like benzodiazepines, can prevent status epilepticus but are underutilized, necessitating improved patient education and action plans.
Area of Science:
- Neurology
- Epileptology
Background:
- Seizure clusters are a significant concern in epilepsy management.
- They negatively impact patient quality of life and increase healthcare utilization.
Purpose of the Study:
- To review definitions, prevalence, risk factors, consequences, and acute management of seizure clusters.
- To highlight the role of rescue medications in aborting seizure clusters.
Main Methods:
- Literature search of MEDLINE database.
- Assessment of studies on seizure cluster definitions, clinical characteristics, outcomes, and rescue medication use.
Main Results:
- Definitions for seizure clusters vary (e.g., ≥3 seizures in 24 hours).
- Patients with severe, poorly controlled epilepsy are at higher risk.
- Benzodiazepine rescue medications can prevent status epilepticus and reduce ER visits, though they are underutilized. Rectal diazepam is FDA-approved; other non-rectal routes are also effective and preferred by patients.
Conclusions:
- Identifying high-risk patients for seizure clusters is crucial.
- Formal action plans and education on rescue medication use can improve outcomes for patients experiencing seizure clusters.
Keywords:
Acute repetitive seizuresBenzodiazepinesEpilepsyRescue medicationSeizure action planStatus epilepticusMore Related Videos
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