[Therapeutic problems in status epilepticus (author's transl)]

Area of Science:

• Neurology
• Pathophysiology
• Pharmacology

Context:

• Status epilepticus (SE) is a prolonged neurological emergency characterized by continuous seizures.
• Understanding the underlying causes and pathological mechanisms of SE is crucial for effective management.
• Current therapeutic strategies aim to terminate seizures, prevent neuronal damage, and address potential complications.

Purpose:

• To review the current knowledge on the causative factors and pathological mechanisms of status epilepticus.
• To present a synopsis of commonly applied therapeutic methods for status epilepticus.
• To advise a step-wise therapeutic procedure for managing different stages of status epilepticus.

Summary:

• This review synthesizes current understanding of status epilepticus (SE) etiology and pathophysiology.
• It outlines established therapeutic interventions, including anticonvulsants like hydantoin and diazepam to reduce cerebral excitability.
• Management strategies also encompass preventing brain edema via osmotherapy and positive pressure respiration, and avoiding secondary complications with antibiotics and intensive care.

Impact:

• Provides a comprehensive overview of status epilepticus management for clinicians.
• Highlights the importance of etiological investigation in all cases of status epilepticus.
• Informs treatment protocols by detailing a step-wise approach to address the multifaceted nature of this condition.