Article
Clinical Neurology
Marin Jacobwitz, Caitlyn Mulvihill, Michael C. Kaufman, Alexander K. Gonzalez, Karla Resendiz, Jennifer M. MacDonald, Conall Francoeur, Ingo Helbig, Alexis A. Topjian, Nicholas S. Abend
Summary: This retrospective study analyzed the use of ketamine infusion for refractory status epilepticus (RSE) in pediatric patients. The results showed that ketamine was effective in reducing seizure frequency and had few adverse events.
Article
Critical Care Medicine
Matthew Luchette, Kerri LaRovere, Cheuk C. Au, Robert C. Tasker, Alireza Akhondi-Asl
Summary: In silico pharmacokinetic modeling of midazolam and pentobarbital suggests that standard treatment protocols for refractory status epilepticus result in higher steady-state serum concentrations. Not including bolus doses delays the achievement of steady-state concentration, while abrupt discontinuation reduces medication exposure. These models provide potential variables to optimize in future clinical studies.
PEDIATRIC CRITICAL CARE MEDICINE
(2023)
Article
Critical Care Medicine
Zachary S. Daniels, Nina Srdanovic, Karen Rychlik, Craig Smith, Joshua Goldstein, Alfred L. George
Summary: This study aimed to describe the prevalence of midazolam treatment failure in children with refractory status epilepticus (RSE) and define a threshold dose associated with diminishing frequency of seizure cessation. The results showed an association between the maximum midazolam dose and seizure cessation, with patients more likely to fail treatment when administered at higher doses.
PEDIATRIC CRITICAL CARE MEDICINE
(2022)
Article
Critical Care Medicine
Zachary S. Daniels, Nina Srdanovic, Karen Rychlik, Craig Smith, Joshua Goldstein, Alfred L. George
Summary: This study aimed to describe the prevalence of midazolam treatment failure in children with refractory status epilepticus (RSE) and determine a threshold dose associated with decreasing seizure cessation frequency. The results showed that patients were more likely to fail treatment when administered midazolam at higher doses, and treatment above 525μg/kg/hr was associated with diminishing frequency of seizure cessation.
PEDIATRIC CRITICAL CARE MEDICINE
(2022)
Article
Neurosciences
Doodipala Samba Reddy, Marcus Zaayman, Ramkumar Kuruba, Xin Wu
Summary: Status epilepticus (SE) is a medical emergency characterized by continuous seizure activity that leads to severe neuronal damage, morbidity, or death. The induction of SE can be caused by various triggers, such as chemoconvulsants like pilocarpine and organophosphates like DFP and soman. These agents share a common feature of cholinergic crisis leading to refractory SE, but their comparative profiles are still unclear. Results from this study revealed distinct convulsant and neuronal injury patterns following exposure to cholinergic agonists, OP pesticides, and nerve agents, highlighting the importance of understanding different SE models for the development of new anticonvulsant therapies.
Review
Biochemistry & Molecular Biology
Tzu-Hsin Huang, Ming-Chi Lai, Yu-Shiue Chen, Chin-Wei Huang
Summary: Status epilepticus (SE) is a neurological emergency with high mortality rate. The downregulation of GABAA receptors and upregulation of NMDA and AMPA receptors are the most widely accepted hypothesis underlying BZD resistance.
Review
Medicine, General & Internal
Yazeed S. Alolayan, Kelly McKinley, Ritwik Bhatia, Ayham Alkhachroum
Summary: RSE is defined as continuous status epilepticus that persists despite administering at least two appropriately dosed parenteral medications, while SRSE is status epilepticus that persists at least 24 h after adding at least one appropriately dosed continuous anesthetic. Other therapeutic interventions include immunotherapy, neuromodulation, ketogenic diet, or even surgical intervention, with continuous EEG monitoring being essential for diagnosis and treatment.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Clinical Neurology
Simona Lattanzi, Giada Giovannini, Niccolo Orlandi, Francesco Brigo, Eugen Trinka, Stefano Meletti
Summary: This study aimed to evaluate whether differences in clinical outcomes exist according to treatments received and seizure activity resolution in patients with refractory status epilepticus (RSE). The study found that different types of RSE are associated with higher mortality rates and functional deterioration at discharge.
JOURNAL OF NEUROLOGY
(2023)
Review
Clinical Neurology
Siew-Na Lim, Tony Wu, Wei-En Johnny Tseng, Hsing- Chiang, Mei-Yun Cheng, Wey-Ran Lin, Chia-Ni Lin
Summary: Perampanel shows effectiveness and satisfactory safety profile in the emergency treatment of established refractory and super-refractory status epilepticus. Patients with unique types and causes of SE, particularly nonconvulsive status epilepticus, may have a better response to perampanel treatment.
JOURNAL OF NEUROLOGY
(2021)
Article
Veterinary Sciences
Patrick Roynard, Ann Bilderback, Curtis Wells Dewey
Summary: Ketamine 5 mg/kg IV bolus may be successful in treating RSE in dogs, but its efficacy in handling CS is limited. The incidence of adverse effects is low, but timing of administration should be carefully considered.
FRONTIERS IN VETERINARY SCIENCE
(2021)
Review
Geriatrics & Gerontology
Batool F. Kirmani, Katherine Au, Lena Ayari, Marita John, Padmashri Shetty, Robert J. Delorenzo
Summary: Super-refractory status epilepticus is a life-threatening neurological emergency with high morbidity and mortality, resistant to normal treatment protocols. There is a lack of robust published data regarding the safety and effectiveness of various therapies, emphasizing the need for large randomized multicenter trials to compare newer therapies for this challenging condition.
Article
Clinical Neurology
Esra Kochan Kizilkilic, Rumeysa Unkun, Ugur Uygunoglu, Sakir Delil, Cigdem Ozkara
Summary: COVID-19 infection can lead to neurological complications, including epileptic seizures and status epilepticus. IL-6 plays an important role in the severity of symptoms, and tocilizumab, as an IL-6 inhibitor, can be used for the treatment of these complications.
EUROPEAN JOURNAL OF NEUROLOGY
(2022)
Article
Clinical Neurology
Katrina Peariso, Ravindra S. Arya, Tracy Glauser, Nicholas Abend, Cristina Barcia Aguilar, Marta L. Amengual-Gual, Anne Anderson, Brian Appavu, J. Nicholas E. Brenton, Jessica Carpenter, Kevin D. Chapman, Justice Clark, William Gaillard, Marina Gainza-Lein, Joshua Goldstein, Howard M. Goodkin, Zachary S. Grinspan, Rejean Guerriero, Paul Horn, Linda A. Huh, Robert H. Kahoud, Sarah Kelley, Eric Kossoff, Kush Kapur, Yi-Chen Lai, B. Oyinkan A. Marquis, Tiffani McDonough, Mohamad Mikati, Lindsey P. Morgan, Edward T. Novotny, Adam Ostendorf, Eric Payne, Juan Piantino, James E. Riviello, Tristan C. Sands, Carl Stafstrom, Robert Tasker, Dmitry S. Tchapyjnikov, Alejandra Vasquez, Mark Wainwright, Angus Wilfong, Korwyn Williams, Tobias Loddenkemper, PSERG
Summary: This study aimed to identify patient-specific factors associated with the development of refractory convulsive status epilepticus (RSE) in children treated in emergency care. The study found that a family history of seizures and the use of rectal diazepam were associated with a decreased likelihood of RSE.
Article
Critical Care Medicine
Clara Marie Bode, Simon Bruun Kristensen, Hanne Tanghus Olsen, Camilla Dyremose Cornwall, Lars Roberg, Olav Monsson, Thomas Kroigard, Palle Toft, Christoph P. Beier
Summary: The study aims to investigate the risk factors for the development of postictal encephalopathy and its impact on survival after discharge. The results show that postictal encephalopathy is common after status epilepticus and is associated with poor long-term survival. Seizure characteristics are not independently associated with postictal encephalopathy, while etiology, duration of sedation, age, and premorbid condition are the major risk factors for its development.
NEUROCRITICAL CARE
(2023)
Article
Emergency Medicine
Kyle A. Weant, Stephanie L. Barre, Sara Bruner, Ryan Smiley, Gregory A. Hall
Summary: The study found consistent underdosing of benzodiazepines in both prehospital and emergency department settings according to guideline recommendations. Early seizure cessation and early receipt of antiepileptic drug therapy were associated with multiple significant clinical outcomes.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2021)