Abstract
In adults, status epilepticus represents after stroke one of the most frequent neurological emergencies. Depending on the type and duration of seizures, it can induce considerable morbidity and mortality, therefore requiring immediate management. International guidelines recommend a stepwise approach, where treatment lines are used sequentially and additionally. In early status epilepticus, benzodiazepines represent the first line of treatment, typically followed by intravenous antiepileptic drugs in established status epilepticus. If seizures continue after this stage, the situation is labelled as refractory status epilepticus; intravenous anesthetics with coma induction (third line treatment) are advocated, particularly in patients not protecting their airways and showing generalized-convulsive or nonconvulsive status epilepticus in coma. Additional treatment lines, such as ketogenic diet, ketamine, corticosteroids, may be prescribed in super-refractory status epilepticus, a condition resulting for treatment resistance to at least one trial of general anesthetics.
Besides the first-line treatment, evidence regarding medications commonly used in status epilepticus is quite limited, especially in later stages. In this chapter, we describe pharmacological compounds according to this stepwise approach, considering existing evidence, advantages, and drawbacks of each molecule.
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Beuchat, I., Rossetti, A.O. (2022). Anti-convulsive Drug Use in Status Therapy: Adults. In: Riederer, P., Laux, G., Nagatsu, T., Le, W., Riederer, C. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-030-62059-2_370
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