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Review: Recent and future advances in the treatment of status epilepticus

Interdisciplinary Epilepsy Center Marburg Department of Neurology Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35033 Marburg, Germany, rosenow@med. uni-marburg.de

Susanne Knake

Interdisciplinary Epilepsy Center Marburg Department of Neurology Philipps-University Marburg, Marburg Germany

Status epilepticus (SE) is one of the most frequent neurological emergencies with an incidence of 20/100,000 per year and a mortality between 3% and 40% depending on etiology, age, SE type and duration. Generalized convulsive forms of SE (GTCSE), in particular, require aggressive treatment. Presently, only 55—80% of cases of GTCSE are controlled by initial therapy. Therefore, there is a need for new options for the treatment of SE. Here we review the current standard treatment including recent advances and provide a summary of preclinical and clinical data regarding treatment options which may become available in the near future. The initial treatment of SE usually consists of a benzodiazepine (preferably lorazepam 0.1 mg/kg) followed by phenytoin or fosphenytoin or valproic acid (where approved for SE therapy). With intravenous formulations of levetiracetam, available since 2006, and lacosamide, which is expected for autumn of 2008, new treatment options have become available, that should be evaluated in prospective controlled trials. If SE remains refractory, the induction of general anaesthesia using propofol, midazolam, thiopental, or pentobarbital is warranted in GTCSE.

Key Words: status epilepticus • antiepileptic drugs • lorazepam • levetiracetam • lacosamide

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Therapeutic Advances in Neurological Disorders, Vol. 1, No. 1, 25-32 (2008)
DOI: 10.1177/1756285608094263


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This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Rosenow, F. Articles by Knake, S. Search for Related Content Social Bookmarking                         What's this?