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Understanding and Treatment of Status Epilepticus
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Understanding and Treatment of Status Epilepticus

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: closed (29 February 2016) | Viewed by 78339

Special Issue Editors

Prof. Dr. Paul M. Vespa

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Guest Editor
Director of Neurocritical Care, David Geffen School of Medicine, University of California, Los Angeles, 757 Westwood Blvd, Room 6236 A, Los Angeles, CA 90095, USA
Interests: traumatic brain injury; intracerebral hemorrhage; status epilepticus; stroke; subarachnoid hemorrhage; coma
Prof. Dr. Gretchen M. Brophy

E-Mail Website
Guest Editor
Pharmacotherapy & Outcomes Science and Neurosurgery, Virginia Commonwealth University, Medical College of Virginia Campus, 410 N. 12th Street, Richmond, VA 23298-0533, USA
Interests: neurocritical care; status epilepticus; traumatic brain injury; brain injury biomarkers; neuroprotection; pharmacotherapy; thrombosis and hemostasis; sedation and delirium

Special Issue Information

Dear Colleagues,

Status epilepticus is one of the most urgent types of neurological emergencies, which remains difficult and confusing to intensivists. There is a substantial body of literature about the evaluation and treatment of status epilepticus, starting in the prehospital emergency setting. Intensivists are frequently called to intervene and require a concise and practical set of guidelines. Recent efforts to formulate interdisciplinary consensus guidelines have been made. This Special Issue will discuss the prehospital, emergency, and intensive care treatments of status epilepticus, the use of continuous electroencephalography, the evaluation for typical causes of status epilepticus, the treatment of refractory status epilepticus, the potential role of immunotherapy for status epilepticus, the prognosis for refractory status epilepticus, new clinical trials in status epilepticus, and review the guidelines for the treatment of status epilepticus.

Prof. Dr. Paul M. Vespa
Prof. Dr. Gretchen M. Brophy
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.


Keywords

  • status epilepticus
  • refractory status epilepticus
  • continuous electroencephalography
  • brain monitoring
  • neurocritical care
  • convulsions
  • coma
  • encephalitis
  • nmda encephalitis
  • plasmapheresis
  • hypothermia
  • prognosis
  • midazolam
  • lorazepam
  • propofol
  • ketamine
  • pentobarbital
  • levetirecetam
  • lacosamide

Published Papers (6 papers)

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Review

704 KiB  
Review
Adult Status Epilepticus: A Review of the Prehospital and Emergency Department Management
by Michael Billington, Osama R. Kandalaft and Imoigele P. Aisiku
J. Clin. Med. 2016, 5(9), 74; https://doi.org/10.3390/jcm5090074 - 23 Aug 2016
Cited by 13 | Viewed by 16632
Abstract
Seizures are a common presentation in the prehospital and emergency department setting and status epilepticus represents an emergency neurologic condition. The classification and various types of seizures are numerous. The objectives of this narrative literature review focuses on adult patients with a presentation [...] Read more.
Seizures are a common presentation in the prehospital and emergency department setting and status epilepticus represents an emergency neurologic condition. The classification and various types of seizures are numerous. The objectives of this narrative literature review focuses on adult patients with a presentation of status epilepticus in the prehospital and emergency department setting. In summary, benzodiazepines remain the primary first line therapeutic agent in the management of status epilepticus, however, there are new agents that may be appropriate for the management of status epilepticus as second- and third-line pharmacological agents. Full article
(This article belongs to the Special Issue Understanding and Treatment of Status Epilepticus)
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1648 KiB  
Review
Status Epilepticus: Epidemiology and Public Health Needs
by Sebastián Sánchez and Fred Rincon
J. Clin. Med. 2016, 5(8), 71; https://doi.org/10.3390/jcm5080071 - 16 Aug 2016
Cited by 69 | Viewed by 10744
Abstract
Status epilepticus (SE) is defined as a continuous clinical and/or electrographic seizure activity lasting five minutes or more or recurrent seizure activity without return to baseline. There is a paucity of epidemiological studies of SE, as most research is derived from small population [...] Read more.
Status epilepticus (SE) is defined as a continuous clinical and/or electrographic seizure activity lasting five minutes or more or recurrent seizure activity without return to baseline. There is a paucity of epidemiological studies of SE, as most research is derived from small population studies. The overall incidence of SE is 9.9 to 41 per 100,000/year, with peaks in children and the elderly and with febrile seizures and strokes as its main etiologies. The etiology is the major determinant of mortality. Governments and the academic community should predominantly focus on the primary prevention of etiologies linked to SE, as these are the most important risk factors for its development. This review describes the incidence, prevalence, etiology, risk factors, outcomes and costs of SE and aims to identify future research and public health needs. Full article
(This article belongs to the Special Issue Understanding and Treatment of Status Epilepticus)
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Figure 1

199 KiB  
Review
Comparison of Intravenous Anesthetic Agents for the Treatment of Refractory Status Epilepticus
by Michael E. Reznik, Karen Berger and Jan Claassen
J. Clin. Med. 2016, 5(5), 54; https://doi.org/10.3390/jcm5050054 - 19 May 2016
Cited by 30 | Viewed by 7884
Abstract
Status epilepticus that cannot be controlled with first- and second-line agents is called refractory status epilepticus (RSE), a condition that is associated with significant morbidity and mortality. Most experts agree that treatment of RSE necessitates the use of continuous infusion intravenous anesthetic drugs [...] Read more.
Status epilepticus that cannot be controlled with first- and second-line agents is called refractory status epilepticus (RSE), a condition that is associated with significant morbidity and mortality. Most experts agree that treatment of RSE necessitates the use of continuous infusion intravenous anesthetic drugs such as midazolam, propofol, pentobarbital, thiopental, and ketamine, each of which has its own unique characteristics. This review compares the various anesthetic agents while providing an approach to their use in adult patients, along with possible associated complications. Full article
(This article belongs to the Special Issue Understanding and Treatment of Status Epilepticus)
1420 KiB  
Review
Managing Status Epilepticus in the Older Adult
by Stephane Legriel and Gretchen M. Brophy
J. Clin. Med. 2016, 5(5), 53; https://doi.org/10.3390/jcm5050053 - 11 May 2016
Cited by 13 | Viewed by 6801
Abstract
The aim of this systematic review was to describe particularities in epidemiology, outcome, and management modalities in the older adult population with status epilepticus. There is a higher incidence of status epilepticus in the older adult population, and it commonly has a nonconvulsive [...] Read more.
The aim of this systematic review was to describe particularities in epidemiology, outcome, and management modalities in the older adult population with status epilepticus. There is a higher incidence of status epilepticus in the older adult population, and it commonly has a nonconvulsive presentation. Diagnosis in this population may be difficult and requires an unrestricted use of EEG. Short and long term associated-mortality are high, and age over 60 years is an independent factor associated with poor outcome. Stroke (acute or remote symptomatic), miscellaneous metabolic causes, dementia, infections hypoxemia, and brain injury are among the main causes of status epilepticus occurrence in this age category. The use of anticonvulsive agents can be problematic as well. Thus, it is important to take into account the specific aspects related to the pharmacokinetic and pharmacodynamic changes in older critically-ill adults. Beyond these precautions, the management may be identical to that of the younger adult, including prompt initiation of symptomatic and anticonvulsant therapies, and a broad and thorough etiological investigation. Such management strategies may improve the vital and functional prognosis of these patients, while maintaining a high overall quality of care. Full article
(This article belongs to the Special Issue Understanding and Treatment of Status Epilepticus)
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Figure 1

538 KiB  
Review
Treatment of Established Status Epilepticus
by Jessica J. Falco-Walter and Thomas Bleck
J. Clin. Med. 2016, 5(5), 49; https://doi.org/10.3390/jcm5050049 - 25 Apr 2016
Cited by 49 | Viewed by 12674
Abstract
Status epilepticus is the most severe form of epilepsy, with a high mortality rate and high health care costs. Status epilepticus is divided into four stages: early, established, refractory, and super-refractory. While initial treatment with benzodiazepines has become standard of care for early [...] Read more.
Status epilepticus is the most severe form of epilepsy, with a high mortality rate and high health care costs. Status epilepticus is divided into four stages: early, established, refractory, and super-refractory. While initial treatment with benzodiazepines has become standard of care for early status epilepticus, treatment after benzodiazepine failure (established status epilepticus (ESE)) is incompletely studied. Effective treatment of ESE is critical as morbidity and mortality increases dramatically the longer convulsive status epilepticus persists. Phenytoin/fosphenytoin, valproic acid, levetiracetam, phenobarbital, and lacosamide are the most frequently prescribed antiseizure medications for treatment of ESE. To date there are no class 1 data to support pharmacologic recommendations of one agent over another. We review each of these medications, their pharmacology, the scientific evidence in support and against each in the available literature, adverse effects and safety profiles, dosing recommendations, and limitations of the available evidence. We also discuss future directions including the established status epilepticus treatment trial (ESETT). Substantial further research is urgently needed to identify these patients (particularly those with non-convulsive status epilepticus), elucidate the most efficacious antiseizure treatment with head-to-head randomized prospective trials, and determine whether this differs for convulsive vs. non-convulsive ESE. Full article
(This article belongs to the Special Issue Understanding and Treatment of Status Epilepticus)
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Figure 1

255 KiB  
Review
Management of Status Epilepticus in Children
by Douglas M. Smith, Emily L. McGinnis, Diana J. Walleigh and Nicholas S. Abend
J. Clin. Med. 2016, 5(4), 47; https://doi.org/10.3390/jcm5040047 - 13 Apr 2016
Cited by 35 | Viewed by 23030
Abstract
Status epilepticus is a common pediatric neurological emergency. Management includes prompt administration of appropriately selected anti-seizure medications, identification and treatment of seizure precipitant(s), as well as identification and management of associated systemic complications. This review discusses the definitions, classification, epidemiology and management of [...] Read more.
Status epilepticus is a common pediatric neurological emergency. Management includes prompt administration of appropriately selected anti-seizure medications, identification and treatment of seizure precipitant(s), as well as identification and management of associated systemic complications. This review discusses the definitions, classification, epidemiology and management of status epilepticus and refractory status epilepticus in children. Full article
(This article belongs to the Special Issue Understanding and Treatment of Status Epilepticus)
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