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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Preliminary results of the global audit of treatment of refractory status epilepticus
Epilepsy and Behavior, Volume 49, Year 2015
Notification
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Description
The treatment of refractory and super refractory status epilepticus is a "terra incognita" from the point of view of evidence-based medicine. As randomized or controlled studies that are sufficiently powered are not feasible in relation to the many therapies and treatment approaches available, we carried out an online multinational audit (registry) in which neurologists or intensivists caring for patients with status epilepticus may prospectively enter patients who required general anesthesia to control the status epilepticus (SE). To date, 488 cases from 44 different countries have been collected. Most of the patients had no history of epilepsy and had a cryptogenic etiology. First-line treatment was delayed and not in line with current guidelines. The most widely used anesthetic of first choice was midazolam (59%), followed by propofol and barbiturates. Ketamine was used in most severe cases. Other therapies were administered in 35% of the cases, mainly steroids and immunotherapy. Seizure control was achieved in 74% of the patients. Twenty-two percent of patients died during treatment, and four percent had treatment actively withdrawn because of an anticipated poor outcome. The neurological outcome was good in 36% and poor in 39.3% of cases, while 25% died during hospitalization. Factors that positively influenced outcome were younger age, history of epilepsy, and low number of different anesthetics tried.This article is part of a Special Issue entitled "Status Epilepticus". © 2015.
Authors & Co-Authors
Hocker, Sara E.
United States, Rochester
Mayo Clinic
Trinka, Eugen
Austria, Salzburg
Christian-doppler-klinik
Shorvon, Simon D.
United Kingdom, London
Ucl Queen Square Institute of Neurology
Singh, Gagandeep P.I.
Unknown Affiliation
O'Brien, Terence J.
Unknown Affiliation
Cook, Mark James
Unknown Affiliation
Kumlien, Eva
Unknown Affiliation
Kälviäinen, Reetta K. K.
Unknown Affiliation
Newton, Charles R.J.C.
Unknown Affiliation
Nabbout, Rima C.
Unknown Affiliation
Groppa, Stanislav A.
Unknown Affiliation
Statistics
Citations: 51
Authors: 11
Affiliations: 4
Identifiers
Doi:
10.1016/j.yebeh.2015.04.010
ISSN:
15255050
Research Areas
Cancer
Health System And Policy