Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- persistent or repetitive tonic-clonic seizures with altered level of consciousness (generalized convulsive SE)
- altered awareness/confusion (nonconvulsive SE)
Outros fatores diagnósticos
- focal SE without impaired consciousness
- low oxygen saturation
Fatores de risco
- nonadherence to anticonvulsant drugs
- alcohol-use disorder
- stroke
- refractory epilepsy
- toxic or metabolic causes
- processes leading to direct cortical structural damage
- drug use
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- anticonvulsant drug blood level
- toxicology screen
- comprehensive metabolic panel
- CBC
- ECG
- electroencephalography (EEG)
Investigações a serem consideradas
- ABG
- CT head
- lumbar puncture
- MRI head
- continuous EEG (cEEG)
Algoritmo de tratamento
generalized convulsive status epilepticus
nonconvulsive status epilepticus
focal without impaired consciousness
Colaboradores
Autores
Emily L. Johnson, MD
Associate Professor of Neurology
Johns Hopkins Medical Institutions
Baltimore
MD
Declarações
ELJ declares that she has no competing interests.
Agradecimentos
Dr Emily L. Johnson would like to gratefully acknowledge Dr Ronald P. Lesser, Dr Mohammad Koubeissi, and Dr Nabil Azar, previous contributors to this topic.
Declarações
RPL or his wife have stock in the following companies, which sell health care products: Abbott Labs, Apple, Avanos, Celgene, Express Scripts, Johnson and Johnson, and Pfizer. NA declares that he has no competing interests. MK declares that he has no competing interests.
Revisores
Maria Jose Bruzzone Giraldez, MD
Assistant Professor Epilepsy Division
University of Florida
Gainesville
FL
Declarações
None
Yvonne Hart, MBBS
Consultant Neurologist
John Radcliffe Hospital
Oxford
UK
Declarações
YH has been reimbursed by UCB Pharma Ltd, Janssen-Cilag Ltd, Pfizer Ltd, and Eisai Ltd for attending conferences; has taught at meetings sponsored by the above companies and by GlaxoSmithKline Services Unlimited; and has received payment for advisory board work from UCB Pharma Ltd, Janssen-Cilag Ltd, Eisai Ltd, and GlaxoSmithKline Services Unlimited.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referências
Principais artigos
Brophy GM, Bell R, Claassen J, et al; Neurocritical Care Society Status Epilepticus Guideline Writing Committee. Guidelines for the evaluation and management of status epilepticus. Neurocrit Care. 2012 Aug;17(1):3-23. Resumo
Glauser T, Shinnar S, Gloss D. Evidence-based guideline: treatment of convulsive status epilepticus in children and adults: report of the Guideline Committee of the American Epilepsy Society. Epilepsy Curr. 2016 Jan-Feb;16(1):48-61.Texto completo Resumo
National Institute for Health and Care Excellence (UK). Epilepsies in children, young people and adults. Apr 2022 [internet publication].Texto completo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Nonepileptic SE
- Delirium
- Coma
Mais Diagnósticos diferenciaisDiretrizes
- Emergency management of the pediatric patient with convulsive status epilepticus
- Evidence-based guideline: treatment of convulsive status epilepticus in children and adults
Mais DiretrizesFolhetos informativos para os pacientes
Epilepsy: what is it?
Epilepsy: what are the treatment options?
Mais Folhetos informativos para os pacientesConectar-se ou assinar para acessar todo o BMJ Best Practice
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