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Status epilepticus

Última revisão: 7 Aug 2025
Última atualização: 18 Feb 2025

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)
Detalhes completos

Outros fatores diagnósticos

  • focal SE without impaired consciousness
  • low oxygen saturation
Detalhes completos

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
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • anticonvulsant drug blood level
  • toxicology screen
  • comprehensive metabolic panel
  • CBC
  • ECG
  • electroencephalography (EEG)
Detalhes completos

Investigações a serem consideradas

  • ABG
  • CT head
  • lumbar puncture
  • MRI head
  • continuous EEG (cEEG)
Detalhes completos

Algoritmo de tratamento

AGUDA

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

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

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 diferenciais
  • Diretrizes

    • Emergency management of the pediatric patient with convulsive status epilepticus
    • Evidence-based guideline: treatment of convulsive status epilepticus in children and adults
    Mais Diretrizes
  • Folhetos informativos para os pacientes

    Epilepsy: what is it?

    Epilepsy: what are the treatment options?

    Mais Folhetos informativos para os pacientes
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