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Status epilepticus

Last reviewed: 19 Aug 2025
Last updated: 18 Feb 2025

Summary

Definition

Анамнез и осмотр

Ключевые диагностические факторы

  • persistent or repetitive tonic-clonic seizures with altered level of consciousness (generalized convulsive SE)
  • altered awareness/confusion (nonconvulsive SE)
Полная информация

Другие диагностические факторы

  • focal SE without impaired consciousness
  • low oxygen saturation
Полная информация

Факторы риска

  • nonadherence to anticonvulsant drugs
  • alcohol-use disorder
  • stroke
  • refractory epilepsy
  • toxic or metabolic causes
  • processes leading to direct cortical structural damage
  • drug use
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

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

Исследования, проведение которых нужно рассмотреть

  • ABG
  • CT head
  • lumbar puncture
  • MRI head
  • continuous EEG (cEEG)
Полная информация

Алгоритм лечения

Острый

generalized convulsive status epilepticus

nonconvulsive status epilepticus

focal without impaired consciousness

Составители

Авторы

Emily L. Johnson, MD

Associate Professor of Neurology

Johns Hopkins Medical Institutions

Baltimore

MD

Раскрытие информации

ELJ declares that she has no competing interests.

Выражение благодарностей

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.

Раскрытие информации

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.

Рецензенты

Maria Jose Bruzzone Giraldez, MD

Assistant Professor Epilepsy Division

University of Florida

Gainesville

FL

Раскрытие информации

None

Yvonne Hart, MBBS

Consultant Neurologist

John Radcliffe Hospital

Oxford

UK

Раскрытие информации

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.

Список литературы

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Основные статьи

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. Аннотация

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.Полный текст  Аннотация

National Institute for Health and Care Excellence (UK). Epilepsies in children, young people and adults. Apr 2022 [internet publication].Полный текст

Статьи, указанные как источники

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