Which of the following is the first drug of choice for status epilepticus?
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Epilepsy.com Seizure Emergency Editor Matthew Hoerth MD speaks with Dr. Christopher Kramer, a neurointensive care specialist from the Mayo Clinic, about the importance of recognizing and treating status epilepticus. A paper published in the Neurocritical Care Journal from 2012 nicely outlined guidelines for treating this neurologic emergency. This paper detailed the subtypes of status epilepticus, emphasized the high mortality rates of this condition, and summarized the best medical evidence for treatment. Show Convulsive Status EpilepticusThis term is used to describe the more common form of emergency situation that can occur with prolonged or repeated tonic-clonic (also called convulsive or grand mal) seizures. Most tonic-clonic seizures end normally in 1 to 2 minutes, but they may have post-ictal (or after-effects) symptoms for much longer. This makes it hard to tell when a seizure begins and ends. Status epilepticus occurs when….
This type of status epilepticus requires emergency treatment by trained medical personnel in a hospital setting. This situation can be life-threatening and getting treatment started fast is vital. The outlook for this type of status may vary depending on the cause of the emergency and if other medical problems or complications occur.
Nonconvulsive Status EpilepticusThis term is used to describe long or repeated absence or focal impaired awareness (complex partial) seizures.
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It is usual to initiate treatment with a fast acting benzodiazepine, and intravenous lorazepam is the drug of choice. Alternatives include other intravenous benzodiazepines or intravenous lignocaine, the latter possibly being preferable in patients with respiratory disease.
What is the immediate treatment for status epilepticus?Stabilization of airway, breathing and circulation and expeditious termination of seizures are immediate goals. Intravenous benzodiazepines-diazepam, midazolam or lorazepam and phenytoin are the first line drugs recommended for termination of seizures.
What was the first drug used to treat seizures?1861 – Bromides – The first medication used to provide control for seizures; however, severe side effects occurred. The bromides extracted a heavy cost in terms of toxicity. 1912 – Phenobarbital – This medication was as effective as bromides, however easier to administer and less toxic.
What is the first line treatment for epilepsy?Anti-epileptic drugs (AEDs) AEDs are the most commonly used treatment for epilepsy. They help control seizures in around 7 out of 10 of people. AEDs work by changing the levels of chemicals in your brain.
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