Status Epilepticus

Abstract

Status Epilepticus (SE) is a serious disorder and should be treated as such. SE is common in pediatric practice. Most authors now define SE as recurrent epileptic seizures containing for more than 30 minutes without full recovery of consciousness before the next seizures begin. The aim of drug treatment is to bring the seizures under control as quickly as possible. The first line drugs used for SE are benzodiazepines, phenytoin and Phenobarbital. SE that has not come under control after 1 hour despite adequate doses of first line anti-epileptic drugs is called refractomy SE (RSE). In dealing with patients with RSE, there comes a point during the acute management when the therapeutic objectives change from trying to control the SE to cerebral protection by primarily suppressing the central nervous system metabolism and therapy controlling SE. General anesthesia and Phenobarbital coma is recommended for RSE. Diazepam infusion, continuous infusion of Midazolam and repeated bolus doses of Phenobarbital every 30-60 minutes are other strategies for RSE