Management of Status Epilepticus by Different Pediatric Departments: Neurology, Intensive Care, and Emergency Medicine.

IF 2.1 4区 医学 Q3 CLINICAL NEUROLOGY European Neurology Pub Date : 2023-01-01 Epub Date: 2023-08-30 DOI:10.1159/000533191
Özge Dedeoglu, Halise Akça, Serhat Emeksiz, Ayşe Kartal, Neşe Çıtak Kurt
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Abstract

Introduction: The aim of this study was to explore the differences in status epilepticus (SE) management among pediatric neurology, emergency medicine, and intensive care specialists in Turkey.

Methods: A 22-item questionnaire regarding first-, second-, and third-line management strategies of SE including demographic characteristics and common etiologies according to the specialty of participants was mailed to 370 specialists working in Turkey.

Results: A total of 334 participants (response rate 90%) comprising 136 pediatric neurologists, 102 pediatric emergency medicine specialists, and 96 pediatric intensive care specialists completed the survey. While intensive care specialists frequently managed SE due to metabolic and autoimmune reasons, the most common etiologies encountered by emergency medicine specialists were epilepsy and infections. More than half of the intensive care specialists (64.6%) reported using non-BZD antiseizure medications in the 5th minute of the seizure. Most of the neurologists (76.4%) preferred to administer intravenous (IV) levetiracetam infusion as a second-line agent. About half of intensive care specialists and neurologists tried immunomodulatory therapies in super-refractory SE. Intensive care and emergency medicine specialists were less likely to favor ketogenic diet and pyridoxine therapy for the treatment of super-refractory SE. The rate of requesting EEG monitoring to recognize nonconvulsive SE (NCSE) was found to be very low except for neurologists.

Conclusion: There was no consensus among neurologists, intensive care specialists, and emergency medicine specialists in the management of SE in Turkey. Familiarity with particular antiseizure medications and the etiologies they manage seem to be the most important factors influencing the attitudes.

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不同儿科对癫痫状态的管理:神经病学、重症监护和急诊医学。
引言:本研究的目的是探讨土耳其儿科神经病学、急诊医学和重症监护专家在癫痫持续状态(SE)管理方面的差异,根据参与者的专业,将包括人口统计学特征和常见病因在内的SE三线管理策略邮寄给370名在土耳其工作的专家,96名儿科重症监护专家完成了调查。虽然重症监护专家由于代谢和自身免疫原因经常治疗SE,但急诊医学专家遇到的最常见病因是癫痫和感染。超过一半的重症监护专家(64.6%)报告在癫痫发作的第5分钟使用了非BZD抗癫痫药物。大多数神经科医生(76.4%)更喜欢将左乙拉西坦静脉输注作为二线药物。大约一半的重症监护专家和神经学家在超难治性SE中尝试了免疫调节疗法。重症监护和急诊医学专家不太可能支持生酮饮食和吡哆醇治疗超难治型SE。除神经学家外,要求脑电图监测以识别非惊厥性SE(NCSE)的比率非常低。结论:在土耳其,神经学家、重症监护专家和急诊医学专家对SE的管理没有达成共识。熟悉特定的抗癫痫药物及其病因似乎是影响态度的最重要因素。
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来源期刊
European Neurology
European Neurology 医学-临床神经学
CiteScore
4.40
自引率
4.20%
发文量
51
审稿时长
4-8 weeks
期刊介绍: ''European Neurology'' publishes original papers, reviews and letters to the editor. Papers presented in this journal cover clinical aspects of diseases of the nervous system and muscles, as well as their neuropathological, biochemical, and electrophysiological basis. New diagnostic probes, pharmacological and surgical treatments are evaluated from clinical evidence and basic investigative studies. The journal also features original works and reviews on the history of neurology.
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